Nov. 6, 2001

Managing in a World of Risk

A Conversation About Post-Sept. 11 Life

From the Airwaves is a transcript of “The GW Washington Forum,” the weekly public affairs radio program produced by GW, hosted by Richard Sheehe, and broadcast on WWRC-AM 1260 in Washington. This conversation, with Jack Harrald, director of the Institute for Crisis, Disaster, and Risk Management, and Dr. Keith Holtermann, chief of research and health policy analysis at The George Washington University’s Ronald Reagan Institute of Emergency Medicine, comes from a recent program.

Richard Sheehe: After the immediate shock of the terrorist attacks begins to recede, homeland security is taking the forefront. How do we prepare for the next attack? What are the kinds of threats that may be out there?

Jack Harrald: I think we will see something different. What this event has raised in the national consciousness is a sense of vulnerability and people are dealing with that, which is different than risk. The difficulty you’re seeing in the press is any sort of estimate of what the likelihood or probability is. We don’t have any way to estimate other than intelligence sources what the likelihood of an event is. People are looking at the vulnerability and the potential consequences and you have a dialogue that isn’t anchored in some rational thought of this.

Keith Holtermann: I think an important consideration that you need to bring into this is that as you begin to harden and make certain areas more secure, and less vulnerable, then you’ve softened other targets. We need to really think about if we make the downtown Washington, DC area impenetrable — we monitor the traffic, we don’t allow Ryder vans to approach the White House — we’ve then softened other targets.

RS: In terms of sheer manpower? If we’ve got everyone downtown then are suburbs more at risk?

KH: I believe the other areas become more enticing to a terrorist because they are easier to hit. If we make something difficult to hit, then we’re not providing as much at a shopping mall or somewhere else where large numbers of people are congregated, but maybe wouldn’t have that same kind of icon effect as the World Trade Center.

JH: I think you see that, and part of the focus is on increasing airline security, which we must do. But the flip side of that is will that make us safe? The answer, of course, is no. Part of what we’ve learned is that we are vulnerable. Emergency management and emergency medicine systems must be prepared to deal with potential mass casualty events, whatever their costs are.

RS: It’s almost like a pendulum swing. Before these terrorist attacks, few Americans even thought about the threat. Now, we’re hypersensitive to the threat. Are there any keys to getting the right level of sensitivity and awareness to threats?

KH: That’s an individual question, something each person needs to come to grips with. I’m getting over a cold and my first thought (was bioterrorism). So the issue here is terrorists clearly win when we have these kinds of thoughts. In order for us to consciously beat them, we need to be conscious not to think that way. We really do not want to be afraid. We want to go ahead. We want to buy a new car. We want to buy a new refrigerator. We want to go out and spend money. We want to believe the economy is not going to be hit again or will not continue to go down because of what recently happened. I think that’s the way you beat it. It’s really by consciously saying I don’t want to be affected by this. ‘I’m going to do what I believe I would have done in this situation anyway and then feel good about that.’ Go on to feel that this is not only something that’s helping me, but it’s something that’s helping the nation, the economy, my friends, my family. Then, hopefully, eventually that feeling of having to do that consciously will slip away.

JH: I think we need to make a concerted effort to understand the threat, understand the vulnerabilities. There are things we can do. We focus on security, but there’s also design, individual behaviors, individual protections, our abilities, particularly in the chem/bio area, to detect when an event has happened. One thing about the conventional attack on the World Trade Center was that there wasn’t any confusion in anyone’s mind that something had happened. In a biological event, that is a problem and the ability to act and respond to that. The focus right now is on what the federal government is going to do. We’re looking at the security aspects — the FBI and what the is military doing. The solutions to understanding the vulnerabilities and being prepared to deal with future events largely are local, that is, your local emergency medical system, your emergency management system, your state, your county, your city. This is where we have to be prepared, this is where we have to be equipped, this is where we have to understand our vulnerabilities.

