Responding to Chemical and Biological Incidents
It is 5:30 on a cool, still evening in Washington.
There is a slight haze due to the rush hour traffic. It is getting
dark and a thermal inversion is holding the haze in place. A tanker
truck pulls to a downtown curb. The driver turns on the flashers,
exits, and walks up the street, apparently in search of a pay
phone to call for help. He is never
seen again. Two men get out on the other side of the vehicle.
One moves to the valves extending from the tank and quickly begins
opening them. An officer at a nearby Federal building comes out
to see what is going on. The second man shoots him repeatedly.
With the sounds of the shots still echoing, both men run south.
They don't get far before falling to the sidewalk gasping.
Pedestrians and drivers begin coughing and
collapsing in an expanding circle around the truck. The odor of
chlorine fills the air. Everyone is trying to escape, but the
gas is expanding and being drawn into vehicle and building ventilation
9-1-1 calls from cells phones and surrounding
buildings flood the switchboards. More alarming to inbound firefighters,
the calls are coming from many floors of the buildings. As the
responders close on the scene, they find the streets blocked with
wrecked, stalled, and abandoned vehicles.
City fire and emergency services would be overwhelmed
in the above scenario. The casualties could number in the hundreds
and be scattered through numerous multistory buildings and vehicles.
Simply conducting a methodical search for casualties would require
a major effort. Chlorine gas is heavier than air. Drawn into buildings
by ventilation systems, it could form pockets, particularly in stairwells
and other low points. Thus every rescuer would need individual protective
equipment to move safely. DC Fire has made major strides in preparing
for such an emergency, yet like all city fire departments it simply
cannot afford the necessary manpower and equipment.
On Scene in Two Hours
Fortunately, DC Fire has trained with and can
call on the Marine Corps Chemical Biological Incident Response Force
(CBIRF). Its 117 marines and sailors, on 1-hour alert, can be on
scene within 2 hours. Working under the direction of DC Incident
Command System, they can increase the city's ability to conduct
rescue and mass decontamination operations. If the initial force
is insufficient, an additional 200 marines and sailors can be dispatched
within 4 hours. Since CBIRF trains full-time and has protective
equipment to conduct three entries per person, the unit can conduct
sustained operations. Unfortunately, it is the only Department of
Defense (DOD) unit that provides a major search, extraction, and
First responders know what is required to react
to a chemical, biological, radiological, nuclear, or high-yield
explosive (CBRNE) attack. They must execute mitigation and rescue.
Mitigation consists of both stopping the release of more agent and
cordoning off the area to limit victims. Rescue consists of entering
the contaminated area, finding victims, extracting them, decontaminating
them, and treating them. Both tasks must be accomplished quickly
to minimize casualties. The final task, recovery, is not one for
first responders; it will be a time-consuming process better handled
Most major municipalities can at least mitigate
the effects of a chemical or high-yield explosive attack. They have
well-trained hazardous materials (HAZMAT) teams that can stop additional
release. Their police departments can identify the contaminated
area by observing people in the vicinity. They can then expand the
area to allow for contamination migration and establish the cordon.
In addition, many cities have basic radiation detection instruments
and can establish a cordon in radiological or nuclear attacks. Biological
attacks unfold more slowly, and mitigation is primarily thorough
identification and quarantine using preventative health and medical
Unfortunately, municipalities cannot conduct
the large-scale search, rescue, decontamination, and treatment needed
in such an attack. Even the Tokyo Fire Department, one of the best
trained and equipped in the world, was overwhelmed by a badly executed
sarin gas attack on their subway system. Cities simply cannot afford
to keep the large number of trained personnel on alert to respond
to such an incident.
Examining the sequence of events after a CBRNE
event reveals the gap in resources. Obviously, local authorities
will provide the initial response. In the case of a CBRNE event,
they will immediately call in all off-duty first responders. Even
then, only HAZMAT-trained and equipped responders can safely enter
such an environment. Given the intense physical effort required
to conduct mass personnel rescue and decontamination, the on-duty
shift will exhaust its people-and more importantly its on-truck
supply of protective equipment-within hours. Currently, their only
source of relief will be the off-duty shifts using whatever equipment
is available in ready local stocks. The best local response forces
can sustain is 8 to 16 hours in a contaminated environment, even
drawing on robust mutual aid agreements. While the Department of
Justice funded pre-positioned stocks will provide additional equipment,
no personnel come with it.
