Talk:Alleged Chemical Attack, August 2, 2016

Clinical Signs
Videos/photos:
 * https://www.youtube.com/watch?v=A_zlUzpLJrs

To do: review this and other material, make notes, plug these into this table from the Alleged Chlorine Attack Checklist page. --Caustic Logic (talk) 08:47, 15 September 2016 (UTC)

Clinical Signs
Other than the one photo, which is very valuable, there's not much (visual) to go on for a table here. There's a bit of footage run by RT, which I hear was filmed by ANNA News. And there's what was reported. So okay, a table. --Caustic Logic (talk) 08:47, 15 September 2016 (UTC)

Video and Photos:
 * https://www.youtube.com/watch?v=hwD1ltIJklI (ANNA News)
 * https://www.youtube.com/watch?v=eJncYIr-TSg (RT broadcast)
 * firefighter photo
 * Another photo (forthcoming)

Russian Warning?

 * Syria Analysis: Russia’s Propaganda Over “Rebel Chemical Attack” in Aleppo. Lucas starts out certain the Russian-Syrian claim of a chlorine attack must be false, possibly lodged to distract from the government's genuine use of chlorine the same day. Lucas notes in support:
 * However, the Russians made a critical mistake in their presentation:


 * "Moscow informed Washington of the use of toxic shells on Monday, Lieutenant-General Sergey Chvarkov, head of the Russian Reconciliation Center in Syria, said."


 * Syrian State news agency SANA indicated — and Russian State outlet RT’s story repeats — that the toxic attacks occurred on Tuesday, as part of “terrorist” shelling that killed seven people and wounded 25.


 * The difference in dates raises the question of how Russia could have told Washington about a chemical attack that had not yet occurred.

Sometime that's what's called a "warning." As Press TV decided, reasonably enough, Russia says warned US before Aleppo toxic attack by militants
 * Moscow says it had warned Washington about the use of toxic shells by a US-backed “moderate” militant group before the Tuesday attack that killed seven people and injured over 20 more in Syria’s Aleppo.
 * On Wednesday, Lieutenant-General Sergey Chvarkov, the director of the Russian Reconciliation Center in Syria, said the information was given to the US on Monday, a day prior to the attack.

However, "informed of the use" of weapons does sound, on the face of it, like a report on an event, not a warning of it. But of course language and translation issues might be involved.

Options:
 * Time zone issues seem unlikely; it seems the attack was at night, maybe early evening. This would be mid-morning the same day in Washington, not Monday "their time." If there was an attack on Salaheddin earlier, maybe a post-attack alert would arrive late on Monday...
 * It could be an honest goof-up in stating the day; said on Wednesday, he might mean that day, but got the day before Tuesday confused with a day after? Or, it felt like two days since yesterday, when he informed them, on Tuesday, just after the inicdent.
 * It could refer to a warning, maybe based on some kind of intelligence (observed movements of strange materials, etc.)
 * Maybe it's really what the Russians wrote out, in a "critical mistake" they never noticed - Russian propagandists tried to make sense, but simply didn't realize Monday is not Tuesday. --Caustic Logic (talk) 12:10, 15 September 2016 (UTC)


 * First reports came on this came on Tuesday Aug 2 (links here from that day). There was Russian MoD press conference on Aug 1, around 6 p.m.m, but nothing on chemical attacks said there (helicopter downing reported, and that a massive rebel attack near Ansar, south west of Aleppo, was repelled)   RT report may be goof-up made after the event (on Aug. 3). Do not see timely made report of the warning.  (There may be plenty of behind the scenes warnings based on received intelligence, but no reliable info is seen that the warning was made on this occasion) --Resup (talk) 13:09, 15 September 2016 (UTC)
 * Maybe it was a private warning, in which case we'd have no public record. Thanks for looking for one though, for good measure. I'll presume there wasn't one. --Caustic Logic (talk) 22:57, 15 September 2016 (UTC)

ANNA News Report
This deserves its own space for clue-mining. Full video, original posting: [https://www.youtube.com/watch?v=hwD1ltIJklI Срочно! Газовая атака боевиков в Алеппо 02.08.2016 г.] (Urgently! Terrorist gas attack in Aleppo 02.08.2016)

