One Science for CBRN Mitigation
A.L. Sobel, M.D., M.S.
Assistant to the Provost and VP
University of Missouri
Overview
In an age of terrorism, targeting of civilians and critical infrastructure has
become all too commonplace.
The threat environment has emerged as a setting that merges the
complexities of tactical and strategic actions. Across the spectrum of
operations, the field of management of CBRN operations spans the
principles of complex emergencies, security, stability, transition, postincident recovery/reconstruction, mass care, and psychosocial dynamics.
There are many insertion points for technologies in the gap areas,
specifically in the area of mobile adaptive communications and sensor
fusion that may assist in the conduct of operations and organization of the
public.
Immediate objectives are for threat verification as the driver for ensuing
operations and best measurable outcome. Although an “All Hazards”
response is viewed as the optimal approach in the setting of high uncertainty,
the diverse issues affecting the optimal management of unconventional
threats are many. This paper will specifically focus on chemical and
biological threats and some of the gaps that must be addressed.
Threat Detection and Identification
Threat verification may be challenging due to compromise many factors,
such as: the operational environment, confounding sensor data and
information, time delay, inadequate sampling, lack of recognition of the
event, lack of training and other human factors and technical issues.
However, let us assume that sampling is adequate with minimal time delay
and contamination of evidence, and the presence of coexisting observables
that may assist in threat location and mechanism of action.
Protection of Responders
Protection of responders must be one of the initial priorities in response to
CBRN attacks. The rationale for such actions is two-fold: (1) protection of
critical personnel and (2) mitigation of the effects of such an attack. All
hazard response algorithms allow for the most flexible personnel protective
posture while optimizing responder and victim survivability.
Decontamination
Routine protocols exist for chemical decontamination, particularly of nerve
and other traditional military agents. However, protocols are variable in
efficacy and availability for novel agents and other next generation agents. A
similar case exists for radiological agents, given the routes of contamination
are through primarily skin, respiratory and gastrointestinal routes. In the case
of infectious biological agents, however, decontamination is not the standard
of care. Surface disinfection may have variable effectiveness, although
respiratory containment of threat agents is the first priority of consideration.
Medical Management
Medical management of CBRN events must be adaptive. An initial
comprehensive assessment of the extent of contamination and/or infectious
or toxin dose and routes of dissemination must be determined. Agent
identification, population and individual susceptibility must be rapidly
assessed. The most critical aspect of medical management is timely, accurate
information management and characterization of the attack.
Information Dissemination
Information management is probably among the most ineffectively managed
aspects of emergency and disaster response. A disaster of any scale requires
pre-emptive information flow to minimize public fear and mobilize
leadership and confidence in public services.
Levels of uncertainty should be minimized and specific actions encouraged
through clear communications across all levels of responders, the general
public, decision-makers, and relevant agencies.
Cooperation between media, authorized subject matter experts, and public
safety and other government communications is required for seamless
information flow. These communities of interest must not operate in “silos”
rather, they must routinely work to achieve value-added through
collaboration. Routine interagency and transnational cooperation minimizes
misinformation and enables recruitment of the public as a partner in
emergency response and security. Additionally, the public seeks direction
and clear guidelines during emergencies, and emerges as a force-multiplier
in a response. In summary, although public behavior may not be fully
anticipated during a WMD event, clear, expert guidelines enable fear to be
channeled into action and positive behavior.
Command, Control and Communication
Command and control (C2) is one of the highest priorities of emergency
management of CBRN operations. The most important aspect of command
is delineation of clear-cut lines of responsibility. Typically, the first onscene responder leadership is traditionally in charge. Once again, this
approach must be adaptive. Specifically, if specialty areas of expertise and
capability are required, the personnel most trained, equipped, and
knowledgeable must be considered as the most reliable first-echelon
decision-making authority. Of course, this does not imply overall C2, rather,
situation-specific control and information source. Typically, as a response
progresses and phases of the operation unfold, so does the nature of the
information and knowledge required to successfully contain the threat and
minimize collateral damage.
International Collaboration
Collaboration is the cornerstone to containment of a WMD event, from
measurable geopolitical effects, casualty and terror generation, and critical
infrastructure destruction/disruption. The greatest enabler of international
collaboration is sharing of time-sensitive, validated, actionable, and relevant
information dissemination.
Collaboration ensures consistency of
information, shared situation awareness, and input to policy and action.
International collaboration is especially valued for ability to pre-empt or
disrupt future WMD events and maximize the efficiency and surge capacity
of a response.