Out-of-state, mobilized military and commercial
assets should begin arriving in significant numbers around the 72
to 120 hour mark assuming rapid identification and mobilization.
Federal-local coordination is improving but still cannot ensure
reinforcement by that time. Even when they do arrive, few personnel
will have the training and equipment to work in a contaminated environment.
During the gap before mobilized assets arrive,
the first responders will be struggling to continue rescue operations.
Even with total mobilization of all shifts and resources, they will
be overwhelmed by the number of casualties. Moving casualties is
physically demanding and exponentially more so in a contaminated
environment. Responders must wear heavy, hot, and restrictive personal
protective equipment. Under current Occupational Safety and Health
Administration (OSHA) and National Institute for Occupational Safety
and Health (NIOSH) regulations, they are limited to level A (fully
encapsulated) suits whenever they enter an unknown environment.
Even after the agent is identified, most departments around the
country lack any other personal protective equipment.
Thus the deficiency in response to CBRNE lies
primarily in the rescue of victims between the time local responders
are overwhelmed and other assets can mobilize. Neither state nor
Federal assets, with the exception of CBIRF, are currently prepared
to assist. A secondary deficiency lies in the limited number of
rescue personnel that can be mobilized after the initial crisis.
This may seem like a harsh assessment given
the effort since 9/11. In fact there has been a great deal of discussion
and some progress on defining the DOD role in homeland defense.
With the standup of the Office of the Assistant Secretary of Defense
for Homeland Security, the department now has a single point of
contact. This staff can take a coherent overall look at what the
DOD response role should be.
Unfortunately, this top-level effort is still
in its infancy. On the tactical level, despite an alphabet soup
of acronyms, DOD provides little support to first responders. CBIRF
offers a robust, immediate asset within the national capital region,
but elsewhere its response is slowed by the time-distance problem.
Who Has the Mission?
While there is a long list of other DOD assets,
none are trained or equipped for rescue operations in a contaminated
environment. The most publicized asset, National Guard civil support
teams (CSTs), consists of 32 teams stationed around the country,
but they are limited to 22 personnel per team. While they bring
an exceptional reconnaissance, advice, and communication capability,
they provide extremely limited assistance for the actual rescue
and decontamination of victims. In essence, they can tell a local
incident commander what the contaminant is, recommend what to do,
and provide a powerful communications capability. But they cannot
Aside from CBIRF and CST, the other DOD assets
are essentially headquarters. These provide even more communications
assets and numerous experts to advise the incident or unified commander,
but they cannot assist in the trenches. The Army provides the chemical
biological rapid response team (CBRRT), which furnishes expert advice,
superb communications assets, and a command team. They bring no
one who can assist the first responders in the hot zone.
The Army has also been studying a guardian
brigade to consolidate many of its chemical and biological defense
assets: outstanding technical escort unit soldiers, CBRRT, some
chemical companies, explosive ordnance disposal experts, detection
experts, and numerous scientists. Unfortunately, these assets still
consist mostly of headquarters and technical experts. The proposed
organization contains very few soldiers equipped to go downrange
and none specifically trained for search, extraction, decontamination,
and treatment of casualties. Combining them in a brigade may offer
training and organization benefits but will not increase the number
of responders on the scene. However, it will require more personnel
for the brigade headquarters.
In addition to these headquarters, all the
services and many Federal agencies have experts who can respond
to biological and radiological incidents. However, none are trained
and equipped to participate in the rescue aspects of CBRNE response.
One final problem with DOD assistance is the
first responders' perception of what such help means. There is an
impression among local authorities that when DOD comes to town,
it brings two things: a large headquarters and someone saying, "We're
from DOD and we're in charge." Frankly, first responders do
not think they need either.
The obvious question is whether DOD should
take on the mission. Isn't it more suited to the Department of Homeland
Security (DHS)? It could end up there once the department is stood
up and fully functioning. But some aspects of CBRNE response heavily
favor a military force heading the effort.
First, the mission requires fit young people.