KH: Nearly every major city that had an office of emergency management, and had a very competent office of emergency medical services and fire department should have already done a scenario on what happens if a major airliner were to crash into my city. It wasn’t like we didn’t know the World Trade Center was vulnerable. It had been attacked before. We had been told many times that there were other events that were to occur, but were thwarted. These are pre-planned scenarios that, either using computer modeling or through real-life situations, such as an airplane crashing at an airport, we run those simulation drills yearly or every six months, depending on the size of the airport and FAA regulations. We run these kinds of drills and this comes down to the general preparedness of the emergency medical service system, the fire suppression services, the police services, and how well they’ve prepared for a general event, not even a terrorist event. Many of these other events, for example though, if it were to be some kind of chemical terrorism, really turn out to be hazardous material events that our fire departments respond to on a daily basis. They’re prepared to handle those kinds of events. There are some other very serious considerations that need to come into play, similar to what happened in the Atlanta abortion clinic bombings, where there were secondary devices that were there to trap the emergency services responders that came in. There are issues of dirty bombs, for example, where we not only have to deal with the aftermath of a sudden explosion, but someone could put plutonium next to the stick of dynamite. The foundation of our response is that of our everyday preparedness. That is where we really need to concentrate on and make our everyday preparedness perfect.

RS: We spoke about the kinds of threats and what we have to do is build upon the existing emergency management structure. What are people in the emergency management field thinking about now as you look at this response. What are we learning about what to do right, what we can do better?

JH: The press, and I think correctly so, focuses on the individual heroism of the individual responders and response groups. Basically, we have the best system in the world and the system works. What Keith was talking about of improving the system through what we learn in actual events and in drills is of critical importance. What we’re looking at is where can this system be improved, particularly those of us who have been working this system have been talking a long time about the potential mass casualty/mass fatality event. We have not had a mass fatality event of this magnitude in the United States for 101 years, not since the Galveston hurricane, which was about the same number of fatalities. In the press and in the public, there’s a perception that bad things can happen, but they’re not going to hurt a lot of people. Now, we know that peace is gone forever. Looking at the systems and integrating systems and getting information between systems, that’s where we’re looking for the improvement. The issue of providing information on structural engineers to the responders. What are the first responders exposed to? What are the hazards? One of the things that happened in the Pentagon response is medical responders, some from this University, were right there with the firemen, working with the building designers, saying there are no hazardous materials. That lab that people are saying is in there is a photography lab. It’s not some sort of hazardous materials lab so the first responders are not risking their lives.

RS: A lot of these firefighters died not from the smoke, but when the building collapsed. Is there a way to anticipate whether a building is going to collapse?

KH: I believe absolutely that’s the case. This is where issues of pre-planning come into play. We don’t have infinite resources. We can’t pre-plan every possible event. We do look at communities, FEMA, and its roll-out to individual state, county, municipal offices of emergency management, to look at issues of risk and vulnerability in every community, so that if you have a series of chlorine tank cars parked in a given area, they look at what is the most common prevailing wind, how this affects it, how you would do evacuations. All of that is very well pre-planned and written into actual scripts so that when those events occur, you’re not standing up there trying to figure out what to do, but you’re actually going pretty much by a line-by-line guide on how you’re going to work through that scenario. Of course, things always change and people need to be in that piece of the interaction, but you do script a lot of this.

JH: That information is known somewhere in the system. The person who needs to know is the person who’s making the decision of sending 20, 50, 100 people into that structure. That’s a difficult issue because we’re dealing with structural issues. Twenty years ago, we were talking about chemical issues. Firemen were dying going into warehouse fires because they weren’t told, and didn’t know, what was in that warehouse. We’ve solved that problem. I think we have to solve the problem of detection of chemical and biological agents so that we have technology to protect our people.

RS: Is there a central database of buildings and what’s in them?

JH: This is an issue of local preparedness and in most major metropolitan areas, that’s known. Hazardous materials have to be reported to the EPA and where they’re stored. Hazardous materials in transportation are noted on the transportation aspect and the Department of Transportation regulates that. There are some difficult issues with temporary storage of hazardous materials. But, in general, the firefighters responding to buildings know what’s there, know what the structure is. There are areas of the country where that may not be true, but the technology and the capability exist in most metropolitan areas.

RS: Did our preparations for the Y2K crisis, which never materialized, help us at all?

JH: Where that really helped us was in the corporate crisis management. This has been the biggest economic hit on corporations, from a damage point of view, of any event in American history. Major companies, in spite of tremendous loss of life and an incredible loss of equipment, are up and running. The World Trade Center was attacked before and lost power in 1993. People got their back-up sites going and then the Y2K aspect happened and you’re right, there is much more capability to back-up systems. The thing you see from a corporate point of view that no company that I know of plans for is the loss of people. Companies have lost 30, 40, 50, 70 percent of their senior employees. So the knowledge to run the systems is going to be difficult to replace.

 

Send feedback to: bygeorge@gwu.edu