Flashback: 1998 Smallpox “War Games”

A 1998 article published in The Guardian, described a secret meeting of US Federal agencies in March of that year to play out what would happen if terrorists attacked the United States with a hybrid smallpox virus for which there was no cure. 

This article from 1998 caught our attention as it all seems eerily familiar to what we have learned over the past two years regarding pandemic scenarios and the actors involved.

The 1998 exercise underlined the need for a sweeping plan that President Clinton was to approve that week. Clinton’s interest in germ warfare was deepened by books and there was one in particular that alarmed him: The Cobra Event by Richard Preston.

The Guardian’s article noted that an expert on genetic engineering, William Haseltine, said that any trained molecular virologist could create such a virus in a laboratory.

1998 was a troublesome year for Bill Clinton. In January 1998, allegedly under the recommendation of the president, Monica Lewinsky filed an affidavit in which she denied ever having had a sexual relationship with him. Within weeks, Lewinsky was taken by FBI agents and U.S. attorneys to a hotel room where she was questioned and offered immunity if she cooperated with the prosecution. A few days later, the story broke, and Clinton publicly denied the allegations, saying, “I did not have sexual relations with that woman, Ms. Lewinsky.”

Problems were brewing in Iraq. In his 1998 State of the Union Address, Clinton warned Congress that Iraqi dictator Saddam Hussein was building an arsenal of chemical, biological and nuclear weapons.  The administration was battling with al-Qaeda.   In August 1998, Clinton ordered cruise missile strikes on targets in Afghanistan and Sudan, targeting the Al-Shifa pharmaceutical factory in Sudan, which was suspected of assisting Osama bin Laden in making chemical weapons.

Preston is still writing books about viral outbreaks. In his latest book, published in 2019, he makes clear that the Ebola outbreak of 2013 and 2014 is a harbinger of further, more severe outbreaks, and of emerging viruses heretofore unimagined in any country, on any continent.

Haseltine has recently written an article on the current pox outbreak. Although we do not cover Haseltine’s recent article here you may be interested to read it to get a feel for his stance as it is now and possibly was back then.

“Poxviruses are back, and it is no surprise,” Heseltine wrote last week. “Climate change and increased globalisation have enabled viruses to mutate and spread at unprecedented rates … Reinstate smallpox vaccinations to target emerging poxvirus strains.”

War games show up germ defences

Clipped from The Guardian, 28 April 1998

One day last month, 40 officials from more than a dozen US federal agencies met secretly in Washington to play out what would happen if terrorists attacked the United States with a devastating new type of germ weapon. The results were not encouraging.

In the scenario, terrorists spread a virus along the Mexican-American border. After doctors diagnosed the epidemic as smallpox vaccines were rushed in to immunise the population, but the virus turned out to be a hybrid for which there was no cure.

As the scenario unfolded, officials playing the role of state and local officials were quickly overwhelmed by a panicked population, thousands of whom were dying, and discovered huge gaps in logistics, legal authority and medical care.

The outcome of the exercise surprised some participants but illustrated what others had long suspected the US, despite huge investments of time, money and effort in recent years, is still unprepared to respond to biological weapons. The exercise, officials said, also underlined the need for a sweeping plan that President Clinton is expected to approve this week.

Mr Clinton’s interest in germ warfare has been deepened by books, aides said. He was so alarmed by one a novel by Richard Preston titled The Cobra Event, which portrays a lone terrorist’s attack on New York City with a genetically engineered virus that he instructed intelligence experts to evaluate its credibility. Experts tend to disagree on the plausibility of such high-technology threats. But most agree that the danger will grow and that such an attack, if successful, could be catastrophic.

Apprehension about germ warfare grew in 1995 as Iraq admitted that it had built a large biological arsenal and was prepared to use it during the Gulf war in 1991. The General Accounting Office, in a report in December, criticised the government for a serious lack of coordination in efforts to counter the terrorist threat. The US government concedes at least some of its failings. According to a draft of an interagency study, government counter-terrorism programmes suffer from a lack of intelligence-sharing and a lack of information about what individual terrorists or groups may be plotting.

William Haseltine, an expert on genetic engineering whom the White House asked to review the scenario, said that it was realistic. “You could make such a virus today,” he said. “Any trained molecular virologist with a really good lab can do it.”

Administration officials said the scenario was intended to inflict a substantial disaster to put strain on the system and reveal any weaknesses.

Among the shortcomings, officials said, were that in such emergencies, hospitals would quickly exhaust supplies of antibiotics and vaccines. One participant said that it was very difficult “to get trained, immunised medical staff into an infected area”.

Washington may now create a national stockpile of vaccines. antibiotics and antidotes.

The smallpox scenario

We were unable to find details online of the smallpox “war games” held in secrecy in 1998, nor were we able to find details of Heseltine’s review of that scenario.  However, in August 1999 Tara O’Toole of Johns Hopkins School of Public Health wrote a smallpox attack scenario.  She began:

Smallpox virus, which is among the most dangerous organisms that might be used by bioterrorists, is not widely available. The international black-market trade in weapons of mass destruction is probably the only means of acquiring the virus. Thus, only a terrorist supported by the resources of a rogue state would be able to procure and deploy smallpox.

The following scenario is intended to provoke thought and dialogue.

Centres for Disease Control and Prevention: Smallpox: An Attack Scenario, August 1999

In the scenario conclusions O’Toole noted:

Tourist trade, a major source of state income, is at a standstill. Many small businesses in the city have failed because suppliers and customers are reluctant to visit the area. Attendance at theatres and sports events is down markedly. In several states, public schools are dismissed 1 month early, in part because parents, fearful of contagion, are keeping their children home, and partly because teachers are refusing to come to work. Across the country, people refuse to serve on juries or attend public meetings for fear of contracting smallpox. In hospitals and HMOs where staff have not been vaccinated, healthcare personnel have staged protests, and some have walked off the job.

Smallpox continues to spread in many parts of the world, echoing its formerly endemic character. Without a vaccine, the only control method is isolation, which hinders, but cannot halt, the spread of the disease. By year’s end, endemic smallpox is re-established in 14 countries. The World Health Assembly schedules a debate on re-enacting a global smallpox eradication campaign.

Centres for Disease Control and Prevention: Smallpox: An Attack Scenario, August 1999

Richard Preston ramping up the fear

In August 1999, Health Law & Policy Institute published an article which stated:

A rapidly growing body of research suggests that the danger of intentional release of the smallpox virus by various terrorist, or even governmental, organizations is increasing. A recent literature search revealed over 200 publications on related issues during the past two years. This topic was brought into sharper focus in a July article by Richard Preston (The New Yorker, July 12, 1999, pp. 44-61), the author who “popularised” the Ebola virus in his book The Hot Zone. [link included is our own]

In June, experts met in Atlanta to evaluate the possible threats from bioterrorism. Smallpox was unanimously determined to be the greatest threat to the U.S., followed by anthrax.

The growing menace of smallpox used as a weapon of terror confirms the necessity of keeping the virus for research and proceeding on development of a new vaccine and anti-viral drugs with all deliberate speed.

Smallpox and Bioterrorism: A Growing Threat, Health Law & Policy Institute, 3 August 1999