Extracting bodies from a contaminated environment is physically
demanding, calling for a combination of aerobic and anaerobic conditioning
that should be a hallmark of ground combat forces but is not usually
enforceable in civilian organizations. Second, until certain OSHA,
NIOSH, and Code of Federal Regulations requirements are rewritten,
civilian responders do not have access to the full range of personal
protective equipment military personnel can use. Third, training,
maintenance, and readiness requirements are high for this type of
work. Military forces have a culture of performing exactly these
functions in peacetime. Finally, the sheer cost of maintaining over
a hundred civilian personnel on alert is prohibitive. There is no
additional pay for alert status in the military. Further, tours
in these units are usually limited to a few years, so the burden
of onehour alert status does not become unbearable. Marines and
sailors of CBIRF stand a month of one-hour alert followed by a month
of regular duty. During the alert month, they conduct all training
and exercises in the immediate vicinity of CBIRF headquarters so
they can always respond in an hour.
The one DHS exception could be the Coast Guard.
It already provides three regional, highly skilled HAZMAT strike
teams under its national strike team. It also has the necessary
military structure. While true experts, the teams lack sufficient
manpower. Perhaps the Coast Guard could be enlarged to fulfill the
rescue mission, but it is currently badly stretched and has a very
small manpower base.
The solution is multiple CBIRFlike units that
are regionally based. Their location should depend on population
mass. CBRNE weapons are most effective when used in heavily populated
areas. Obviously, response is faster if the unit is located in the
area attacked. Therefore, we would station units in Atlanta, Boston,
Chicago, Denver, Los Angeles, Seattle, and Washington. This concept
would provide numerous benefits:
• The vast majority of the population
is within a five-hour drive of a CBIRF unit.
• Each unit would keep a 117-man response
team ready to deploy in its own vehicles on 1-hour alert, and another
unit of similar size and identically equipped would be ready in
• Units could reinforce each other by
ground or air, providing both the massive effort and long-term sustainment
needed for rescue operations in a mass casualty event. The industrial
accident at Bhophal, India, showed how big an incident can be. Records
from World War I and the Iran-Iraq war reveal that victims of chemical
attacks may be disabled and immobile but still live for days. Clearly
we need a robust, sustainable capability.
• The Nation could respond to multiple
attacks, a key capability given the al Qaeda pattern of conducting
Finding the Right Unit
The next issue is who should provide the units.
DOD could use active forces, Reserve/Guard forces, or a mix. To
understand the skills required, we should examine CBIRF, which has
determined that the following unit capabilities are needed to conduct
operations in a contaminated environment: CBRNE reconnaissance,
security, extraction, decontamination, medical, command and control,
CBRNE reconnaissance. This requires the ability
to detect and identify chemical warfare agents, toxic industrial
chemicals, toxic industrial materials, biological agents, and all
types of radiological contamination. CBIRF uses all standard DOD
chemical detection equipment and papers, the mass spectograph/gas
chromograph, and a more sophisticated mobile lab. It also has a
standoff chemical agent detection van. For biological agents, it
employs assay tickets and polymerase chain reaction technology that
uses DNA identification of proteins present in biological agents.
For radiological detection, it has individual detectors for each
marine and sailor as well as all military detection equipment. This
allows it to identify alpha, beta, gamma, X-ray, and neutron radiation.
These skills require extensive training and are highly perishable.
Security. This is not security as it is normally
envisioned. It is not about facing outward and isolating the site.
CBIRF security personnel face inward. They must keep the decontamination
and medical facilities from being overrun and contaminated by victims
while they set up. To protect the set up, they must wear personal
protective equipment. These marines are dressed when they arrive,
move downrange, triage and assist victims, and keep order while
decon sets up and recon enters the hot zone. Since they are wearing
only limited protection, they use risk-based assessment to determine
their limit of advance. Simply stated, if unprotected victims are
in distress but are still moving or breathing by the time security
marines arrive, the atmosphere should be safe for the marines, who
will advance to help those victims but no farther and never indoors
until the recon teams have made entry. Security marines are not
fulltime extraction marines; they have had the twoweek CBIRF basic
course to become qualified responders and participated in two days
of training in risk assessment and tactics. Each month before they
are assigned to a response force, they attend a day of refresher
training. Thus they are qualified to assist with the manpower-intensive
task of moving nonambulatory victims.
