Dr. Ze'ev Rothstein, the Director of the sprawling Tel Hashomer Hospital (Sheba Medical Center) outside Tel Aviv, is exhibiting supreme confidence and calm as, in Bush-like fashion, he receives a smallpox vaccination in front of the rolling TV cameras and assures the public that "it didn't hurt at all."

Then, suddenly, all hell breaks loose. An air-raid siren sounds, an authoritative voice announces the code for an incoming missile, and a first-response team of doctors and nurses struggles to don its bulky protective suits and lumbers out to deal with the victims on the site of the hit, as a menacing cloud of gas swirls up around them. Minutes later, another team —in standard attire because they're working in-side a "sealed" emergency room, begins to address the gravest cases — administering antidotes, intubating the patients, hooking them up to computers, and trying to revive them with a range of methods and gadgets familiar to fans of "ER." In another section of the emergency room — this one set aside for the "moderately wounded" — a patient stumbles in on his own steam, covered with blood, shouting in panic, and shaking violently from the effects of nerve gas, for minutes on end, as the doctors and nurses work on him. And in a fourth room, a woman suffering from shock shouts hysterically over the fate of a loved one as a nurse struggles to calm her and keep her out of the way of the attending physicians.

Doctors in protective suits work on a 'victim' of a simulated bio-chemical attack in a training exercise at Sheba Medical Center-Tel Hashomer

If panic has settled in — a point vigorously contested by various professional observers, who say that the public mood is actually far calmer than it was 12 years ago — one reason may be that the government is giving out mixed messages. On the one hand, leading military officials, from the chief of staff down, have been assuring the public that the likelihood of a successful nonconventional missile strike is "very low." They note, for example, that unlike his threats to "burn" Israel, issued before the outbreak of hostilities in January 1991, Saddam Hussein has conspicuously refrained any from saber-rattling in Israel's direction this time round. Even were such a threat to slip out, Saddam's capability to carry through on it is far weaker than it was 12 years ago. At the same time, Israel's active-defense capability — meaning a combination of the already deployed Arrow anti-ballistic missile system and improved American-supplied Patriot missiles — has improved dramatically over the same period. It has also been widely reported that the United States has promised Israel that its army will give priority to taking control of western Iraq — whence any Scuds destined for Israel must be launched — in order to quickly dispel the missile threat.

On the other hand, the sporadic "be prepared" announcements, the stream of video clips, and occasionally contradictory voices — such as a leaked statement by Defense Minister Shaul Mofaz that the probability of a chemical or biological warhead falling on Israel is "not at all low" — are definitely fomenting war jitters.

	IDF rescue unit soldiers at the site of a Scud hit enactment

More good news is that the Iraqi detonators known to the previous generation of inspection "are very primitive," in Baram's words, and explode only on impact rather than over the target — making their dissemination of chemical or biological agents very limited. What's more, he explains, biological warheads are likely to be totally ineffective "because the heat generated by the impact of a missile falling from the height of 100 kilometers is so great that it will kill most, if not all, of the germs." Even the specter of a "dirty war-head," combining explosives with radioactive materials — which the Iraqis are known to have — will not endanger the population at large. "Of course, if it falls directly on your house, you're in trouble," Baram qualifies. But barring such bad luck, at worst a "dirty warhead" will require the evacuation of a limited area for an extended period. "Unquestionably, this kind of weapon causes great financial damage," Baram concedes. "But with time and money, it's a problem that can be solved."

Equally menacing is the prospect that Iraqi warplanes — of which Saddam is known to have 50 — will drop nonconventional bombs on Israeli population centers or spray nonconventional agents into the air. Here too the official assessment of probability is "extremely low," and Baram explains why. "Iraqi pilots are not kamikazes," he pronounces. "If they receive an order to bomb Israel, they probably won't carry it out, because they know they'll be shot down. They will probably take off, especially if they or their families or threatened by the regime," he posits, "but then bail out somewhere over Jordan and let the plane crash where it may." Given the advantages of spy-satellite technology and AWACs planes, even low-flying Iraqi aircraft can be detected — and intercepted — long before they even approach Israeli airspace. "So I'd place the odds of an Iraqi plane ever reaching an Israeli city at 1,000:1," Baram ventures, "especially as Jordan shares an interest in having such planes downed as close to Iraqi territory as possible." And using drones to carry nonconventional agents is an even less promising method for Iraq, "as they're very difficult to maneuver," Baram ex-plains, especially if topographical obstacles like mountains get in the way.

All of this leads Baram, for one, to conclude that the greatest nonconventional danger posed to Israel is actually from an attack by local terrorists — be they agents of Hamas, the Islamic Jihad, Al-Qaeda, or of the three West Bank movements directly associated with Saddam Hussein. "If Saddam manages to provide his followers in the territories with chemical or biological agents, they'll do anything he asks of them," Baram warns. "Biological agents are more suited to this form of attack," he adds, since a single terrorist spreading them can do far more damage than any isolated chemical attack.

