Editor Note: This 6-part series was submitted and scheduled at the end of 2019. In light of COVID-19, we are accelerating the publication of the final three parts to ensure DomPrep readers have this critical information to assist in their jurisdictions’ pandemic response plans.
The Johns Hopkins Center for Health Security is a credible source for dealing with pandemics and disaster response. In 2018, the Center created a realistic simulation of a moderately contagious and moderately lethal virus, similar to the lethality of the 2002 SARS outbreak, which killed about 10 percent of those infected. Designed by senior scholar Eric Toner, the “Clade X” simulation was based on a virus that was bioengineered and released by a group modelled after Aum Shinrikyo – the cult that released sarin in the Tokyo subway in 1995. According to Toner, researchers are convinced that this scenario is plausible – a virus like this could be created and spread to ultimately kill up to 900 million people if no vaccine were successful. Health care systems would collapse, panic would spread, and the U.S. stock market would crash. Toner warned that a pandemic could cause the collapse of hospital systems, “Most people don’t know how close we came to having that happen in the U.S. in 2009 ... due to a not particularly virulent flu strain.”
During that simulation – with experienced medical, national security, and former elected officials as key players – participants deployed National Guard troops across the United States to provide security at pharmacies and hospitals. That action was taken as an acknowledgment that some citizens are not going to simply wait for their turn to get a vaccine but will fight to improve their chances of survival. In some countries, military forces were deployed both to maintain domestic order and secure borders, “Widespread looting in some countries led to violent government crackdowns.”
Tara O’Toole, a former top Homeland Security Department official who played the homeland security secretary in the Clade X exercise commented that, “We are in an age of epidemics, but we aren’t treating them like the national security issues that they are.”
Simulating a Catastrophe & Considering Quarantine
A collapse in the economy, food distribution, and law and order could cause more fatalities than the triggering event. Foreshadowing incidents like the current coronavirus, more than 30 senior government and business executives convened at the 2006 World Economic Forum Annual Meeting. Booz Allen Hamilton’s Influenza Pandemic Simulation explored implications of an influenza pandemic in Europe. Here are some key takeaways from simulation participants:
- Truck drivers being unable or unwilling to deliver goods during the pandemic could cause food stores to close from an inability to restock.
- The entire food chain as well as transportation and logistics are essential industries that would need to be prioritized during a pandemic. Governments would need to assume some responsibility to assist delivery of food and supplies.
- It is unrealistic for officials to simply tell people to stay home.
- To ensure critical infrastructure and resources (e.g., food, fuel, and health care), the government might need to take national control, similar to wartime measures.
- Conditions are likely to be much worse in lesser developed countries.
- Contingency plans should be developed now to go beyond the typical disaster response to include how to respond should the society and economy collapse.
- Looting and vigilantes may require martial law, conscription of workers to augment healthcare and security workforces, and nationalization of critical food and water supplies. Dr. David Nabarro, UN System Coordinator for Avian and Human Influenza, stated after the exercise:
- “Quite likely by day 28 all systems will have fallen apart.”
- “Martial law should be used to protect the people.”
- “Military must be involved in the response to help keep the peace and deliver essential goods and services.”
A 2006 Department of Homeland Security publication stated that an influenza pandemic could cause “unprecedented national economic disruption,” security risks, and social instability:
- “Movement restrictions and/or quarantines will disrupt the supply chains and municipal services.”
- “Business planners should assume some level of social disruption and plan for direct security risks to their operations and along their supply chain.”
- “There will be fundamentally graver negative impacts on individuals, businesses, and the nation from the compounding effects of the disease impacts and disease mitigation strategies applied over a much greater duration than other typical disaster scenarios.”
- “Pandemic influenza has the potential for causing levels of global illness, death, economic disruption, and social disturbance like no other.”
Dr. Margaret Hamburg, then a Department of Health and Human Services official, warned in 2001 that, “[W]e must also recognize that the fear of a silent, invisible killer such as an infectious agent will likely evoke a level of fear and panic substantially greater than what has occurred in response to those more ‘conventional’ disaster scenarios.” She cited the example of panic and civil disruption from the Surat, India plague outbreak in 1994.
Secondary Consequences & Threats of Violence
Nancy Kass, a professor at the Johns Hopkins Berman Institute of Bioethics, and others publishing a study in a biosecurity journal, warned in 2008 that, “the secondary consequences of severe pandemic influenza could be greater than deaths and illness from influenza itself.” “It takes a lot of people to keep society going.” Although traditional pandemic planning gives medical treatment priority to hospital staff and first responders – such as firefighters and ambulance workers – truck drivers, food plant workers, water and nuclear plant workers, hospital janitors, and many others continue to work while risking exposure to the deadly virus or lawlessness. Hurricane Katrina demonstrated how post-disaster events can be more damaging than the event that precipitated it:
A collapse in the economy, food distribution, and lawlessness could cause more fatalities than the triggering event.