Search and extraction. These marines are full-time
extractors and train to a higher level than security marines. They
train to work on supplied air in up to level B protection and to
search collapsed structures and are equipped to find whether the
atmosphere is explosive or has a low oxygen level.
Decontamination. Decon marines take the same
two-week course, then move to a full-time decontamination platoon
where they train to meet standards for setting up the site rapidly,
determining the best decon methods, and deconning the patients and
equipment taken downrange. The actual tent set up for ambulatory,
nonambulatory, and force protection lines is relatively cheap-$20,000-$25,000-and
the force requirement is only 15 personnel; so it is possible to
have multiple decon set ups in an organization. CBIRF has three
complete sets of decon tents- they simply never throw away the previous
set. They have full-time manning for two tents and can augment with
headquarters/security marines to man the third set.
Medical. CBIRF has 2 board-certified emergency
room physicians, an assistant, an emergency room nurse, and 22 corpsmen.
All are trained to treat combined CBRNE and trauma casualties. This
unit should be bigger since medical care will be in high demand
and CBIRF apparently has the only medical personnel who routinely
enter contaminated zones and work in protective equipment.
Command group and cold zone support. The command
group provides the scene size up, coordination, liaison, and operational
control of all CBIRF forces. Cold zone support provides all aspects
of logistic, administrative, and communications support to include
resources for reconstituting each team when it exits the hot zone.
The key question is how to expand existing
capability so the entire Nation is covered. There are three options:
an active duty force expanded to regimental size, a Reserve or Guard
force, or a combination.
An active duty force would provide the fastest
response for localities with a battalion stationed nearby. The regimental
headquarters and a response battalion would logically be collocated
near Washington, DC, the most obvious target for a terror attack.
With fewer than 3,000 personnel, the regiment could expand up to
another six battalions located to provide maximum coverage based
on population density studies and drive times from their locations.
The probability of being a target should also be factored in. There
will be argument against using regular forces, given their heavy
worldwide tasking. Yet the 3,000 personnel required is only .25
percent of the 1.2 million active duty personnel. And equipping
six additional CBIRFs would cost only $150 million-.03 percent of
the $400 billion DOD budget. The CBIRF annual operations and maintenance
cost is less than $4 million, so a 7-battalion regiment could be
run for under $30 million.
Given that homeland protection is DOD's top
priority, this seems reasonable to fulfill a critical need. An alternative
is to build a CBRNE regiment from the Guard or Reserve. The National
Guard is working on a proposal for 10 regional response forces.
Unfortunately, the proposal calls for CBRNE response to be an additional
duty, not the primary duty. Worse, the units will not be formed
at the same armory. They will be composite units assembled from
platoons from various companies that would remain focused on their
conventional wartime missions. Somehow they are to provide their
designated CBRNE platoons with the specialized training to function
in CBRNE rescue. Further, these platoons are supposed to integrate
easily with the platoons from other companies, sometimes from different
states, at the crisis site. The intense teamwork required on site
virtually ensures such a unit will fail at the scene.
While the current planned configuration for
a National Guard CBRNE response unit will probably not work, the
Guard can provide such units if they are formed from a single unit,
then trained and equipped with the primary mission of providing
response in CBRNE events. In fact, the Guard could be highly effective
in this mission.
Such a battalion should have about 400 soldiers.
CBRNE must be its primary mission. In keeping with the dispersed
nature of the Guard, each response company would be in a separate
armory with the battalion headquarters collocated with a company.
The companies should be grouped geographically.
Besides the battalion headquarters, there should
be three response companies per battalion. Their schedule would
be the same as other Guard units except they would not train for
combat. They would focus totally on CBRNE response. Their two days
of monthly training would be devoted to the specific platoon skill-decontamination,
search, or extractions, for example. About every fourth month this
would be tested in a company level response drill. The monthly training
would be capped by full profile response training during the two-week
annual training, culminating in at least two exercises with first
responders. Ideally, each exercise would involve different departments
On completion of annual training, a response
company would stand one month alert. It would not remain on active
duty but would have to stay within a certain time radius of the
armory. Each soldier would carry a pager. The pager alert would
also serve as electronic mobilization orders. Each soldier's response
gear would be in his personal vehicle. That way he could either
meet the force at the marshalling area or at the armory. Depending
on the location of armories and where soldiers live, the alert time
could vary, but the lead elements need to be moving out in an hour
Under this process, each company would have
the alert for a month. Each battalion could cover one quarter. Four
battalions from one brigade would cover a year. A brigade could
be assigned to each Federal Emergency Management Agency region so
each region would always have a response company on alert. That
is a huge commitment-yet only 40 small battalions would provide
complete coverage. The Army National Guard fields 8 divisions and
15 enhanced brigades, or about 47 total brigades. The vast majority
were not activated for Desert Storm or Iraqi Freedom. Ten of these
brigades could be converted to this critical mission since they
do not seem to be needed for warfighting.