Yet even an isolated chemical-terror at-tack could wreak far more havoc than the worst Israel has experienced to date. Tel Aviv University chemistry professor Uzi Even, who became a Meretz Knesset member last November, calculates that the ex-tent of casualties from a chemical weapon wielded by a lone terrorist is ten times greater than the damage caused by the same quantity of explosives. "If we're talking about 10 kilograms [22 pounds] of explosives being able to kill around 20 people in the terrorist's immediate vicinity," he says, "10 kilos of a chemical agent will kill 200." And even if Israelis were to start carrying atropine injections around with them, the nerve gases believed to be in Saddam's arsenal act so quickly that those exposed to a concentrated, massive dose of any one of them "will die before they even understand what's happened," Even explains.

The best way to ensure that neither chemical nor biological agents reach prospective terrorists in the territories, Baram proposes, is to "immediately close all the bridges over the Jordan, or at least thoroughly check every person coming in through them, right down to his after-shave lotion — especially his after-shave." Israel, he adds, should also employ all its intelligence capabilities to ascertain whether biological agents have already arrived in the territories." Till now, he adds in a reassuring tone, "my assessment is that nothing has."
The validity of this assessment is bolstered by the fact that, toward the end of December, the government decided not to immediately inoculate the population at large against the most daunting biological threat: smallpox. (Seventeen thousand first-responders — police, rescue workers, and medical personnel — are already being vaccinated.) This decision was based, in part, on intelligence evaluations about the gravity of this threat. But the policy could change at a moment's notice. For it's not necessary for a terrorist to wield a spray can of smallpox virus to wreak general havoc; suffice it for a single "manicide" terrorist infected with the scourge to mix among the Israeli population. Smallpox is a highly contagious disease spread through the simplest of human contact — even merely breathing on people in one's vicinity.

There's no cure for smallpox, but its fatality rate was 30 percent a century ago, and modern medical techniques for keeping patients alive (such as respirators) can be expected to lower it. Fortunately, explains Tel Aviv University Medical School Professor Yehuda Danon, an adviser to the government on viral warfare, a person still incubating the virus, which goes on for a 3-4 day period, is not contagious. "He can only infect others after a rash appears," Danon explains. So while it is almost impossible to detect a Typhoid-Mary-like carrier, it's easy to identify him as soon as he exhibits a rash. And once the first case of smallpox is detected — anywhere in the world — Israel will actually be in a better position than most countries, since it will be able to vaccinate its entire population in a matter of days.

Of course, even if none these nonconventional scenarios are played out, Israel is not necessarily out of the woods. There's always the chance — especially if the American operation in Iraq drags out over months, say Israeli strategic experts — that Hizballah will open a "second front" by attacking Israel with its hundreds of Iranian-supplied missiles capable of reaching as far south as Haifa. Recent reports have it that Syria has been accelerating its own arms shipments to Hizballah. Worse yet, a recent powerful explosion at a Hizballah base in Lebanon's Biqa Valley has been attributed to weapons — perhaps even medium-range missiles — smuggled to the organization from Iraq. So far, there is no reason to believe that Hizballah has been supplied with chemical or biological warheads for these missiles. But the picture remains fuzzy. Prime Minister Ariel Sharon recently claimed that Iraq has transferred some of its weapons of mass destruction to Syria, to hide them from the prying eyes of U.N. inspectors. Damascus, moreover, has weapons of mass destruction of its own that it could, theoretically, supply to its Lebanese proxy.

All of this renders Hizballah a wild card in the looming war on Iraq. Still, strategic analysts say that Israel's deterrent posture vis-à-vis Hizballah is actually stronger than any other prospective actor in the looming war. Some even believe that while attention is focused on the U.S.-led operation in Iraq, Israel may act (certainly if it is attacked) to destroy the organization and its infrastructure in Lebanon. But the best way of keeping Hizballah out of the fray, the analysts agree, is for the United States to do some diplomatic arm twisting in Damascus and Beirut and prevail upon these two governments to curb Hizballah's actions — lest they too be included in the "axis of evil" on America's ultimate list of targets.

While the Home Front Command (HFC) has been working hard to assure Israelis that they will be properly protected against worst-case scenarios, it has been plagued by a spate of press exposés, based on information leaked from both the defense and health ministries. One has claimed that 30 percent of the country's citizens do not have suitable gas masks — which come in only one "adult" size and therefore, it was charged, do not properly fit teenagers and women. Another particularly detailed report charged that the country's store of smallpox vaccine is actually a danger to public health, as it has not been produced under sterile conditions and may even be contaminated with cholera and plague bacteria.

Prof. Even is also troubled by the fact that all his requests (in his capacity as a member of the Knesset well versed in chemical-warfare issues) to clarify various questions have been summarily rebuffed by the HFC, the chief of staff, and the defense minister. He is concerned, for example, that the material used to cleanse an area after a chemical attack — a foam made from a substance resembling bleach that's sprayed from a ground vehicle resembling a fire engine — can't reach the chemical agents in liquid form that have settled on rooftops, trees, electricity and telephone polls, so that some system must be developed for spraying this foam from the air. But he particularly frets over whether Israel is well equipped to identify the exact nature of chemical payload, which, he says, is likely to contain a combination or "cocktail" of chemical agents."