- Loss of electricity and heat
- Scarce clean water
- Backed up sewage
- Widespread social chaos
- Outbreaks of other infectious diseases
- Social degeneration, looting, or violence
Former Central Intelligence Agency Director Admiral James Woolsey warned in 2017 that North Korea probably has nuclear warheads optimized for high-altitude electromagnetic pulse (EMP) effects. When delivered by satellite or intercontinental ballistic missile (ICBM), one detonation even without great accuracy could disable the national electric grid for over a year, killing up to 90 percent of the population through societal collapse and starvation. The number killed in the initial nuclear detonation would be much less than post-incident fatalities.
Food supplies that could typically last for two to five days could be depleted within hours due to panic buying and hoarding. This phenomenon is currently occurring across the United States. Gangs too may accelerate the breakdown in law and order and magnify looting and marauder threats in a pandemic. The United States has about 50 murders daily, 33,000 violent and criminally active gangs, and about 1 million gang members. In addition to local drug and mafia gangs, foreign gangs are present across the country. MS-13, a Latino gang known for brutal murders, has an estimated 10,000-150,000 members in 42 U.S. states. With law enforcement personnel reduced from a pandemic, focused on protecting medical facilities and enforcing quarantines, or ineffective due to no electricity, gangs and lawbreakers have more opportunity for criminal activity.
If either the viral threat or lawlessness threat is severe, truckers may not be willing to risk their lives to deliver food, retail workers may refuse to work, and food production may cease. Even without such threats to food distribution, quarantines and road closures could hinder or prevent food shipments. Rural farm states, for example, may close their borders to keep out refugees from urban areas who may bring violence or to stop road traffic that could increase the risk of spreading the virus. These states may reason that they have plenty of food and water, so they are better off with a strict quarantine. The opposite may be true for people in more urban states, but road closures and border control are ultimately state and local government decisions. While people can go for many days without food, a food shortfall or just the rumor and fear of no food, could lead to panic and breakdown in law and order.
Leadership Challenges: Viruses, Vaccines & Violence
The 2006 Pandemic Influenza National Strategy and Implementation Plan warned that, “civil disturbances and breakdowns in public order may occur.... Local law enforcement agencies may be called upon to enforce movement restrictions or quarantines, thereby diverting resources from traditional law enforcement duties. To add to these challenges, law enforcement and emergency response agencies can also expect to have their uniform and support ranks reduced significantly as a result of the pandemic.” In addition to quarantine enforcement, the impact of supply chain disruptions and conflicts “as persons vie for limited doses of vaccines and antiviral medications” are noted.
Another factor that could raise public outrage and incite violence is the necessary yet contentious practice of prioritizing who receives vaccines. A pandemic caused by a biological attack would require government at all levels to ration urgent care and vital supplies. Hospitals would have to turn sick people away. It takes six months or more to produce a vaccine for a new flu variant or virus. While the public waits for vaccines, the death toll will rise. The need to give medical personnel, law enforcement, military, and other key workers priority will lead to unequal distribution of vaccines. Some who object would attempt to steal vaccines or food for their families or lash out at perceived injustice. Those categorized as nonessential workers (truck drivers, food plant workers, etc.) may use this as another reason to stop working to reduce their risks during the pandemic. Rather than calmly accepting a low priority and long wait for vaccines, people are more likely to take actions to save their lives, which may include breaking laws and killing if necessary.
The 2006 Department of Defense Implementation Plan for Pandemic Influenza called for the military to be prepared to assist with dealing with lawlessness and societal stress:
- “State, tribal and local jurisdictions will be overwhelmed and unable to provide or ensure the provision of essential commodities and services.”
- “The provision of routine security services for the protection of critical infrastructure will require federal augmentation.”
With so many variables and so little data from past experience, there is no valid way to predict how people will react in a severe pandemic. The response to COVID-19 will provide many new lessons learned. Variables that have significant and uncontrollable impact include rumors and the way the media portrays events. Although government officials may feel uncomfortable or believe it is politically incorrect to write about and plan for the likelihood that a segment of the population will loot and kill, this kind of violence needs to be considered and planned for so it can be deterred and mitigated.
This article is Part 4 of a six-part series on closing disaster recovery gaps and preparing for triggering events that could cascade into long-term societal disruptions:
Triggered Collapse, Part 4: Cascading Consequences Beyond the Event
Triggered Collapse, Part 6: A Nationwide Call to Action