It is interesting to stop for a moment and think, “How did we get here?” The emergency preparedness and response profession has come a long way, offering emergency preparers, responders, and receivers many more invaluable tools at their disposal than their counterparts had in previous years. Over time, plans and procedures have adapted to ever-evolving needs and environments. And technology has advanced beyond the imagination of their predecessors 50 years ago. However, for every advancement, a new challenge(s) emerges.
Understanding history is a critical component of emergency preparedness, response, and resilience. History has a way of exposing preparedness and response gaps and providing a roadmap for best practices going forward. Unfortunately, when not examined and taken into consideration, history tends to repeat itself. As threats evolve over time, the same response to a similar threat (like an active shooter, biological attack, domestic terrorism, or natural disaster) could have even greater consequences. For this and many other reasons, the past must be studied, lessons must be learned, and new approaches must be applied.
There is no way to list or train for the innumerable mass casualty scenarios that a responder could face on any day, at any time, in any place. This means that no emergency response can be perfect and no plan flawless. However, rather than focusing on the “what ifs” after an incident, responders need to decide on the “what nows.” The military and civilian responders to the 16 September 2013 Washington Navy Yard shooting have done that. Not only have the involved agencies created their own lessons learned, they have also coordinated with each other to bridge the response gaps that were exposed. Key takeaways from the shooting as well as actions that have been taken since the incident were shared on 17 September 2019, when public safety agencies throughout the National Capital Region convened to reinforce communications efforts and address any remaining interoperability concerns.
The healthcare industry presents many challenges for emergency preparedness professionals. The planning process for a major crisis involves numerous stakeholders, each with their own plans and procedures. Emergency medical services and hospitals, in particular, are tasked with managing dynamic, ever-changing environments that are difficult to predict. A medical surge could easily lead to shortages in critical resources if mutual aid agreements, healthcare coalitions, and other collaborative efforts are not already in place before disaster strikes.
Each year, the Federal Emergency Management Agency’s (FEMA) Ready campaign recognizes September as National Preparedness Month. Agencies and organizations across the United States participate in this national preparedness effort by sharing educational resources, organizing events, and mobilizing action to help reduce risk and build community resilience. FEMA recognizes that, when individuals and communities prepare for any of the numerous potential threats they may face, the nation as a whole benefits.
After a disaster, stories often emerge about companies and organizations that provided resources and services to aid in the response efforts. Sometimes these are prearranged formal agreements, but often they emerge more spontaneously as the need arises within communities. It, of course, is not possible to plan for every potential threat or scenario. However, there are many actions that could be taken in advance of an emergency to build resilience into any ensuing scenario.
Disaster planners recognize the need to build interagency, interdisciplinary support to combat widespread disasters with far-reaching consequences. However, gaining such buy-in can be challenging – especially when stakeholders do not recognize the threat to their communities or do not understand the roles they can and should play in mitigating such threats. This is important considering that an international threat can quickly become a local problem and a local threat can transform into an international concern.
The Homeland Security Act of 2002 created the Department of Homeland Security (DHS) to safeguard the United States against terrorism. The department brought together 22 different federal agencies, each with a role to: prevent terrorism and enhance security, especially from a chemical, biological, radiological, nuclear, or high-yield explosive (CBRNE) attack; manage borders; administer immigration laws; secure cyberspace; and ensure disaster resilience. That is just the federal part of the equation. The first DHS Secretary, Governor Thomas Ridge, envisioned an enterprise where state, local, tribal, and territorial governments were also an integral part of that mission. What is not clearly stated is the role that nongovernmental organizations play. This would include industry, think tanks, and media.
The National Biodefense Strategy highlights President Donald Trump's commitment to protect the American people, “and establishes objectives to effectively counter threats from naturally occurring, accidental, and deliberate biological events.” This strategy is intended to guide innovation and collaboration beyond the federal government. The president is targeting this strategy for action by state, local, territorial, and tribal (SLTT) entities, practitioners, scientists, educators, and industry.
This report is a meeting readout. It relays the sentiments of the many experts who participated but is not an exhaustive analysis of the recommendations and how they should be implemented. It is meant to lay the groundwork for the next steps, which key leaders and policymakers should consider. The information relayed herein is generally reflective of the opinions voiced at the meeting as well as the survey respondents, though any given statement should not necessarily be viewed as consensus.
In almost any adverse incident, whether natural or manmade, the general public is involved. At times, they are the victims and survivors. Active bystanders may be the true first responders simply because of proximity. Volunteers often surge forward hoping to help. Eager though untrained, members of the public can be a help or hindrance – and the difference may be how effectively they are led.