By Shawn D. Smith
“About 15 floors down from the top, it looks like it’s glowing red.” — Pilot of helicopter Aviation 14, radioing at 10:07 a.m., 9/11, New York City.
“I don’t think this has too much longer to go. I would evacuate all people within the area of that second building.” — Second pilot radioing seconds later.
Those warnings, caught on police radio, were transmitted 21 minutes before the collapse of the World Trade Center. The warnings were relayed to police officers, but not to fire fighters, who continued to try to rescue people trapped in the buildings until the buildings collapsed around them.
The World Trade Center tragedy of 9/11, the subsequent anthrax incidents in Florida, Washington, D.C., New Jersey, and Connecticut and the 2005 hurricanes that ripped through the Southern states, exposed the vulnerabilities within our cities and in many private industries, including those covering the industrial, transportation and healthcare markets. Clearly as a nation, we now realize that we are at constant risk for mass casualty situations, either resulting from natural or man-made events.
Our communities have always been susceptible to threats from natural hazards such as hurricanes, tornadoes and floods. After 9/11, there was a shift in priority from recovery to preparedness, with a focus on the need to protect, in advance of an event, the safety and security of our nation’s citizens and our critical infrastructure resources.
Unfortunately, even with this new focus on preparedness (and with the associated federal funding becoming available) most private sector organizations and many communities across the nation are not adequately prepared for even common emergency situations. Most organizations are not aware of their vulnerabilities or their capacity to respond to emergency situations. They do not have an accurate or complete set of emergency response plans for the hazards they face, and many do not have established polices and procedures for coordination with other agencies in response to an emergency event. Finally, most organizations are not aware of the latest tools and techniques available to disseminate real-time alerts and to facilitate bi-directional communication and messaging between emergency response participants, which would improve preparedness and collaboration.
Public Health Agencies
The lack of coordination among agencies is even more evident with respect to bioterrorism, an event that would involve local and state public health departments. Local public health agencies (LPHAs) have not always been identified locally or nationally as first responders in disasters. Although a public health official is often present at an emergency operations center during a natural hazard response, or a community drill, these agencies are often left out of pre-disaster planning activities. Consequently, many LPHAs lack the expertise and human/physical resources to appropriately assess a community’s vulnerability, capacity and readiness for a chemical or biological incident, or their ability to develop a response plan and to simulate/drill against this plan to improve the preparedness of the community.
Even so, a guidance associated with funding from the Centers for Disease Control and Prevention (CDC) places the LPHA in the role of “Incident Command” for bioterrorism response. Putting public health agencies in charge of the response to a bioterrorism event is intentional. The CDC recognizes that LPHAs are uniquely positioned to compile, analyze and disseminate information critical to the public’s health and are vital to maintaining a coordinated response to a chemical or biological incident.
Most hospitals, for example, are only aware of cases of communicable disease among their own population of patients, and few have direct experience with chemical exposures. Many other agencies (with the possible exception of fire, police and EMS) are not often aware of the appropriate protocols for treating victims of a chemical incident. Public health agencies likely are a community’s only center of expertise for the clusters, trends and recognizable patterns inherent to significant disease outbreaks.
Information sharing and inter-agency coordination are clearly needed to facilitate a successful emergency incident response. Yet many public and private organizations lack the comprehensive emergency response plans that define the roles and responsibilities of trained personnel responding to an unexpected incident and describe how to work “side-by-side” with responders from other agencies.
Training itself is an issue, as many organizations do not know where to turn for assistance regarding emergency preparedness, nor do they have the time to stop the daily task of operating a business or service to educate personnel on how to respond to disasters or to implement the emergency preparedness and response requirements now mandated by the federal government.
In the local communities, where such training is mandated, agencies participating in an emergency response are often not coordinated in their efforts, and, to make matters worse, severe shortages exist in the area of emergency management personnel. The preparedness and response expertise reflected in this type of human capital is in great demand post-9/11, but very hard to find.
Clearly, the response to a bioterrorism incident would be improved with better collaboration and coordination among the agencies and private companies participating in this response effort. How is this accomplished? With training on the principles of Emergency Management and the Incident Command System (ICS) established by FEMA for use in response to any type of hazard (an all-hazard approach), and the implementation of “inherently safer technologies for improved incident response,” advocated by the Department of Homeland Security.
The all-hazard approach has been a cornerstone of FEMA’s response program since the agency was first established. It integrates the various emergency plans and activities into a “life cycle” of mitigation, preparedness, response and recovery (the principles of emergency management) and, when combined with the incident command system, provides a template for inter-agency coordination that is directly applicable to events stemming from chemical and biological hazards, as well as all other man-made or natural events.
Every community with an emergency operations center has “in-house” expertise on the all-hazard approach, which should be utilized to assist other agencies (such as public health) in the assessment, planning and simulation of a community-based response to emergency situations. Each and every year, cities across the nation demonstrate that collaboration between agencies, using the all-hazard approach to fully prepare the communities for a coordinated incident response. This example refers to communities that are within a 10-mile radius of a nuclear power facility, where radiological emergency preparedness (REP) exercises are performed.
