Unless you have been living in the woods under a rock, you have heard about the Ebola outbreak and the first person in America to die from the virus in Texas. I decided to write this article because I am a big believer in the old adage – “An ounce of prevention is worth a pound of cure.” I did not write this article to scare people; rather, I wrote it so that people will think about the possibility, and start to prepare and plan for it.
Since September 11, 2001, I have cautioned “JAILS” to be on the alert for people (being booked) who might have infectious or contagious diseases. Infectious and contagious diseases should be considered additional weapons in the terrorist arsenal.
When I work on emergency / contingency plans, the following quote from the 911Report resonates in my mind. “We were unprepared. We did not grasp the magnitude of a threat that had been gathering over a considerable period of time. As we detail in our report, this was a failure of policy, management, capability, and, above all, a failure of imagination.” [1] I am especially aware of this portion of the quote by Chairman Thomas Kean – “ above all, a failure of imagination.”
When your enemy does not fear dying or in some cases has a desire to die for their cause, anything is possible. Recruiting followers to be infected with the Ebola virus, or other contagious diseases, with the intention of infecting other people, is probable and, in my opinion, turning a disease into a weapon – “Bioterrorism”! Sheriff and jail administrators should use this time to insure that they and their facilities are prepared for this new type of terrorist threat.
Now is the time for jails to increase their intake and processing vigilance, to include but not be limited to the following:
- Keep strict adherence to following the “Universal Precautions”.
- Ask the detainees if they have been to any of the countries now experiencing the Ebola outbreak.
- Ask detainees if they have been sick recently and, if so, what type of illness did they experience? (Did they seek medical care?)
- Ask detainees if anyone that they have been in close contact with recently had been ill and, if so, what type of illness was it, and did they seek medical care?
- Ask the detainees if they have been in contact with any people who have been in countries experiencing the Ebola outbreak
- Take the temperature of all incoming detainees.
- Observe detainees for symptoms of Ebola.
- Insure that the booking area and holding area cells are kept clean and disinfected, at a minimum once a shift, if possible.
Symptoms of Ebola include
- Fever (greater than 38.6°C or 101.5°F)
- Severe headache
- Muscle pain
- Weakness
- Diarrhea
- Vomiting
- Abdominal (stomach) pain
- Unexplained hemorrhage (bleeding or bruising)
Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola,
but the average is 8 to 10 days. [2]
It is believed that for people to become infected, they have to have direct contact with body fluids from a person who is “contagious”. If terrorists were going to use Ebola as a weapon, they would certainly devise methods for engaging in direct contact, especially in a correctional setting. For example:
- Spitting in the eyes of correctional personnel.
- Entering into a physical confrontation with correctional personnel and biting them.
- Throwing urine or feces in the faces of correctional personnel.
(Years ago when HIV/Aids was rampant, these and other methods were used by inmates who were trying to infect correctional personnel.)
Correctional staff should adhere to strict “Universal Precautions” and wash their hands often during their shift. They should CHANGE THEIR PROTECTIVE GLOVES AFTER TOUCHING EACH DETAINEE. So often I have seen officers shake down detainees/inmates with the same pair of gloves, going from one inmate to another. Additionally, I have seen them wipe their eyes or foreheads. BE CAREFUL! (A doctor in Madrid says the Spanish nurse infected with Ebola remembers touching her face with her gloves after treating a dying priest.) [3]
I have believed, since the attacks on 911, that if terrorists wanted to use a biological attack to spread terror in the Unites States, they could and would use jails. My rationale for this is as follows. Before anyone could identify the initial source, hundreds, perhaps thousands of people, would have been exposed to the disease, and large numbers could be infected, thereby, possibly infecting other people with whom they came in contact. For example, think of how fast head lice and scabies spread through a jail because of the close contact among the detainees, as well as the poor personal hygiene of many of the detainees/inmates.
Scenario
Contagious person(s) are arrested and brought into the booking area on a busy Thursday, Friday, or Saturday night. The person is held in jail until Monday, (depending on the jurisdiction) thereby exposing and potentially infecting everyone he/she comes in contact with during their stay – staff, other detainees, inmates, and perhaps some religious and/or volunteers.
On Monday, the contagious detainee(s) are loaded into a transportation van and moved to the courtroom (again depending upon the location). If it is a courtroom arraignment, even more people could be exposed. Whether, in a courtroom or through video arraignment, the contagious detainee(s) are either held or released. Regardless of the outcomes of the arraignment processes, the potential for a great number of people to be exposed has existed.
