From: Date: Fri, 21 Sep 2001 03:14:20 EDT Subject: Chemical, Nuclear & Biological Dave Pizer asks what will happen to cryonicists who die or who become ill in a biological warfare/terrorism situation. Both military and civilian planners have been considering this alternative seriously for the past decade. The threat is properly designated Chemical, Nuclear and Biological (CNB) warfare or terrorism. Recently government action in this area has become much more aggressive. Given the government's swift action in grounding all civil aircraft, and the swift action of CNB units to schools in Southern California after two "hoax threats" this is what would happen: 1) All exposed people would be decontaminated on site providing the threat was known and the site quarantined. 2) The credibility of the threat would be ascertained. If it was deemed to be real or possibly real, all exposed individuals would be removed to prophylaxis and treatment centers set up from highly portable, self-contained, HEPA-filter gear remote from civilian areas (probably a military base). Transport to these centers would not be elective; they are protective detention camps. 3) Post Exposure Prophylaxis (PEP) would be given if available against the agent and the affected population would be watched for development of disease. Regrettably, for large numbers of exposed people PEP would either not be available (stockpiles are not adequate), ineffective in many cases, or not possible (etiologic agent is novel or no known prophylaxis or treatment exists; the hemorrhagic fevers would be examples). 4) If disease develops and results in deaths, early victims would be autopsied to verify the initial diagnosis and to be certain that the disease was following its natural history and had not been modified from the wild type if it is an existing pathogen (such as anthrax). 5) Depending upon the novelty and pathogenicity of the etiologic agent samples might be sent to off site locations for further evaluation, such as the CDC in Atlanta, or government facilities which few civilians know exist and if they do, they aren't talking. All such sample receiving facilities would have P4 rating. 6) All human and animal remains aside from tissue and fluid samples for medical/scientific evaluation would be cremated. End of discussion. The above presumes a limited, deliberate and relatively contained assault with a known etiologic agent. If the number of casualties is too high for the scenario described above, all traffic in all likely affected areas will be stopped. Just as the President issued orders to shoot down the civilian jet liner headed toward the White House and the Pentagon, similar orders would be activated automatically to deal with any unauthorized personnel trying to leave the quarantined area. Within the quarantined area (or in the even that the etiologic agent is widespread (say over a significant geographical area of the US) detention centers will be set up. All individuals exposed to the etiologic agent or deemed to present a risk of transmission will be taken to detention centers where they will be triaged according to their condition. If you live within a large geographical area which has been affected or is quarantined these detention centers should be avoided under almost all circumstances. They will not be called detention centers; they will be called treatment and prophylaxis centers. In reality they will be death camps. Your first tip-off you are not in a good place will be the presence of heavy earth moving equipment on the site when you arrive. If a quarantine area is large (an entire state or large geographical region) the quarantine should (in my opinion) be respected both on moral and commonsense medical grounds. Under these conditions, isolating yourself within the quarantine area and avoiding the detention or "treatment and prophylaxis" facilities would seem more than prudent. There are many, many other precautions and even post-attack prophylaxis which can be used to good end if people are prepared in advance of a CNB terrorist act. I personally keep a range of items, most simple, some not, all relatively inexpensive, at the ready. If the WTC attack has any lessons to teach it is that chance is often fate. If you were on the observation deck you didn't make it. However, and equally valid lesson is that chance favors the prepared; rapid evacuation of the building saved thousands of lives. At one point the WTC PA system was urging people in the South tower to return to their desks. Those who had been through the first terrorist attack pretty uniformly refused to do this and urged their coworkers to leave with them. Experience and preparedness can save many lives. If you want to survive a CNB attack and are interested in what can be done for preparedness in the Western United States please contact me by email. Mike Darwin