Conference Proceedings
Section III:  TRANS-ATTACK PANEL: Emergency Response

Paper Presentation...

Jerry L. Harper
Law Enforcement Issues in a Bio-event

Both biological terrorism and natural outbreaks of disease present complex issues for law enforcement agencies. Both are clearly public health emergencies demanding response from the public health and medical communities; recognition of the issues facing law enforcement agencies is essential. While the law enforcement roles in bioattacks which are essentially intentional outbreaks, including both traditional criminal intelligence and investigation are generally recognized, other aspects are frequently overlooked. In the case of bioattack, criminal intelligence and investigation must be integrated with medical and epidemiological investigations to ensure a comprehensive understanding of the event. In addition to these "crisis management" roles, law enforcement plays critical role in enforcing quarantines, managing crowds, providing security of medical facilities, health care providers, and shipments of medical supplies. These missions are largely the responsibility of local law enforcement agencies. Rules of engagement for quarantine, Force protection, and Site security issues in bio-events, both intentional and natural will be discussed. Emphasis will be placed on identification of problematic issues, the need to synchronize law enforcement and public health response for bio-events.

Terrorism has been a persistent threat during the closing years of the 20th century. As we cross into the 21st century we can expect that threat to continue and perhaps mature. In the recent past, terrorism has been a mechanism for airing grievances and engaging in warfare by proxy to alter or influence the prevailing political climate. Towards these ends, terrorists had largely relied on a narrow, effective range of weapons: guns and bombs. In the closing years of the 20th Century questions about the future course of terrorism have increasingly considered the potential for terrorists to embrace "higher levels of destruction and the exotic products of technology to achieve their ends." Bioterrorism or the use of biological weapons in a civilian setting as a weapon of mass destruction (WMD), tool of terror or revenge is one potential outcome of a possible shift in terrorist targeting toward the generation of mass casualties.

Both biological terrorism and natural outbreaks of disease present complex issues for law enforcement agencies. Both are clearly public health emergencies demanding response from the public health and medical communities; recognition of the issues facing law enforcement agencies is essential.

Intentional attack is not the only concern. The growing bioengineering industry and the routine shipment of etiologic agents can also trigger a biological emergency or bio-event. The general lack of preparedness for a conventional bio-hazmat incident underscores concerns about the capacity to respond to both bioterrorism and other bio-events.

Law enforcement plays critical role in enforcing quarantines, managing crowds, providing security of medical facilities, health care providers, and shipments of medical supplies. These missions are largely the responsibility of local law enforcement agencies. Rules of engagement for quarantine, Force protection, and Site security issues in bio-events, both intentional and natural require additional attention from the law enforcement community.

Should a bio-event, either a terrorist-instigate bioattack or a natural outbreak occur, police would be faced with considerable challenges. These include:

• Recognizing that an attack (or outbreak) has occurred;

• Lack of knowledge and experience of biological warfare issues;

• Lack of personal protective equipment (PPE) and doctrine for its use;

• Security and Crowd Control: Scene Control, Containment and Site Security of the incident scene, hospitals and treatment areas;

• Issues of Quarantine (what is the legal foundation, can quarantine be implemented, what level of force is acceptable);

• Demands for increased staffing to handle multiple missions spread over a potentially large geographic area with multiple police providers;

• Priority provision of vaccines and prophylaxis to public safety personnel;

• Force protection (ensuring the safety of responders and response equipment);

• Integration of Criminal and Public Health Investigations;

• Issues of Command and Jurisdiction.

Situational Recognition and Lack of Knowledge and Experience

Difficulties in recognizing the onset of an attack or outbreak or closely linked with a lack of knowledge and experience with biological warfare issues among civil police. Biological events regardless of cause may be difficult to detect. An intentional attack may present no discernible signature. Delayed effects; diffuse case presentation: cases distributed over large geographic area, at different times, to different agencies (hospitals, 9-1-1 public safety answering points, EMS providers, etc.); difficulty in detection and diagnosis may mask a bioattack.

Even with enhanced preparedness efforts, a "suspicious outbreak of disease" may not yield a clear terrorist nexus for several days or even weeks. Additional training and exercises for law enforcement and police providers in issues related to biological terrorism are essential. Such efforts should include awareness for first responders, supervisors and command personnel. They should emphasize the need to develop a close working relationship with public health providers and clearly articulate the different risks and response requirements for those diseases that are communicable and those that are not.

Lack of personal protective equipment (PPE) and doctrine for its use

The vast majority of law enforcement agencies in the United States (and elsewhere) have limited quantities of personal protective equipment (PPE) for biological emergencies stockpiled or deployed. Largely such equipment consists of respiratory protection (masks) for use during or immediately after an aerosol attack when the risk of secondary contamination due to re-aerosolization is greatest. Availability of such equipment must be increased. Likewise, protocols for its employment must be developed.

Security and Crowd Control: Scene Control, Containment and Site Security of the incident scene, hospitals and treatment areas.

This is the pivotal issue for law enforcement agencies. Police maintain order and return calm to disaster and crime scenes. The site of an intentional release (e.g., food tampering or aerosol release of biologic agents) must be contained, evidence collected and processed. These are not the only site security missions. Once media reports of an outbreak or attack are disseminated, victims (those actually exposed to the agent or those whom become concerned that they were exposed) may converge upon hospitals and other medical facilities to seek, or demand, treatment.