Horizontal communication and rapid exchange of information among agencies is a basic requirement during any emergency, and the all-hazard approach has proven to be a successful response system for both natural and man-made events. Each community should leverage their experience and knowledge of the all-hazard response system, and ensure that all agencies participating in an emergency incident response are cross-trained in this approach.
What else would help our nation’s communities and private sector organizations to better prepare for the threats that we face on a daily basis? The Department of Homeland Security has legislated the use of “inherently safer technologies” in response to emergency situations. Technologies exist that, had they been utilized, would have made a dramatic and positive difference in the overall preparation for, and response to, 9/11 and subsequent incidents.
What technologies would qualify for funding by Homeland Security awards and make an immediate difference in a community-wide response to a natural or man-made emergency? Clearly there are a lot of vendors making announcements in today’s marketplace on technologies related to homeland security, from chem/bio decision aids for first responders to syndromic surveillance and health alert tools, to mobile command centers filled with sophisticated communications equipment. There is no question that these products add value and individually can improve a part of the overall incident response.
However, it is in the area called “consequence management” where new technologies can really make a difference in the way a community responds to an emergency situation. Consequence management includes measures to protect public health and safety, restore essential services and provide emergency relief to governments, businesses and individuals affected by the consequences of a natural or man-made hazard. Consequence management is based upon the emergency management principles of mitigation, preparedness, response and recovery defined by FEMA back in the 1970s with the creation of the Federal Disaster Response Plan.
True consequence management provides not only heightened preparedness for potential disasters but also focuses on improved emergency response and constant, consistent actions that mitigate the risk of emergency incidents. It also provides for coordinated efforts in recovery and remediation, from volunteer credentialing to asset management and tracking, key components in relief efforts from catastrophic emergencies, like Hurricane Katrina from last year. FEMA further defines the components of a consequence management solution as the following:
- Hazard/Threat vulnerability and emergency readiness assessments
- Human and physical resource catalogue (emergency response/recovery assets
- Customized, hazard-specific contingency plans for emergency response
- Pre-built standard operating procedure templates/checklists
- Geo-mapping and situational awareness (tools for mission planning, asset tracking, and training/exercises)
Communication and Alert Tools
- Risk surveillance and event prediction
- Real-time alert dissemination with chain-of-command notification
Medical Response Tools
- Syndromic surveillance tied to point of care/incident clinical documentation
- Command, control, communciation, coordination and information
- Damage assessment and reimbursement
- Volunteer management/credentialing and Asset management (Mutual Aid)
The above components combine to form a solution that provides hazard vulnerability and emergency readiness assessments for any type of emergency (an all-hazard approach) followed by response plans jointly developed by government and industry (mutual aid), improved alert dissemination and communication leading to coordinated medical response and overall incident command and control, with a focus on improving the preparedness and response efforts of first responders (firefighters, policemen and emergency medical technicians) and local emergency managers (trained incident commanders who typically manage the emergency operations center that resides in each community). The solution is completed with components for recovery/remediation, including the management of volunteers and assets from lending organizations.
The need for a complete consequence management solution to better prepare for and respond to natural and man-made emergencies is clear. There are numerous and meaningful, measurable benefits to improving command, control, communication, coordination and recovery within each community for all-hazard emergency situations, the number one benefit being the saving of lives.
Several different software automation tools are available to support the planning, coordination and response of local governments and private sector organizations to potential emergencies. These solutions include the latest in event prediction, community-wide physical and human resource identification and management, automation of contingency plans, awareness of emergency situations via geo-mapping, real-time inter-agency communication and overall incident response task workflow and management. Consequence management technologies serve to help our communities establish control over their resources, effectively plan for emergency situations and improve the appropriate response to an event, thereby mitigating risk and saving lives.
So what overall functionality should a true consequence management solution provide?