Notes, narration, and dialog: Description:
 * Today 02.08.2016. Old Aleppo was attacked with gas by terrorists. Toxic substances were used in the area of ​​Al-square Sahet Aumit. According to preliminary information strike came from the area of ​​Bab al-Hadibo. Where locates terroristic group Harakat Nour al-Din al-Zenki. Presumably mustard or nerve gas was used. At the moment, the number of deaths - up to 10 people, injured (poisoning) 20.
 * According to an eyewitness, the day before the terrorists dug tunnel towards government troops. The Syrian army has blown it. There are containers with toxic substances. One after another, killed 5 soldiers, who went down under the earth. Just got poisoning the rescuers who arrived at the gas attack.
 * Сегодня 02.08.2016 г. Старый Алеппо подвергся газовой атаке со стороны боевиков. Отравляющие вещества были применены в районе площади Сахет аль-Аумит. По предварительной информации удар был нанесен из района Баб аль-Хадиб. Где дислоцируется группировка Нириддин аз-Зинки. Предположительно был применен горчичный или нервнопаралитический газ. На данный момент количество погибших - до 10 человек, раненых (отравленых) около 20. 
 * По словам очевидца, со вчерашнего дня террористы копали тоннель в сторону правительственных войск. Сирийская армия его подорвала. Там находились емкости с отравляющими веществами. Один за другим погибли 5 бойцов, которые спустились под землею. Так же отравления получили спасатели, которые прибыли на место газовой атаки. 


 * eyewitness at 2:32-4:06, speaking in Arabic, and translated to Russian, to say (as translated to Russian): (after the Syrian army blown tunnel made by terrorists), we decided to check what was there underground. One Syrian soldier went down, and we realized that he died. Than, one after another, 4 of his comrades tried to take him out. All of them died as well, because they did not understand what was there underground. Than we called for emergency services, and special people were able to extract him. We understood that nerve gas containers are underground, because all muscles relaxed and people could not breathe. Emergency services had gas masks. But that gas affected through the skin too. Altogether, 5 people died in front one of my eyes. Among emergency services, there were some poisoned as well.
 * Noted: several casual words heard in Russian in hospital on the video, in addition to the Russian translation; vast majority is Arabic later translated to Russian:
 * 1:40-1:42 вези-вези-вези-...(repeated)! давай-давай-давай! (vezi, davai- repeated), approx. roll-roll-roll-...!, go-go-go!, exclamations urging to roll the cart quickly (same voice as translator?)
 * 1:57-2:00 double translation to Russian, brief broken Russian with many 'mgm' ('OK'), and a perfect, loud one (probably later voice-over)
 * 4:00 indistinct in the background, smth like и никак не спасти? если принудительную вентиляцию легких делать?. Translated: no way to save him? (What) if we do forced lung ventilation?(indistinct). All said quickly in the background and hard to pick up (had to listen many times to pick up; had trouble picking up the second sentence but now clear that this is what he says)  --Resup (talk) 14:33, 17 September 2016 (UTC)


 * Resup, hope you don't mind I put this here. Interesting additions there. Notes where they belong, I guess. --Caustic Logic (talk) 13:23, 17 September 2016 (UTC)

Time and Location: At the video's start is a good outdoors shot. It seems to be near sunset, with low sun on trees and distant buildings. I checked and sunset was at 19:35 that day in Aleppo. Russian sources say the attack was around 7:05 pm, and I estimate this as between 7:15-7:25.

The camera should be facing south-southeast (sunlight coming from w-nw, behind and to the right), looking across a walled park area of moderate size, apparently across from (south-southeast of) a hospital. There's a signs above the door at 1:03, digging for a translation.

The text adds the attacks was in "the area of ​​Al-square Sahet Aumit." Sahet = yard, Aumit must = Awameed, meaning pillars. This still doesn't help find it on Wikimpaia.

"According to preliminary information strike came from the area of ​​Bab al-Hadibo." The closest I can find to this in WM labels is Bab al-Hadid roundabout. This should be in the rebel-held strip within Old Aleppo, right between the government-held citadel and Hannano barracks. It would be a short range attack within the Old City, and apparently involved tunnels dug and chemicals there, besides the reported 7 shells. It's said that the Zenki group is based there. They've denied their guilt pointing out "the movement does not have long-range weaponry to attack regime positions located deep in western Aleppo." (via SNC)) --Caustic Logic (talk) 08:30, 17 September 2016 (UTC)

Nerve Agent?
Strangely, I see little sign (though some sign) of chlorine here, with this soldier and the few others seen looking more like victims of a nerve agent. ANNA adds: "Presumably mustard or nerve gas was used." Scratch mustard gas, but nerve maybe.
 * Also, a final death toll of 13 seemed high for dispersed chlorine. 4-5 deaths almost right away seemed high. I'm thinking these soldiers died from the nerve gas, and those who died later were mostly from chlorine. (it could well be both were used to confuse things, as was done in the Khan al-Assal attack) --Caustic Logic (talk) 13:28, 17 September 2016 (UTC)

No signs of mass vomiting, defecation, etc. as with sarin. But the first soldier's strange stiffness and wiggling is not a chlorine thing that I know of. He's got no redness, no coughing at the moment. And the balding man inside seems quite dazed with eyes not working right. Likewise, no redness or coughing.