The equipment we have can identify the presence of a chemical agent in the area of a missile hit but not the exact nature of that agent," he says. "That analysis must be done by taking a sample to a laboratory, and the labs outfitted for this purpose are all situated in the same region of the country." This means it will be necessary to keep at least part of the population in its shelters or "sealed room" for hours — especially if the attack occurs in an outlying area — while the lab tests are being done. Aggravating this problem is the reported assessment by Defense Ministry chemical-protection expert Esther Krasner that if held in a 5-square-meter sealed room for two hours, a family of four runs the risk of being suffocated.

In addressing the safety of the smallpox vaccine, Israel's medical community has come vocally to the Health Ministry's defense. Professor Danon, for one, was quick to take to the airwaves and pronounce the Israeli-produced vaccine "effective, sterile and safe." And echoing that message, Tel Hashomer's Dr. Rothstein told The Report: "If that weren't so, I would hardly have myself vaccinated here right before your eyes." Rothstein went a step further in explaining that the whole uproar was precipitated by a disgruntled Health Ministry official in "revenge" for her dismissal.

The HFC similarly downplays the criticism of the gas masks as being motivated by commercial interests (namely, a desire to introduce a more advanced Israeli developed mask, dubbed "Sapphire" into production and distribution). All in all, Col. Gidi Shenhar, a senior HFC officer, has characterized the standard gas masks as "high quality." In talking to The Report, he also stressed that the public's level of protection cannot be judged on the basis of any one element, as it is a "package" comprised of the "protection kits" and the" protected areas," in which Israel has made great strides over the last decade with the addition (by law) of reinforced-concrete, hermetically sealed shelters within every Israeli apartment constructed over the last decade. "When you look at the whole picture — including the means of protection, our very advance detection devices for identifying materials precisely and quickly, cleansing measures, and Israel's medical capabilities — we're talking about a substantial improvement over the situation in1991," he says.

Public reaction to the charges raised by the two press exposés has been surprisingly muted. The Knesset is not in session (its members are out campaigning for the upcoming election), and not a single political figure has called for an investigation into the these alleged failings. On the contrary, Labor Party chairman Amram Mitzna has actually charged that the government's spotlighting the dangers of the looming war — despite the low probability that Israel will be attacked — is essentially a "cynical" election gimmick designed to deflect attention from the ever-spreading Likud corruption scandal. If so, that tactic hasn't -succeeded, as the investigation of hanky-panky continues to dominate the headlines, and the latest polls show the Likud's electoral strength continuing to drop. At any rate, say seasoned political observers, sooner or later the dangers posed by a war against Iraq would have focused attention on this prime security issue for Israelis, even if the prime minister had not shown up for a photo-op at a civil-defense drill. "The possibility of war is not a fraud perpetrated on the public; it's a fact of life that naturally arouses anxiety here," says Tel Aviv University sociologist Professor Daniel Bar-Tal. "It also naturally plays into the hands of the incumbent government, because people are not interested in changing their national leadership on the eve of a war." Endorsing that analysis, Bar-Ilan political scientist Professor Shmuel Sandler takes it a step further in mooting that the shadow of a looming war will probably not have a major impact on the contest between the country's two major parties. "Even those who are abandoning the Likud because of the corruption scandal are not moving over to Labor," he notes, "and that's because Labor is no longer identified with 'security' — as it was for so many years — and voters still blame it for Oslo." If Labor's electoral standing is harmed by the prospect of a war in the region close to Election Day, he adds, it has only itself to blame. "Labor knew that January would be a decisive month, so it was stupid to allow the elections to be scheduled for that time," Sandler says bluntly. "You can't even say that former party chairman Binyamin Ben-Eliezer shot himself in the foot when he brought the government down. The party forced him to do that, knowing full well that instead of having their chairman heading the Ministry of Defense in wartime, he would be reduced to serving as a commentator on the radio."

With any luck, though, Israel will not find itself in need of expert commentary, if and when the American offensive begins. Then again, there's always the darker, pessimists' view: that the elections will not be held on the appointed date, because Israelis will be hunkered down in their shelters, hoping to be spared the worst.

Copyright © The Jerusalem Report 1999-2001

Sheba Medical Center-Tel Hashomer is the largest and most comprehensive hospital and research facility in Israel, and the entire Middle East. The Center's 150-acre campus on the outskirts of Tel Aviv has 1,900 beds and serves over 800,000 patients annually from Israel and neighboring countries, including civilians, soldiers and visitors. Sheba is the teaching facility for The Sackler School of Medicine at Tel Aviv University and conducts clinical trials and research with the Weizmann Institute of Science. For over 50 years, Sheba's core philosophy remains unchanged: to extend the finest medical treatment, rehabilitation, and compassionate care to all our patients, regardless of race, religion or nationality.