Hospitals and other treatment areas (i.e., casualty collection points, vaccination centers, distribution points for antibiotic prophylaxis, etc.) may require a police presence to maintain order and manage crowds. Like issues of enforcing quarantine (discussed below) this may become problematic. How much force can be used to isolate and contain victims and secure treatment areas? What rules of engagement for using force in these situations apply? These are critical legal and public policy issues that have only begun to be recognized.

Issues of Quarantine

What is the legal foundation for quarantine? While health authorities (in California, the State Health Officer) will declare quarantine, law enforcement agencies will be required to enforce it. While some small-scale examples of enforced isolation or quarantine exist (e.g., cases of individual patients with antibiotic resistant tuberculosis come to mind) large-scale quarantines are outside the experience of contemporary police agencies. The preferred response to a large outbreak is prophylaxis with antibiotics and vaccine. Yet, if the number of persons exposed exceeds the supply of antibiotics quarantine may still be necessary.

The same concerns regarding the foundation for using force and the appropriate rules of engagement for using force raised while discussing security and crowd control apply here. Police executives and elected officials must begin to examine the appropriate response to these issues. Finally, technological solutions in the form of less-lethal (non-lethal) weapons may be useful tools for addressing these force issues. (Consider for example the use of non-lethal acoustic weapons for area denial, maintaining a cordon or directing a crowd into designated areas. Obviously both technical and ethical issues must be evaluated, but non-lethal options should be considered as an alternative to deadly force or impact weapons for these missions.)

Demands for increased staffing to handle multiple missions spread over a potentially large geographic area with multiple police providers

Addressing bio-events (i.e., large-scale aerosol releases or smaller incidents where person-to-person transmission is possible) can be expected to require a sizable police response. A number of police missions (crowd control, force protection, area security, etc.), requiring numerous officers to respond to a number of separate venues is possible. Coordination among a number of agencies is likely. Even if quarantine is enacted, exposed persons can be expected to have traveled out of the contained area prior to its closure. Mutual Aid and military support to civil authorities (MSCA) are likely to be required to mobilize sufficient police resources. These measures require a high level of situational awareness and resource coordination.

Priority Provision of Vaccines and prophylaxis to Public Safety Personnel

Law enforcement officers (as well as fire, emergency medical service and hospital personnel) require priority access to prophylaxis and/or vaccines if they are to effectively carry out their missions. Sufficient stockpiles or caches of medical supplies to fill this need, along with the logistical capacity to distribute prophylaxis and vaccines to key public safety personnel are essential. Such planning is complex and its need is just beginning to be recognized.

Force Protection (ensuring the safety of responders and response equipment)

Law enforcement personnel can be expected to be called upon to escort medical providers engaged in treatment and prophylaxis/vaccination provision, and medical supplies. Planning and training for such missions incorporating the element s discussed above is essential.

Integration of Criminal and Public Health Investigations

While the law enforcement roles in bioattacks, which are essentially intentional outbreaks, including both traditional criminal intelligence and investigation are generally recognized, other aspects are frequently overlooked. In the case of bioattack, criminal intelligence and investigation must be integrated with medical and epidemiological investigations to ensure a comprehensive understanding of the event. Training for police in their role in supporting such missions is needed.

Issues of Command and Jurisdiction

Managing the multiple aspects of a complex biological emergency requires well-honed command skills. Law enforcement command personnel will be called upon to exercise these skills in a situation few have trained for and even fewer, if any, have experienced. Public safety and health needs will have to be balanced in a time competitive situation. Resource and equipment shortfalls will challenge decision-making. Outside assistance from state or federal agencies will be marshaled, but it will take time to arrive. Finally, multiple disciplines from multiple levels of government will ultimately respond requiring development of a cohesive Unified Command Structure.

Conclusion

The potential for terrorism involving biological agents requires law enforcement agencies to develop new skills, refine existing skills, and build new relationships with other disciplines. New linkages with the medical, public health and national security communities are an integral ingredient of such skill-building. New doctrine, reinforced through training and tested through exercises is necessary. This paper identified some of these needs. Future discussions are necessary to build from this starting point.

Jerry L. Harper retired in January 1999 after 37 years with the Los Angeles County Sheriff's Department, the last 6 as Sheriff Sherman Block's undersheriff, the second highest position in the department of almost 15,000 people. He ran the day to day operations for the sheriff and oversaw a budget of 1.3 billion dollars. He also oversaw media relations. He was the department's chief of planning for the 1984 Olympic Games in Los Angeles. He also oversaw planning and security for the 1994 World cup in Pasadena, California. He has taught and consulted in various subject areas since his retirement: Instructor of Civil Disorder Management for the IACP, International Association of Chiefs of Police, also teaches "risk management"; Consultant for the United States Departments of State and of Justice in assessing the civil disorder capabilities and needs of the Republic of Indonesia; Senior Consultant for the United States Department of Justice in the "Working Group on Civil Disorder"; Teaches and consults and holds "fellow status" with the University of California at Los Angeles, UCLA; Instructor for the National Training Officers Association in the subject of "Critical Incident Management"; He has been a consultant to the police departments of Denver and Portland for Y2K planning and he was an observer during the 1999 World Trade Organization disturbances in Seattle, Washington. Mr. Harper has been teaching civil disorder management for about 35 years and has taught the subject in France, Canada and Indonesia as well as all over the United States.