Both the soldier and the balding man are seen vomiting later, but not earlier. The soldier might be cough-vomiting, and he's quite red. This could be delayed chlorine (but eye redness wouldn't wait, would it?) Or it could be from the water they poured into his face at the start of the video, and/or from medications given. --Caustic Logic (talk) 08:30, 17 September 2016 (UTC) Medications Used:
 * https://en.wikipedia.org/wiki/Sodium_lactate "It also can be given intravenously as a source of bicarbonate for preventing or controlling mild to moderate metabolic acidosis in patients with restricted oral intake (for sodium bicarbonate) whose oxidative processes are not seriously impaired." (might suggest chlorine, or that this is what they suspect - It turns to acid, might cause "acidosis")


 * https://en.wikipedia.org/wiki/Metronidazole - common general anti-germ medicine, unclear relevance, except that it often causes nausea and vomiting.

Hydrogen cyanide?
Apart from the vomiting, I don't see any signs of organophosphate (nerve agent) poisoning in this video: no miosis, urinary/fecal incontinence, muscle fasciculation, paralysis. The man in the blue T-shirt is able to wave his arms about, so not paralysed. But he seems to be unable to stand, and confused enough to struggle with his rescuers.

For people trapped in the confined space of a tunnel, almost any toxic gas / vapour / smoke might be lethal. But if there were fatalities among people in the open, the agent is likely to be something more toxic than chlorine. A possible agent is hydrogen cyanide: this causes metabolic acidosis, for which sodium lactate would be appropriate treatment. If it was cyanide, those heavily exposed in the tunnel would die in a few minutes, before reaching hospital. With a lower, non-lethal dose, symptoms of cyanide poisoning include:-

General weakness, malaise, and collapse, headache, vertigo, dizziness, giddiness, inebriation, confusion, abdominal pain, nausea, vomiting, shortness of breath, possibly associated with chest pain. Cyanide poisoning doesn't cause cyanosis because it blocks oxygen uptake by cells: victims remain pink but don't have the cherry-red colour of carbon monoxide poisoning.

The other two drugs shown - metronidazole and ranitidine- aren't likely to be used to treat suspected poisoning.

If the doctors were treating these victims with sodium lactate, it's likely that their working diagnosis was cyanide poisoning. There are many drugs and chemicals that cause metabolic acidosis, but cyanide is the only one likely to be used as a CW agent. Did any reports mention cyanide? Pmr9 (talk) 14:33, 17 September 2016 (UTC)


 * Excellent - could be a non-nerve agent that affects the nerves and cyanide sounds plausible (The Wikipedia page agrees - I didn't know it was a basis of Zyklon B). The disorientation to me doesn't seem great, just hard time moving. The struggle seems justified - some asshole poured water right in his face, so he flips over (not very well) to not drown. --Caustic Logic (talk) 00:28, 18 September 2016 (UTC)

New report from Vanessa Beeley hears 20 soldiers died in the tunnel, besides 3 rescuers (RSCD) and at least 4 women residents. Unclear if that's all correct and how it squares with the prior reports of 13 killed, mostly civilians. It still seems to be two incidents, a tunnel one and later a possible rocket attack, sounding here more like the same poison in both cases, and no chlorine involved. (needs review). Anyway, through at least 2 interviews, some details added, all seeming to me in line with a call of Hydrogen cyanide or similar.

Cyanide poisoning: Early symptoms include headache, dizziness, fast heart rate, shortness of breath, and vomiting.[2] This may then be followed by seizures, slow heart rate, low blood pressure, loss of consciousness, and cardiac arrest.[2] Onset of symptoms is usually within a few minutes.[2][3] ...

If cyanide is inhaled it can cause a coma with seizures, apnea, and cardiac arrest, with death following in a matter of seconds. At lower doses, loss of consciousness may be preceded by general weakness, giddiness, headaches, vertigo, confusion, and perceived difficulty in breathing. At the first stages of unconsciousness, breathing is often sufficient or even rapid, although the state of the person progresses towards a deep coma, sometimes accompanied by pulmonary edema, and finally cardiac arrest.

"One of my crew radioed me that he couldn't feel his limbs."

“I entered the tunnel and immediately began to feel strange. My whole body seemed to lose control. I couldn't breathe. I pulled on the rope."