Battalion and brigade staffs would be much
smaller than their combat arms counterparts under this plan. They
would be essentially administrative headquarters, although the battalion
staff must be prepared to function as the response force command
element if two or more companies are committed to an event. CBIRF
manages that with fewer than 20 personnel.
Company staffs would be larger than combat
arms company staffs in order to provide personnel for the incident
response command post, support personnel to furnish administrative,
intelligence, logistic, and communications support, and professional
trainers. In addition, each company would need full-time soldiers
or civilian contractors to maintain the equipment, stay current
on changes in tactics and techniques in this fast-moving field,
and then set up the training to keep the company current. CBIRF
used four full-time trainers-a former fire chief, a former tech
rescue leader, a former paramedic/rescue man, and a former nuclear,
biological, and chemical (NBC) staff noncommissioned officer.
Each company would consist of a headquarters/security
platoon, reconnaissance element, extraction platoon, personnel decontamination
platoon, and medical platoon. The headquarters platoon must be larger
than that normally associated with a line company but in keeping
with those associated with independent companies. Its personnel
would have their normal duties but would also train to provide a
protective skirmish line to the force as it sets up. This requires
knowledge of level C protective equipment and basic military police
compliance techniques. CBIRF uses the standard techniques taught
in the Marine Corps martial arts program. However, CBIRF has found
that the most effective way to protect the force is to provide initial
victim assistance. The team would use a bullhorn and hand signals
to guide ambulatory victims to the decon triage area where medical
personnel would immediately begin to triage and treat victims with
symptoms. Security force personnel would talk the others through
buddy assistance and provide initial supplies for simple buddy decontamination.
The security force personnel would also have a fire hose line for
gross decontamination using the fog setting. Since the full decon
site set up should take no more than 15 minutes, the initial victims
would be triaged and ready to decontaminate about the time the line
is ready. Once the decontamination line is functioning and the reconnaissance
element has found the edge of the hot zone, security personnel would
move to that position to assist at the casualty collection point.
They would also operate any vehicles that provide evacuation from
the casualty collection point to the decon triage site. (CBIRF uses
a Gator/trailer combination for this mission.)
The headquarters/security platoon would provide
the command group, the security platoon, and the cold zone support
group. The command group consists of the company commander, emergency
services officer (firefighter), NBC officer, medical officer, radio
operator, logistic officer, law enforcement liaison officer, and
incident commander liaison officer. This team provides all on-site
command, control, and coordination functions.
The headquarters/security platoon would provide
the security force personnel to execute the missions above. The
company executive officer would lead all other soldiers in the platoon.
In addition, the headquarters/security platoon, with 35 personnel,
would provide a cold zone support group of 10 soldiers to give logistic
support and assist with reconstitution of the platoons after their
The recon element would need full-time soldiers
due to extensive training and highly perishable skills. They must
be able to detect and quantify all chemical warfare agents, toxic
industrial chemicals/materials, and biological and radiological
agents. Fortunately, this mission can be filled by the existing
National Guard CST. Since they would no longer have their command,
coordination, communication, decontamination, or medical functions,
the 22 personnel can easily be configured as the reconnaissance
element. They have the skills; they would simply need to organize
and train to send a higher percentage of their personnel downrange
to provide the multiple teams required in a major incident. CST
must be embedded in each response company so they train together
constantly. This calls for either forming new teams or reassigning
existing teams from states with low threat of attack.
The extraction platoon's primary function is
to enter the hot zone, find victims, package them for movement,
then move them to the edge of the hot zone. It will have a commander
(preferably a professional crash fire rescueman), a sergeant, two
radio operators, and two 14-man extraction squads with a squad leader,
his rescue buddy/radio man, and three fire teams of four. Each team
will be broken into two-man extraction teams. This gives each rescue
squad six two-man rescue teams plus the squad leader and his buddy.
