Mass casualty drill challenges health system

A dirty bomb went off in Seattle. A plague was let loose in Chicago. Now officials are tallying the lessons learned from the test.

By Victoria Stagg Elliott, AMNews staff. June 2/9, 2003.

On a Monday in May, while workers are taking their lunch break in Seattle's downtown, a dirty bomb exploded, directly injuring 100 and terrifying many who feared exposure to residual radiation. Meanwhile, that evening in Chicago, travelers and hockey fans started showing up at hospitals, coughing up blood.

Wait. Don't panic. It was only a drill.

The U.S. Dept. of Homeland Security's Top Officials 2 -- TOPOFF 2 -- designed these two simultaneous scenarios to test the ability of hospitals and the public health system to respond to a radioactive bomb and the release of a biological agent.

The drill carried a price tag of $16 million, making it the most expensive emergency preparedness exercise ever. It was also the most comprehensive, and attempted to apply lessons learned from TOPOFF 1 which took place three years ago.

"We hope TOPOFF 2 will provide us with concrete examples of how we can better respond to attacks," said Homeland Security Secretary Tom Ridge. "Because, while we're doing everything we can to prevent, deter and disrupt terrorist activity, we have to be prepared to respond to any real-life scenario that might occur."

Imagine what it was like. For three days, dozens of Chicago-area hospitals received faxes detailing the circumstances of pretend victims. Some of these -- actually volunteers wearing bright yellow T-shirts emblazoned with the words "Role Player" on the back -- showed up in person and mixed with the hospitals' real patients. Hospital workers tried to attend to the needs of both. Periodically, a role player would pull out a card marking him or her as dead.