"Other crew members and civilians reported symptoms of gas poisoning, such as dizziness, nausea, burns, spasms, and difficulty breathing. Four women died from inhaling toxic fumes during this attack, and 25 civilians were affected and hospitalized as a result.” ~ Journey to Aleppo, Mint Press

A cherry red skin color that changes to dark may be present as the result of increased venous hemoglobin oxygen saturation. Despite the similar name, cyanide does not directly cause cyanosis.

"Red spots appeared on my hands ..." (unrelated? Spots suggests caustic, like the burns mentioned)

If a person survives, there may be long-term neurological problems.[2]

"...the crew had no memory recall of the incident and it has only partially returned long after the incident."

"The RSCD team leader told me: “I spent one week in hospital. For three days, I felt like I had gone crazy. I even tried to bite my wife. I was just so full of rage.”

The team leader describes the interviewed rescuer lashing out as he's given a drink of water. As a civil defense guy, that's apparently not the seeming soldier discussed here, seen on video wearing some camouflage, lashing out when he has water basically poured up his nose. The incidents are similar though ... either way, that reaction may not count as deranged.


 * https://www.cdc.gov/niosh/ershdb/emergencyresponsecard_29750038.html
 * ''"Hydrogen cyanide (AC) gas has a distinctive bitter almond odor (others describe a musty “old sneakers smell”), ... the odor does not provide adequate warning of hazardous concentrations." (if you can smell it, it's very strong.)


 * Hydrogen_cyanide - Wikipedia
 * ''HCN has a faint bitter almond-like odor that some people are unable to detect owing to a recessive genetic trait.[10]
 * ''"and there was a strange smell in the air, I still cant describe it”

"It also has a bitter burning taste" and pulmonary edema is mentioned - lung damage? Lasting lung damage is reported. related to the burns? Is that unrelated/from impurities perhaps? Or is it just something else that seems like a match in so many ways? Unclear. --Caustic Logic (talk) 12:31, 30 March 2018 (UTC)

ANNA from Abkhazia
(On ANNA news background). Called "Abkhazian" on the main page -watched it sometime but never occurred it is Abkhazian. Indeed registered in Abkhazia, and founded by Marat Musin, who happens to be an Abkhazian citizen (did not know that either as first and last name is of Tatar origin linguistically). He is a Moscow based academic specializing in Russian economy/economic risks, and also a patriotic front journalist frequently visiting Syria, somehow. Impression is that ANNA operates on a private basis from Moscow, though registered in Abkhazia. You may know more about Marat Musin than I do; but watched some of his interviews in the past and have some idea. He has academic sort of attitude overall, but with strong 'patriotic', though not pro-goverment, overtones (so patriotic opposition type). --Resup (talk) 11:19, 18 September 2016 (UTC)
 * I don't know much (probably less than you) except what ANNA stands for and some related things learned early on in 2012. CE brought their work over to the Houla Massacre investigation and I was impressed. Some were confused by Abkhazia and had to establish they were basically Russian, so the report should be ignored. I'm sure they've done lots of good reporting in Ukraine and elsewhere that I've missed. --Caustic Logic (talk) 12:50, 18 September 2016 (UTC)

Locations
This has been hard to pin down. "Old city" is vague, and there's no Awameed/Awamid anything labeled on Wikimapia in Aleppo, in Arabic (translates columns) or English translit.

A Hamadaniya district is specified - there's a Hamidiya (similar) that should be front-line government-held, just west of the north end of the Hannano military base (Wikimapia). This might be what they meant.

I may have a visual match for the clinic the ANNA news video was filmed at. As noted below, it's filmed near sunset, so must be facing rouhly south over sort of a park area. It would be a little north (deeper into safe territory makes sense), in Midan district: Al-Midan park has some unlabelled buildings to its north, one of which, west of center, might be the place. Not everything is clear, but I see few other possible matches and ... The view south sees a circular structure inside a walled area, a fence and trees around the edge, tall buildings to the left, and even something like a white tent canopy over the street off to the left, which seems to match. Anything to confirm this would be handy, but I'm about 70% sure this must be it. An attack down around Hamidiya (about 1 km S-SW) would be consistent, but other areas could still make sense. --Caustic Logic (talk) 07:07, 18 September 2016 (UTC)

At 1:02 a sign over the door is visible. It seems like 3 words and I could reassemble the first two. In Arabic: الإسعاف الجرا The words translate "ambulances" and "surgeon." The third word is short and ends with ي (ya). Or, better yet, it's two words and the second is الجراحية (aljirahia) = surgery. Ambulances for surgery, emergency entrance. It didn't help locate any labels in the area. --Caustic Logic (talk) 13:44, 18 September 2016 (UTC)