The platoon could flood a target with 12 teams plus two squad leader
teams, and the platoon commander and sergeant with their radio operators
can be two more teams. The total is 32 personnel. This platoon will
require extensive training on protective equipment to be prepared
and equipped for level A, B, or C entries. They must also be trained
in victim packaging and movement as well as primary and secondary
The decontamination platoon will focus on personnel.
It should be composed mostly of NBC people and led by an NBC officer
with an NBC sergeant. They will maintain three decontamination lines.
The first is for decontamination of response force personnel, the
second for ambulatory patients, and the third for nonambulatory
patients. Only 15 soldiers are required to run a full ambulatory,
nonambulatory, and force protection line, but the workload is heavy.
Relief personnel are essential. The platoon total is 25.
The medical platoon should consist of 3 medical
officers and 12 medics. If the manning is available it should be
larger. They must run three sites. The casualty collection point
is the first medical treatment site and is placed at the very edge
of the hot zone with the junior medical officer in charge. He should
take six medics. This is the first opportunity to treat the victims.
They are outside the hot zone and are not being affected by the
poison, so medical personnel can get immediate drugs on board and
stabilize major trauma. The next medical station is decon triage,
manned by an emergency room nurse and four other medics. They maintain
treatment while patients wait for decontamination. The final station
is medical stabilization, consisting of the senior medical officer
and two medics. It is located just beyond decontamination in the
cold zone. This station should be quickly turned over to civilian
first responders, and the response company personnel should move
downrange to decon triage. The platoon total is 15.
While it will require major reorganization,
using the Guard for this mission has a number of positive aspects.
First, providing emergency support to the community is a traditional
Guard mission. Second, Guardsmen can develop long-term relationships
with first responders and other companies and battalions in their
region. Third, a large number of personnel (40 battalions, or 16,000)
will be trained to deal with an emergency in their community whether
they are on alert or not. Fourth, it provides a vital wartime mission
for the Guard. In essence, international terrorists want to bring
the fight to our hometowns. If they succeed, it will be because
we have had no intelligence or warning. Response under these conditions
is clearly in keeping with the historical role of the minuteman.
The third option, mixed Guard and Regulars,
also has distinct advantages. One to three active battalions in
a CBRNE regiment would provide a catalyst for developing new training,
techniques, and equipment for the mission. It would offer a reservoir
of knowledge for active forces in post-CBRNE attack consequence
management. That is a distinctly different problem than traditional
NBC defense for military units. They can also provide an active
duty advocate for their Guard counterparts. The relationship could
be like that between enhanced Guard brigades and their active duty
While expanding CBRNE capabilities is clearly
an idea whose time has come, there will be numerous and loud objections.
Some will cite stretched DOD assets. But official department policy
states that homeland defense is the number one priority. Mitigation
of damage and rescue of civilians post-attack is part of that mission.
Certainly a tiny percentage of DOD assets can be spared for this
Some will argue that posse comitatus prohibits
Federal troops being used in domestic events. This is an invalid
argument since CBRNE units are not armed and do not attempt to enforce
Some will argue that it is a mission for Homeland
Security. This may be legitimate, but unique physical and disciplinary
requirements make it more appropriate for military forces. More
to the point, why should we pay to stand up another bureaucracy
to execute this function when the National Guard already exists
with the manpower, experience, funding, and facilities? More importantly,
from its minuteman roots the Guard has a long history of being first
to defend their communities.
Some will argue this will be a long process.
Indeed, CBIRF has been focused on the mission and refining tactics,
techniques, procedures, and training since 1996. Everything from
standard operating procedures to individual equipment has been worked
out. Further, National Guard CSTs already possess the most time-consuming
and perishable skills-those of CBRNE reconnaissance. Whichever option
we choose, it will not require a great deal of time to execute.
In short, the combination of 9/11 and the anthrax
letters have put us on notice that CBRNE attacks are highly effective
means for terrorist to attack the United States. DOD has made progress
in many areas in response. Unfortunately, it has largely neglected
dealing with the consequences of a CBRNE attack. It is time to rectify
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