Jerry Hauer: Ready to cope with attack

In recent years one major city in the West took that remote possibility seriously enough to invest considerable money, and energy into developing some kind of defence against the almost indefensible - New York.

New York's team was led by Jerry Hauer for six years. He says, "You get yourself ready for it in an organised fashion, and whether it happens next week or in five years, you have the same level or preparedness."

4.000 members of New York's police, fire and emergency units, and 1,500 doctors and nurses have undergone military-style training in how to deal with biological attacks.

Underground attack

The most vulnerable location in any city is the underground with its swirling currents ideal for disseminating airborne anthrax spores or bacteria.

Mr Hauer needed to know what happened when germs were released inside the system. The military obligingly war-gamed it for New York.

Now some major American cities are placing biological sensors at strategic positions inside the underground system to help warn of an attack.

But the real and virtually insoluble nightmare of a biological attack is no-one will know until its too late. Hauer says, "Somebody will release an agent in a building, in a subway, in a sports venue and we won't know about it until people start becoming sick, and it'll be two to three days before that occurs."

Putting in place a public health system that really enables rapid detection is key to our ability

Peggy Hamburg

The Americans under a Federal agency have carefully pre-positioned a series of cargo containers called push-packs in several strategic positions around the continent. They are filled with all the drugs and medical equipment necessary for a major biological or chemical attack.

The ex-Commissioner of Public Health in New York, Peggy Hamburg, says, "The key to preserving lives and reducing the overall human and economic cost of such an attack will be rapid recognition of what's going on and mobilisation of response, and that's why putting in place a public health system that really enables rapid detection is key to our ability."

Panic

There is a fundamental problem with not only the use, but also the thought of the use of biological weapons. It takes very little reality to create an inordinate amount of panic.

Peggy Hamburg: Need to talk about threat

Dr Hamburg says, "We tend to talk about the worst case scenarios where hundreds of thousands or even millions of people might be exposed to an infectious agent, but we also have to recognise that most likely it will be a much less sophisticated attack but still very significant both in terms of the disease and potential death it may cause, but equally importantly the panic that it will cause."

New Yorkers still reeling from the horrors of September 11th could be forgiven for taking badly the news that such American icons as Tom Brokaw of NBC News and Dan Rather of CBS had received anthrax letters. The demand for antibiotics increased tenfold.

It may not be polite to discuss it openly but some believe it is vital that the public appreciate the serious implications of a large attack.

Dr Hamburg says, "I think it is a frightening topic, the prospect of the intentional use of a biological agent to cause panic, disruption, disease and death is scary, there's no doubt about it, but I think we need to talk about it because we need to prepare."

The horrors of September 11th tested New York's emergency management systems to the full and showed how the city could cope with crisis.

The question remains as to how other major cities would cope with the threat of biological attack.