How to plan for a disaster

Hurricane Sandy was far worse than most people expected, but that should have been no surprise. One of the key lessons we’ve learned from natural disasters, as well as from terrorist attacks, is that you should expect the unexpected. Anticipate the unusual. Black swans are rare, but they exist.

That’s one message of a fine new book, “Local Planning for Terror and Disaster: From Bioterrorism to Earthquakes,” edited by Leonard A. Cole and Nancy D. Connell (Wiley-Blackwell, Hoboken, 2012).

Cole, a Ph.D. and DDS, is an adjunct professor of political science at Rutgers University-Newark and director of the program on terror medicine and security at the University of Medicine and Dentistry of the New Jersey Center for Biodefense. A resident of Ridgewood, he is a former president of the Jewish Federation of Northern New Jersey. Connell, a Ph.D., is a professor of infectious disease at the Medical School of UMDNJ.

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Disasters don’t necessarily follow old scripts, they tell us. No terrorists had flown airplanes into office buildings before 9/11. In Great Britain, before 2005 terrorists mostly planted individual explosives. It was rare for them to use a series of explosives, as they did on three London underground trains and a bus in that year.

In Japan, a 25-foot coastal wall had been built for protection against tsunamis. The 2011 earthquake unleashed a 30-foot wave that poured over the wall.

Before the 2001 anthrax attacks in this country, bio-attack scenarios had been created – but no one had considered the possibility of spreading microbes through mailed letters. “Creative thinking, whether about the known or the unknown, is a necessary part of preparedness,” Cole writes.

“Anticipate the unusual” is another way of saying: Be prepared for black swans, as Cole has pointed out. Black swans and such are not as rare as we think.

“Local Planning” may be among the most important books published this year, although its readership unfortunately may be confined to people involved in preventing and responding to terrorist attacks. Certainly more terrorist attacks are coming, along with natural disasters – fires, snowfalls, hurricanes, earthquakes, train wrecks.

How complicated the subject can be is suggested by the fact that 32 people contributed to this book, and that it deals with such seemingly specialized subjects as finding a useful role for volunteers who rush to a disaster site to help. (Their cars just may clog up the roadways, and they may inadvertently contribute to the number of people injured.)

Or just consider triage, the method by which the injured supposedly are treated in accordance with the severity of their wounds. Actually, those who seem fatally wounded might justifiably be neglected in favor of those who seem likely to recover. Soldiers who might return to action quickly might be given priority over ordinary civilians; so might an injured physician who had been treating the wounded. And should medical people treat a suspected terrorist exactly the same as a firefighter in need of help?

We have learned the importance of swift and accurate communication. Both professionals dealing with a disaster and the general public need good advice on what to do. The phrase “the golden hour” refers to the small period of time after an injury when medical help may mean the difference between life and death. And the record in treating people during the golden hour has not been reassuring.

Because of confusion during the 2005 London attacks, fire and ambulance teams sometimes stood by idly while victims lay dying. Only half the 201 London ambulances available were even sent to the attack scenes.

When the first case of anthrax was confirmed in this country during the 2001 bio-attack, Florida’s governor, Jeb Bush, announced: “People don’t have any reason to be concerned.” The U.S. Postmaster General, John Potter, visited the Brentwood postal center in Washington, D.C., and told the employees they were in no danger. (They were.) The Centers for Disease Control and Prevention, usually an exemplary organization, counseled against giving New Jersey postal workers the antibiotic Cipro. Despite that advice, the state’s acting health commissioner, Dr. George DiFerdinando, saw to it that the workers received the medication – possibly saving lives and thus emerging as “an unsung medical hero,” Cole has written.

It was during the dark of night in 1984 when 40 tons of methyl isocynate gas escaped from a Union Carbide plant in Bhopal, India. Because of the darkness, some victims moved toward the source of the contamination. Because they were not advised not to drink milk from cows that had eaten contaminated grass after the Chernobyl disaster, many Russian children came down with thyroid cancer.

In 2001, after Flight 11 crashed into the World Trade Center’s north tower, 911 operators told tower occupants to stay put and await rescue workers. The deputy fire director also told people in the south tower that the buildng was safe and they should remain in their offices. When the south tower was hit by Flight 175, 911 operators again told occupants to stay put – even though five minutes before the fire department had issued an order for everyone to leave the building.

Cooperation between agencies also is a goal. But different branches of government may compete against each other, even during an emergency. The 9/11 Commission report showed that New York police and firefighters continued to operate as independent agencies – their radios could not even talk to each other. The firefighters and the police did not even want to talk to each other.

Still another lesson to be learned: Prepare not just for black swans but for loathesome birds of prey. During the 20,000 Arab terrorist attacks against Israel from 2000 to 2006, some Palestinians on their way to Israeli hospitals were found to have explosives hidden under their clothing. And several Palestinian ambulances were found to be carrying weapons and gunmen.

One of the last chapters in the book focuses on cyber-conflict. One of the chapter’s conclusions is that “time is short before malicious actors in cyberspace reach a stage when they track a hurricane and launch cyber attacks” to impede rescue workers’ efforts.