
The explosions are deafening. They occur in quick succession two minutes after midnight, awaking the citizens of Indianapolis and Raleigh-Durham in the vicinity of both factories. When first responders arrive at both locations, they find the team of security guards dead, shot execution-style outside the entrances to each factory.
It is not a conflagration. It is later learned that the ammonium nitrate bombs were delivered aboard five U-Haul trucks at each location and driven into the corners and center of the factories, and detonated simultaneously. The effect of the combined placement and composition of the devices is devastating—both factories implode, causing the roof of each building to collapse onto the specialized machinery and sensitive equipment used to manufacture insulin: nozzle and plate separators, fill and finish lines, fermentation vessels, bulk media vessels, storage tanks, refolding suites and downstream processing facilities, filtration suites machinery, clean-in-place facilities, cooling/refrigeration plants, high performance liquid chromatography (HPLC) columns, high capacity water purification plants, ozone generators for sterilization, laboratories and insulin stockpiles.
All are destroyed—damaged beyond repair. It takes some time for the extent and scope of the destruction, and too, the long-term implications to be fully realized. There are only two insulin production factories in the United States. Both of them are now destroyed.
It takes two weeks for the supply of insulin already at hospitals, local pharmacies and in the national pharmaceutical stockpile to be depleted. Because insulin is required to be refrigerated, maintaining large stockpiles of insulin in a centralized location is nearly impossible. By the next day, it becomes clear in hospitals around the country that widespread "just-in-time" business practices (reducing inventory stockpiles and delivering products as they’re needed) has further limited the availability of insulin for diabetics.
The National Coordinator for Counterterrorism recalls that indicators emerged at least a year ago of a plan to attack the insulin production plants: an inordinately high volume of internet searches relating to U.S.-based insulin production factories on Google and Yahoo were detected from a known IP located at a madrassa in Peshawar, Pakistan. An Al Qaida notebook discovered in a terrorist training camp had also been found, listing both U.S. and European insulin production plans:
Penza, in the Volga region of Russia.
Tianjin, China.
Aventis Recombinant Insulin Plant, Frankfurt, Germany.
Novo Nordisk factory in Clayton, North Carolina
Novo Nordisk Insulin Bulk Plant, Kalundborg, Sweden

NSA signals intelligence intercepts of encoded digital cell phone conversations in Islamabad six months prior to the attacks pointed to two separate groups of men and women seeking student visas for attendance at the University of Indiana and University of North Carolina. UNC reported to the NC Bureau of Investigation two months prior to the attacks that a group of international students from Pakistan had enrolled, but never attended classes. In Valparaiso, Indiana, a local police investigation was initiated after a farm CoOp reported a warehouse break-in and the theft of an estimated five hundred 50lb sacks of fertilizer. A large automobile dealership along Route 1 in Raleigh, NC reported the theft of nine 50 gallon barrels of waste oil from their premises. In Indianapolis, a U-Haul center reported that five U-Haul trucks had been rented by a group of students of "Middle Eastern origin." Two days prior, one of the Pakistani "students" was issued a ticket for illegal parking on a main thoroughfare in Triangle Research Park, directly across from the insulin production plant. After the attacks, tour logs from both facilities indicated that tours were attended by five to eight Pakistani nationals on student visas.
In some cases, positive actions were taken to investigate and warn the public of a possible terror threat. In a daily secure video teleconference a week prior to the attacks, National Counterterrorism Center (NCTC) and DHS incident management officials requested that the FBI investigate the "lost" Pakistani students. A retired former high-level FBI official made a personal call to the Director of the FBI to express his concern after hearing about the Pakistani students from a former colleague, and reading about the mass thefts of oil and fertilizer in Indiana and North Carolina two days apart in USA Today. When he felt the call was politely listened to, but largely ignored, he appeared on a local Delaware news station summarizing his concern and outrage at the FBI's unwillingness to take the emerging and imminent (yet unspecified) threat seriously. Given his widely-known reputation and media contacts, national media quickly arranged for him to participate in broadcast and print interviews following the attacks.
In response, DHS denied that it ignored the threat and responded by raising the threat level to red or "severe" at all stand-alone government buildings and major financial institutions across the nation. Notices are immediately sent out to other insulin production plants abroad advising them of the threat.
In a press conference a day and a half after the attacks, the Attorney General releases the names and photographs of the Pakistani "students," identifying them as terrorist suspects.
The President declares the situation an “Incident of National Significance.” In the wake of the attacks, hospitals quickly become overwhelmed with patients of all ages with Type 1 and 2 Diabetes, all suffering the emerging onset of insulin shock, many from extreme anxiety. The official national commission appointed to investigate the terror attacks on the U.S. insulin production plants ultimately concludes that the insulin plants are not included in national vulnerability analyses and that a host of intelligence and public warning failures have contributed to the inability of the federal and state authorities to preempt the attacks and mitigate their devastating effects to an entire disabled population.
Fortunately, this is a fictional scenario. And fortunately, scenario-based interagency drills that assume national strategic vulnerabilities, and that work “in reverse” to identify problems and apply broad interagency and intergovernmental strategies to address them are standard procedure with each of the States. Nonetheless, the strategic vulnerability described above does exist, and the gaps in public warning that could prevent such an attack persist. Scenarios such as the insulin production plant attack serve an important primary purpose: linking vulnerabilities—known and unknown—to strategic solutions. Once a threat to our national infrastructure is even remotely detected, a strategy to meet that threat is required. Templated or passive strategies are insufficient when we face terrorist threats because the adversary is capable of deliberate, strategic thought.
To be effective, warnings should be oriented toward the people and sectors of society that are actually at risk, and must include the first responders and officials charged with preventing, responding to and mitigating damage and loss of life. To this end, the Lexington Warning was focused first on the revolutionary movement’s “center of gravity,” the political leadership of Sam Adams and John Hancock. The secondary focus was the militia and their ability to defend the revolution by force, if necessary.