1. Event Prediction and Alerts (real-time identification and visualization of resource status, availability and location, and rapid risk communication/alert dissemination to key personnel as part of a Simulation/Drill exercise, or prior to an actual event)
- Monitoring of multiple information sources for possible alerts to response participants (via existing external system interfaces)
- Rapid risk communication and alerts regarding an identified threat (reaching response participants via email, fax, phone, Internet, cellular, wireless and handheld connectivity and connecting with existing information sources, including EOCs, fire, police, EMS, e911, hospitals, public works and even federal/state agencies)
- Pre-event polling and visualization of physical and human resources (status, availability and location)
2. Contingency Planning (identification of physical and human resources by type and workflow, threat response planning, graphical design of response plans and automation of resource and response plan templates/checklists)
- Human and physical resource inventory automation and cataloguing
- Geo-mapping and situational awareness (asset tracking, mission planning and incident management tools)
- Pre-built response templates/checklists (natural and man-made hazards)
- Response template/checklist design tool (to create custom templates)
- Public/private sector response communication and coordination
3. Consequence Coordination and Response (actual deployment/coordination of resources during an event, rapid risk communication/alert dissemination to response participants, activation of response plans, prompts to users for specific actions, embedded escalation of alerts and prompts and full audit/documentation of actions taken by participants during the event)
- Real-time identification/polling and visualization of physical or human resource status, location and availability
- Real-time alert facility to human participants with embedded workflow, timers and escalation options
- Resource deployment and optimization (automated prompts for users to take appropriate actions, and for specific allocation/coordination of resources across emergency service disciplines)
- Rapid risk communication/alert information dissemination (to the media and the public)
- Command center and control via a graphical user interface (geo-mapping, top-level view of the incident with drill-down to specific components of the response — also allows user input regarding response components that may change a component’s action within the response, or the overall response template)
- Real-time suggested actions for all response participants
- Full audit trail of actual actions performed by response participants
- All functionality available in a “live” incident response is available in a full response simulation
- Real-time event audit and “live” documentation of the entire incident response scenario during the simulation
4. Post-event Audit/Documentation (including resource optimization, recommendations for future events, actual vs. plan reports, and non-emergency coordination such as logistics)
- Graphical reports (standard line/pie/bar graphing tool) of actual vs. plan variances
- Geo-mapping summary of incident response (GIS mapping and trend analysis, with a “playback” of asset movements and actions taken by emergency service discipline)
- Customized regulatory reports (NRC, EPA, CDC, DOT, etc.)
- Post-event resource deployment and coordination planning
5. Recovery/remediation initiatives (including Mutual Aid initiatives such as volunteer credentialing and management; asset identification, coordination and tracking; damage assessment; and inter-agency post-event coordination)
- Volunteer credentialing/management (technologies for identifying persons by role/function, credentialing them and managing their efforts)
- Asset management (identification of available assets for recovery efforts, obtaining, activating and tracking these resources)
- Damage assessment (automated documentation of post-event damage, and submission for financial reimbursement)
- Inter-agency collaboration (post-event planning and coordination between agencies on recovery initiatives)
6. Simulation and Drill Development (automated, real-time coordination of the critical exercises that can expose gaps in response plans, improve response time and mitigate risk to actual events)
- A library of simulations (templates)
- A simulation development wizard (creating custom drills for multiple threats)
- Simulation execution and management (real-time, automated drills with full audit functions by human and physical resource)
- Visualization of the exercise (mission planning and situational awareness of the exercise incident and assets utilized in the exercise via geo-mapping tools)
- Post-drill reports
Benefits of Consequence Management Systems
There are numerous benefits for local communities in identifying and implementing a complete consequence management solution. Among these are:
- Day-to-day value in improved communication among community agencies
- Faster, accurate, more precise alerts to key personnel regarding potential emergencies
- Improved preparedness in advance of potential disasters
- Better coordination among agencies during the response to an incident
- Real-time, accurate information regarding status of human and physical resources responding to an emergency
- Optimized deployment, control and coordination of resources in the field
- Full, real-time audit and documentation of actions taken by incident responders
- Full documentation of mutual-aid requests, and the community response to these requests
- Faster recovery from the event
- Complete control and coordination of simulation/drill exercises to identify weaknesses in emergency response plans by hazard type and to ensure full education/preparedness of response participants
- Ability to document improvements in incident response over time
- A clear indication of positive actions taken to respond to the threat of terrorism, and to protect the safety of citizens within the community
- Proof of steps taken to improve preparedness for, and response to, virtually any kind of emergency situation
- Lives saved as a result of a faster, coordinated disaster response
The greatest benefit to local communities will be in the adoption of solutions that can facilitate the overall incident response to any natural or man-made hazard. These consequence management solutions will provide numerous, quantifiable benefits for U.S. communities and their corporate citizens by mitigating the risks associated with emergency situations, better preparing the community and private sector organizations for these events, vastly improving the response to natural and man-made incidents and facilitating a smooth recovery from the event.
The need for leadership, expertise and resources in identifying and responding to both natural and man-made threats has become more clearly understood in the aftermath of 9/11 and the recent hurricane season. The next task for every community is to define the distinct roles of first responders, the medical community, public health professionals and all other participants in a community-based response system; get them to focus on inter-agency collaboration; cross-train them on emergency management principles and the incident command system; and to define emergency response plans based on an all-hazard approach. And to do so before the next event occurs.
Natural disasters and terrorism do not respect geographic boundaries, and we now know that each and every community in this nation is vulnerable to a natural or man-made disaster. We may not be able to prevent these incidents, but we can minimize the effects of these emergencies, both on an economic and human scale, with the adoption of technologies that provide consequence management solutions, and with a focus on inter-agency collaboration.
Shawn Smith is the President and CEO of Emergency Visions (www.emergencyvisions.com), a software automation and consulting services company dedicated to assisting communities and private sector organizations to prepare for, and respond to, all-hazard emergency situations.