"But if it's not contagious, at worst we're looking at highly localized terrorist incidents. Tragic and horrific, but manageable," the White House chief of staff said.
"You're missing the bigger picture here, Mr. Remy. Herpes simplex encephalitis does more than produce casualties, and if the virus in question has been modified as suggested, the impact of its release can't be understated. Here are the statistics for the unmodified virus. In those treated aggressively, less than three percent regain normal brain function. This can vary from very mild to severe impairment, depending upon several factors. Early treatment with high dose, intravenous acyclovir is the only modifiable factor scientists have identified. However, this may not be an option in our situation. Testing isn't complete, but the initial research conducted by Edgewood indicates that the weaponized strain in question races to the temporal lobe, leaving little hope of recovery."
"How can you know that for sure?" Shelby asked.
"We can't, but based on the information surrounding the current situation, we have to assume a worst-case scenario," Phillips interjected.
"And what is that?" Shelby continued.
"If released in a municipal water supply, unknown to the population, it has the potential to affect nearly everyone. Take a small town of twenty thousand people. Even if we discovered the attack immediately after the virus circulated through the drinking water and treated everyone in the town with acyclovir, 95 % of them will suffer neurological impairment at varying levels. 19,000 citizens. Neurological impairment will range from…" he paused and glanced at the president and the director of the CIA, who shared a glance, and nodded almost imperceptibly toward Phillips.
"Full homicidal rage and hyper-aggressive behavior to minor seizures. Brain damage in almost every case. Edgewood's initial report indicated that we would likely be dealing with the more serious end of that spectrum. The reports gathered by…" He stopped again and looked to the CIA director.
Shelby started to get even more annoyed. He could tell that Phillips was uncomfortable taking the conversation any further, and he knew exactly why. Prior to entering the conference room, Shelby had been cornered by the national security advisor, who informed him that there could be no direct mention of Sanderson's team during the meeting. They could be called "intelligence assets in Europe" or "on-site ground assets," but specific reference beyond that was forbidden.
They didn't have time for the paperwork before the meeting, but information regarding Sanderson's present and future involvement with the government would be classified Compartmentalized Information Security (CIS) Category One. The Black Flag program was once again one of the most highly classified secrets of the United States government. Obviously, Phillips had been given the same speech. He wondered who else had been yanked aside by the national security advisor. Not everyone, or they wouldn't have to dance around this issue during the meeting. The president ended the uncomfortable pause.
"The effects of the virus in question have been confirmed firsthand in Russia. We are dealing with the worst end of that spectrum. I don't mean to cut you off, Dr. Phillips, but let me say what needs to be said. If that virus is released, we face the likelihood of trying to contain an entire city or township of brain-damaged citizens, many of them mentally deranged and violent, who face no hope of recovery. I can't even begin to fathom how we would handle 19,000 cases like Dr. Phillips suggested in just a small township. People would have to be detained and treated compassionately, even the ones that would require maximum-security institutionalization. Imagine this happening simultaneously in fifty-eight separate cities across America. This is the ultimate terrorist weapon, with the potential to tear apart the fabric of American society.
"I want to focus on taking steps to protect our citizens from the release of this virus in the United States, while responsibly and cautiously preparing them for the possibility of an attack. The joint FBI and Homeland Security task force based out of our National Counterterrorism Center is already fast at work tracking down domestic leads. We have assets doing the same thing abroad. So, how do we start preparing the public, while not hindering investigative progress?" the president said.
"We have to be careful with raising the threat level. Orange is significant, but taking it to Red could tip off the group preparing to attack. Possibly accelerate their timeline or cause them to go to ground. Whatever we do, we can't tip them off until the investigation has reached a critical mass," Shelby said.
"But going to Red would leave no question in anyone's mind that this was the real deal. If we're planning to activate the National Guard, I don't see how we can avoid it," said Marianne Templeton, secretary of Homeland Security.
"Going to Red will cause a widespread panic. We need to slowly ease into this, based on the immediacy of the threat. We can activate the National Guard without going to Red," the White House chief of staff said.
"I don't think we can get away with that for very long. Dr. Chandrashekar, where does the CDC stand in terms of a response?" Templeton asked.
"We're already assembling first-response teams and deploying them nationwide, so they can reach anywhere within the continental U.S. within a few hours. These teams will confirm the presence of the virus and allow full-scale resources to be deployed. We'll coordinate with Health and Human Services to educate the public as determined by the administration. We're working up media packages, public education announcements, and response guidelines for first responders," Chandrashekar responded.
"Pauline, what can we expect from your department at the outset?" the president asked.
Pauline Rosenberg, secretary of the Department of Health and Human Services leaned forward to see around Director Shelby.
"Mr. President, my department will work closely with the CDC to ensure the rapid and targeted deployment of our National Disaster Medical System assets. Under your recent directive, we have created and disseminated several National Planning Scenarios intended to guide federal, state and local disaster planning efforts. Unfortunately, efforts to implement the recommendations proposed by these scenarios are still in their infancy at the state and local levels. The sooner we alert state and local governments, the better. These scenarios are designed to focus response efforts for geographically limited disasters projected to produce significant casualties in the tens of thousands. A bioweapons attack is one of the scenarios. State governments need to start readying a response."
"I agree with you, Ms. Rosenberg, but we need to figure out how to do this without creating a panic," the president said.
"What are we doing directly on a federal level?" he asked.
"On a federal level, we are preparing all of our deployable medical response assets. We have fifty-five Disaster Medical Assistance Teams and thirty-one Federal Medical Stations that can be deployed within twenty-four hours. All of the equipment and personnel are being assembled as we speak. Once CDC identifies a hot zone, we will commit these additional assets and start intensively coordinating with local medical and law enforcement authorities. Nineteen thousand patients will require an incredible effort at every level, which will quickly outstrip local resources. Mr. President, you should be prepared to immediately declare any area hit as a federal disaster."
"Nineteen thousand was only an example. The number could be in the hundreds of thousands, depending on the target city," Dr. Chandrashekar informed them.
"What about the Strategic National Stockpile and Project BioShield? We've spent close to forty billion dollars on bioweapons defense since 9/11 and the anthrax attacks. Five billion alone for vaccines," the White House chief of staff said.