Navigating the Storm: Report and Recommendations from the Atlantic Storm Exercise

Abstract

Atlantic Storm was a tabletop exercise simulating a series of bioterrorism attacks on the transatlantic community. The exercise occurred on January 14, 2005, in Washington, DC, and was organized and convened by the Center for Biosecurity of UPMC, the Center for Transatlantic Relations of Johns Hopkins University, and the Transatlantic Biosecurity Network. Atlantic Storm portrayed a summit meeting of presidents, prime ministers, and other international leaders from both sides of the Atlantic Ocean in which they responded to a campaign of bioterrorist attacks in several countries. The summit principals, who were all current or former senior government leaders, were challenged to address issues such as attaining situational awareness in the wake of a bioattack, coping with scarcity of critical medical resources such as vaccine, deciding how to manage the movement of people across borders, and communicating with their publics. Atlantic Storm illustrated that much might be done in advance to minimize the illness and death, as well as the social, economic, and political disruption, that could be caused by an international epidemic, be it natural or the result of a bioterrorist attack. These lessons are especially timely given the growing concerns over the possibility of an avian influenza pandemic that would require an international response. However, international leaders cannot create the necessary response systems in the midst of a crisis. Medical, public health, and diplomatic response systems and critical medical resources (e.g., medicines and vaccines) must be in place before a bioattack occurs or a pandemic emerges.

The development of global vaccine stockpiles

“…14 However, in the next year, a simulated bioterrorism exercise involving several European and North American cities estimated that smallpox vaccine availability in 31 countries and the WHO international stockpile was enough to cover about 10% of the population worldwide. 15 Only eight of the countries involved had sufficient supplies to cover 100% of their own populations, which raised the question of who should receive a vaccine if an event were to occur. In 2013, the WHO Strategic Advisory Group of Experts was asked to provide a recommendation for the size of the stockpile.…”

Reclassifying bioterrorism risk: Are we preparing for the proper pathogens?

“…Furthermore, regarding person-to-person transmission, an anthrax attack could be contained in the targeted area, while even with a prompt response to a smallpox attack, the evolution of a second wave would be hard to avoid, and thus the threat of an uncontrollable pandemic would ensue [20]. The wide variation in availability of smallpox vaccine, even among countries of the European Union [21], underlines the pandemic threat. Moreover, the need for respiratory isolation would impose a heavy burden in healthcare systems [22].…”

“…The recent Atlantic Storm exercise outlined the problems of defining hierarchy [21]. A potential biowarfare attack is a major social, financial and political threat, thus one can assume that decision control should be handled by government authorities.…”

Alliance Reborn: An Atlantic Compact for the 21st Century. The Washington NATO Project

“…Areas for cooperation include improved global biosurveillance capabilities; better early warning and detection systems; robust information-sharing, investigational and preparedness mechanisms; harmonized standards; and medical countermeasures and stockpiles. 23 This is not primarily an area for NATO, but for health and interior ministries, as well as international organizations such as the World Health Organization (WHO.) Bilateral cooperation, and more effective U.S.-EU and global collaboration, including among scientists, is also key.…”