Tucson Fire Department's MMRS Exercise: A Bioterrorism Response Plan

Article excerpt

On September 11, 2001, life changed not only for the nation but also specifically for the United States' fire services. Amid the chaos of the aftermath of the attack, fire departments across the country started to take stock of their own capabilities, recognizing that the nation's firefighters and police would be the real first responders to any act of terrorism. Further examination by public safety departments found that they might be woefully unprepared to face large-scale acts of domestic terrorism.

With local government budgets being tightened, fire departments also are strained as they attempt to purchase chemical and biological detection equipment and pay for additional hazardous-material response training to meet potential threats. Systems must be built, and multiple agencies must coordinate, train, and drill together to enhance a community's ability to handle a surge of hospitalized patients or of victims who need decontamination or chemical-exposure antidotes and pharmaceuticals.

There is no institutional solution to this threat from weapons of mass destruction (WMD). Yet the need for multiple-agency coordination has never been more evident, and while still the responsibility of fire and police, an adequate response can no longer be relegated just to public safety personnel. Local government capabilities, critical infrastructure protection needs, and available community resources all must be identified, with a particular emphasis on the ability to set up "command and control" through the incident command system (ICS).

To accomplish this, the Tucson, Arizona, Fire Department/Metropolitan Medical Response System (MMRS) brought together a multitude of organizations in November 2002 for a conference and training exercise. This exercise--entitled the Tucson Metropolitan Medical Response System Bioterrorism, National Pharmaceutical Stockpile, and Mass-Dispensing Site Conference and Statewide Exercise-drew more then 500 attendees from among fire departments, police agencies, physicians, pharmacists, private citizens, and private sector businesses across the nation.

Attendees came from as far away as Hawaii and even the former Soviet republic of Kazakhstan to view this exercise. Agencies involved included the U.S. Centers for Disease Control and Prevention; U.S. Public Health Service; Arizona's state and local emergency-management organizations; and state and local health department officials.

The primary organizer and sponsor was Tucson Fire/MMRS, which is under the direction of the United States Public Health Service, Office of Emergency Response. Tucson is one of the 120 federally funded cities with an MMRS, which is focused primarily on bolstering local response to a disaster for the first 48 to 72 hours, before federal disaster assistance can arrive locally.

Tucson's exercise was the nation's first large-scale test of a community's ability to receive and mass-dispense federally supplied emergency medication in a bioterrorist attack.

Opening the conference was the U.S. Surgeon General Richard H. Carmona, who helped formulate Tucson's terrorism early-preparedness efforts when he was a local trauma surgeon and public hospital administrator. Presentations profiling biological weapons, given on the first day, also outlined both the state and federal government's roles in responding to bioterrorism events; after the presentations, a fictional bioterrorism scenario was described, and the exercise itself began.

What Took Place

The exercise scenario was based both on a covert release of a biological agent in the Phoenix Valley city of Mesa and on an intentional release of anthrax spores at a Tucson hotel and convention center that had contaminated hundreds of people. Combined, these two theoretical events would use up all local, regional, and state resources and require the governor to activate the Federal Response Plan (FRP) to bring the CDC's Strategic National Stockpile (formally known as the National Pharmaceutical Stockpile) to Tucson. …