The cycle could look like this:
One contagious detainee + arresting officer(s) + booking staff (3 officers) + 10 detainees + transportation officers(s) + courtroom personnel (2 officers) + appointed attorney + remanded to jail or released. Now, several people have been exposed to the disease.
Some other conditions that should be taken into consideration when analyzing why jails may be a prime target for this type of “Bio-Terrorist” attack are that so many of the detainees/inmates:
- Are homeless, which can make it difficult to find them upon their release, in order to ascertain if they have been infected.
- Already have “compromised” immune systems.
- The symptoms of Ebola or other contagious diseases may be masked because of already preexisting medical conditions that detainees and inmates manifest.
- Have additional issues and unconventional lifestyles (Sharing of hypodermic needles, drinking from the same bottles, sexual activity, hygiene, etc.)
Lastly, most jails have quick turnover of detainees, which ensures the terrorists that there will be a constant opportunity for exposing the general populace. Jails are an integral part of the “Government”, and when the source gets traced back to jails, the people could start to lose faith in their government. So, the bad guys win on two levels:
- They manage to expose/infect a great many people to/with Ebola.
- They cause the general public to lose faith in their government.
In both cases they create “terror”.
Being Prepared for the Worst
Some suggestions for what should be part of the facility’s planning process:
Develop policies and procedures for the following concerns:
The securing of the facility at the first suspicion that a detainee(s) is exhibiting the symptoms of the disease.
- No one comes in and no one leaves the facility; the building is secured.
- Public safety and health agencies are notified “IMMEDIATELY”!
- External law enforcement personnel establish a perimeter around the facility.
- External law enforcement personnel identify a “Press Assembly” area and direct all press personnel to that area with instructions that they are “not to leave the Press Area”.
- Follow any directive given to the facility by the local Health Department and/or CDC.
- Shut off all detainee/inmate external telephones temporarily. (This is done so that external law enforcement will have an opportunity to establish an external perimeter. Once the external perimeter is established, then the detainee/inmate telephones can be turned on so that detainees/inmates can communicate with their families, etc.)
- Ascertain all visitors, staff and/or volunteers who “may” have had any contact with the detainee/inmate and compile a list to be given to appropriate agencies.
Develop a “CLOSE” working relationship with the local Board of Health. (In my 40 plus years in the field of criminal justice, I have found that very often the correctional facilities are not on other agencies’ radar screens, so they have to make their presence known.)
There should be a procedure in place for correctional personnel to communicate with their families, etc.
There should be a plan to operate the facility with “ONLY” the personnel who are quarantined within the facility, until other arrangements can be made.
Identify the number of Hazmat suits and where the facility would get them. Total Hazmat precautions must be part of this plan. This means anything coming in and anything going out, to include trash.
Train and practice operating the facility wearing the Hazmat Suits.
REMEMBER, IF THIS IS IN FACT A TERRORIST PLANNED EXPOSURE, THE PLAN COULD ALSO INCLUDE ATTEMPTING TO DISRUPT THE ORDERLY OPERATIONS OF THE FACILITY – SO SECURITY PERSONNEL NEED TO BE PREPARED FOR THAT EVENTUALITY.
Summary
As I mentioned at the beginning of this article, I decided to write it because I am a big believer in the old saying – “An ounce of prevention is worth a pound of cure.” I did not write this article to scare people; rather, I wrote it so that criminal justice professionals will start planning and prepare for the possibility of either detainees or visitors seeking to infect people with Ebola or other infectious /contagious diseases simply to provoke terror, and to disrupt the orderly operations of jails throughout the country.
All of us live in a far different world since September 11, 2001, but as long as we are prepared for eventualities, we should be OK.
BREAK NEWS! A nurse who cared for the man who died from Ebola has proven positive for the virus, “In the first case of Ebola transmission in the United States, a Texas nurse who treated an Ebola-stricken Liberian man has tested positive for the deadly virus. The diagnosis was confirmed Sunday by the Centers for Disease Control and Prevention, four days after the death of Ebola patient Thomas Eric Duncan in Dallas.” [4]
One last thought – if you think that this article may have caused some terrorist groups to consider using this tactic you are wrong, because in all probability they already have thought of it!
[1] 911 Report
[2] http://www.cdc.gov/vhf/ebola/symptoms/
[3] http://www.bbc.com/news/world-europe-29539444
[4] http://www.washingtonpost.com/news/post-nation/wp/2014/10/12/dallas-health-care-worker-who-treated-thomas-eric-duncan-has-tested-positive-for-ebola/?tid=pm_national_pop