At the ready? County tests its terror preparedness with smallpox simulation
A simulated outbreak of terrorist-spewn smallpox at the California State Fair gave Nevada County officials a two-day lesson this week in their abilities to respond to terrorism.
Those involved in the drill were pleased to learn there are measures in place locally to deal with a disaster of almost any kind. But they also found glitches in a system that would have to work smoothly should a major terror attack happen close by.
This week’s mock attack began Thursday with a phone call to Dr. Sheldon Minkin, Nevada County’s health officer. As part of the drill, the California Department of Health reported the FBI had confirmed six cases of smallpox from the fair and needed the county to activate its bioterrorism response plan.
That caused county officials and emergency workers to begin setting up four clinics around the county for immunizations.
“The goal was to immunize everyone in the county within three days,” Minkin said.
They quickly had to find clinic locations, phones, computers, chairs, tables and food. Just the logistics planning showed “many glitches we could never anticipate,” Minkin said.
The next day, emergency workers, law enforcement, nurses and first responders got the initial rounds of vaccines. In a two-hour exercise at the fairgrounds Friday, volunteer victims and workers took the fake dilemma to the next step, which was running an immunization clinic.
Wanting a realistic setting, the exercise featured one “victim” who became disruptive and had to be escorted out. Another feigning a case of smallpox was whisked away to prevent a spread of the disease.
Things got a bit too real for 4-year-old Drew Strange of Nevada City. His father, Red Cross volunteer Ed Strange, and mom, Jen Strange, had taken part as a fake patient family.
“He knew it was fake, but I told him to act it up, make it real,” Jen said.
When volunteers pulled out fake immunization syringes, however, Drew began to cry. He was soon calmed, but everyone involved got a small dose of the kind of chaos and confusion that could result in a real outbreak.
The training drill pointed out to Minkin that “until you do the exercise and solve the problems collectively,” you will not be as prepared.
“When you run the clinic, you look for bottlenecks,” said Rich Reader, the county’s manger of general services, who was acting in his emergency services role. “We needed more registered nurse to screen for the virus.”
Meanwhile, sheriff’s department volunteers were “guarding” smallpox vaccine in an adjacent room.
“There would be a high potential for theft and misuse (of the vaccine)” said volunteer and local pharmacist Bob Meier.
“I would imagine everyone would want it,” said sheriff’s volunteer Barbara Johnson.
The exercise was done in conjunction with Sierra Nevada Memorial Hospital, which soon pointed out problems, Minkin said.
“We were going to screen them and if they had smallpox, we would send them to the hospital.”
The hospital quickly pointed out that it could only handle so many cases, due to existing bed space and people to treat patients. Hospital personnel said they would have to set up a tent outside of the emergency room and then only admit those who already had severe smallpox and needed aid such as respirators and IVs.
“They didn’t want to handle the minor cases,” Minkin said. Minor cases would be treated and sent home for isolation and those in the serious category would be put in field hospitals supplied by the federal government.
Another weakness realized during the drill was that the county’s phone system would crash if too many people called. In fact, the system did crash during a recent flood of calls for real-life flu vaccine.
Overall, the exercise went smoothly, “but obviously, there were problems,” Minkin said.
Whether any disasters will have to be dealt with locally is, of course, unknown. But local emergency officials know that a disaster in the Bay Area or Sacramento could lead people to seek escape in the mountains.
They also know that Beale Air Force Base just below the county line has the main ground radar facility for the West Coast along with the U-2 and Global Hawk reconnaissance missions. Those early-warning capabilities could provide real targets for enemies of the United States and require quick emergency response in Nevada County.
A smallpox primer
In its mock terrorism drill this week, Nevada County used a smallpox outbreak as its case study. Here are some details on its dangers:
• Smallpox is a virus that can kill up to 30 percent of the people who get it, cause scars from a bad rash, and lead to blindness.
• Smallpox vaccine cannot give you the disease. But, unless there is an outbreak, it is not recommended for pregnant women or people with heart, skin or immune problems.
• The vaccine can make you sick, but severe problems are extremely rare and fatality is estimated at one in every 500,000.
Source: Nevada County Community Health Department
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