Laura Ballantyne
Although the dramatic events of the Boston Marathon validated the reality of possible continued terrorist attacks, previous anthrax attacks identified vulnerabilities in early identification of any biological event. Any type of terrorist attack or major incident needs superior coordination among the diverse agencies that respond to such occurrences and tighter control of how areas or sectors are managed.
The rapid evolution of the anthrax cases and their impact across multiple locations, jurisdictions, and professional communities and constituencies (e.g., public health, hospitals, private physicians, police, environmental agencies, military response teams, firefighters, and affected workers and their unions) revealed the benefit of coordination planning.
Some endemic factors that impeded coordination were very basic. Procedures as seemingly routine as standard practices for clinical and environmental testing and use of proper protective clothing and equipment proved to differ among public health officials, fire and rescue services, police, environmental specialists, and so on. For some, responding to these incidents represented the first time they had met with and coordinated with other agencies. This approach results in disagreements on which procedures and standards to follow. In addition, plans need to anticipate the need to forge quick relationships and procedures between the public health departments and local emergency responders or police affected and involved in these types of emergencies. Most importantly, they need to know whom and what are entering into these now "classified hazardous areas." This potentially catastrophic omission needs to be rapidly addressed and quickly rectified.
New and unanticipated working relationships also contribute to difficulties communicating critical information, such as key decisions on who should be allowed to enter such dangerous areas. Should they be expected to just walk in and report to someone who looks in authority? Similarly, communications and coordination channels between public health and private groups affected by the emergency-such as hospitals-do not fully anticipate such mass convergence of emergency responders in their response plans. This results in rapidly establishing ad hoc restrictions, which result in people who could help being restricted while anyone in a uniform is allowed to enter with no questions being sought regarding their validity.
Agency Interoperability
Clearly, these types of events led organizations to recognize the need for greater interaction, control, coordination, and communication among various constituencies. How, then, is it possible to establish a rapidly deployed sector management system that all parties can simply understand and apply-one that will feed a newly defined discipline of what qualifications, competency, authority, and experience are deemed safe to ensure no one is allowed to enter unchecked into such potentially dangerous environments? The answer lies in reasserting the traditional role of sector management while integrating technology that improves the management control functions.
Whenever there is a need to deploy large numbers of emergency service personnel, together with their vehicles and equipment, a sophisticated incident command system (ICS) is brought into use.
This system divides a fireground into sectors for operational command; command support; safety; USAR; marshalling; entry team control; logistics; decontamination; water; foam; relief management; crew rehabilitation; and welfare, communications, and press liaison. In effect, the fire and rescue service controls the inner cordon, the police service controls the outer cordon, and the ambulance service controls the casualty clearing stations.
However, there are major omissions in the system. There is no focal point for the operational sector commande