Quadrennial Homeland Security Review

The Obama Administation, true to its history of using Web 2.0 tools, is looking for feedback on the Quadrennial Homeland Security Review. The conversation will take place in three stages, starting August 3rd. You can check out the website here. Six topics are specifically under review:

• "Counterterrorism and Domestic Security Management
• Securing Our Borders
• Smart and Tough Enforcement of Immigration Laws
• Preparing for, Responding to, and Recovering from Disasters
• Homeland Security National Risk Assessment
• Homeland Security Planning and Capabilities"

I encourage all members of the fire service to make our voices heard in this review. We have too often ceded the high ground on homeland security to the law enforcement community. Indeed, in much (or most) homeland security dialogue at the national level there is more talk of law enforcement and emergency management than response and mitigation.

Let's not let our fire service be left behind. Sign up at that website for updates and participate in the three rounds of dialogue.

Just because we HAVE fancy equipment...*

doesn't mean we HAVE TO USE our fancy equipment. Remember what what Tom Brennan said about a KISS.




*updated because of my embedding FAIL.

Data collection, NFIRS, and peer review

I had an interesting conversation the other day with a friend who spent a couple of years as a casual volunteer firefighter. He knows just enough to identify some issues and needs but not enough to be really well versed in their finer points. The topic turned to the (mostly settled) bunker gear vs. turnout coat/hip boots issue. I've heard, anecdotally, that Boston reported a lower injury rate among crews using turnouts/hip boots, but am unaware of any actual study. My friend asked me what the data say about victim survival rates compared to fire stage and firefighter access (i.e., how deep did they get in there?). I had no answer.

This points up what I believe to be a major failure of the fire service and a stumbling block to ours ever being considered a true profession. Dr. Robert Cherry of Penn State's homeland security grad program teaches that for a field to evolve into a true profession it must have, among other things, peer-reviewed journals. The fire service certainly has some solid trade journals (Fire Engineering, Firehouse, and Fire-Rescue all spring to mind) but no real peer-reviewed journals that are known and distributed nationally. There are some cursory efforts, including from the old West Point of the Fire Service, Oklahoma State University, but have you ever seen a copy? I sure haven't and don't know of anyone who even knows of its existence.

Not only do we lack a sober and earnest collective research discipline, we also lack adequate data collection. Part of that is explainable by the fluidity of the fire scene; how do you even begin to design uniform criteria identifying how deep you went or were able to go or where the victim has crossed the threshold into unsurvivable? NFIRS collects some solid and useful data, but mostly it is useful for prevention and construction efforts. It doesn't really tell us anything about staffing levels or equipment performance/ability. Even if we can't gather this information through NFIRS or some other standardized system we could still encourage solid research and analysis. I am of the opinion that the trade journals we do have are too focused on the task level of our job and not enough on the strategic or technical preparation side. For that sort of discussion you have to go to various blogs and some of the reasonable message boards. But those aren't popular enough and many fire departments are run by chiefs who are scared of the internet, sometimes to the point of having valuable training tools (YouTube!) blocked completely.

How do we have rational and objective discussions about realities, hypotheses, theories, and projections for the future? The answer is that we cannot, we have to make do with arguments from tradition and policy made by anecdote. On some points the sort of solid foundation I'm talking about does exist, but that is rare. The fire service has to evolve to hold place in this information-based world. The Heritage Foundation just slammed the federal grants that are so vital to many departments. The Heritage Foundation is just another mission-oriented think tank, but we lack even that and can't make a counterargument with so much as a bagged study like this.

Read, read, read and explore the blogs, they are our internal evangelists.

That was anticlimactic

So it seems the swine flu petered out without much death or destruction (though Mexico took it harder). The World Health Organization thinks this will be a long slog, and it is worth noting that the 1918-19 influenza had a little stutter-step false start before it came back in force.

Most people I know are blaming the media. I am not surprised at all by that, because most people claim to hate the media. I will ask you this: how many times have you posted a RIT that did not have to save a downed firefighter? That's active preparation, just like what a lot of us went through in the last couple of weeks.

And now we're all tired of the flu, so I'll move on.

CDC guidance for call typing and patient assesment

This is a good one to pass along to your calltakers and study in the morning at shift change.

The issue with this flu is not death...

the issue is continuity of operations and the economy. This is not the 1918-19 influenza; it's (apparently, knocking on wood) not going to kill a whole lot of people. But it will make a lot of people in the work force's primary age groups sick, and people with the flu get very sick.

That is what the hype and the scare tactics miss. People probably aren't going to die, but they are going to miss work and school. Offices and schools are already closing in American cities. What do you do with your kids when they can't go to school? What happens to the economy when even a few business start shutting down? John Robb says it better than I ever could.

How big is your department? What would happen if just 10 percent of your workforce had a highly infectious illness that takes its victims completely out of commission for a week or two?

That is why this is (potentially) a big deal. And if it peters out, then it's a great dress rehearsal for The Big One.

Reflexive anti-hype as bad as reflexive media hype

"Remain calm, all is well."

We're at Phase 5 on the World Health Organization's pandemic alert level. What does that mean? "Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short." Things are quickening around the world and especially the United States. Schools around the country are starting to shut down and it won't be long before we start seeing some commercial enterprises lose functionality.

All over the news, newspapers, and news websites we're treated to a constant barrage of images of people in masks and alarming headlines about panics and runs on stores. The press gets a bad rap in situations like this, and often deserves it. Many people have become so inured to the alarmist infotainment thrown out by the 24-hour cable channels that they reflexively and vociferously disbelieve whatever the media says about whatever is going to kill everybody this week.

That has been amply demonstrated in my own city this week as the emergency management coordinator, who is not part of the fire department, has been sending out the official City emails about the swine flu to the employees. Yesterday afternoon he said, among other things, that there was no epidemic and that no one should be alarmed because this was the same as any other flu. I believe that all his emails/memoranda to this point have specifically said the media is just trying to scare people and that we and our families should ignore them.

This is neither helpful nor factually correct. We are now to the point the WHO defines as "pandemic imminent" and schools in our immediate area are closing. We think we may have made the first swine flu-related EMS call in our jurisdiction yesterday and the City's memorandum-of-record, from last night, says essentially "move along, nothing to see here."

Sober and context-rich analysis is lacking in the media, but it is also lacking in these emails. Just because the media implies a bunch of people are going to die does not mean that quite a few people won't die. Antipathy toward the press has in this case turned preparedness on its head and, perversely, actively discourages people from planning and preparing for things to get worse. It was obvious then (this was last night) and is more obvious now that things are getting worse and will continue to do so for some time.

Most of the people who received those emails/memoranda are not firefighters or cops or paramedics, they are just regular people. Discouraging them from preparing is bad enough, but authoritatively telling police, fire, and EMS supervisors that the the threat is inflated and minimal is downright reckless.

It is always appropriate to strike a calm and reasoned tone, but it is also always appropriate to be honest and not allow our biases to unduly affect our conclusions. That includes biases against the media and the urge to show people your head is even more level than theirs.

Ramping Up or Ramping Down?

Things look like they are heating up, with the number of laboratory-confirmed cases in America more than doubling today and Russia and England suspending consular services in Mexico City, and a whole bunch of countries issuing travel alerts on Mexico. Mexican authorities have shut down all schools across the country and Texas authorities are shutting down more schools around San Antonio.

The strongest impression on me has been the seriousness and urgency of the leading public health agencies. The World Health Organization raised the pandemic alert level to Phase 4, that last stop before a full-blown pandemic. The CDC and its Mexican and Canadian counterparts have been all over the news giving interviews and sharing information, showing everyone they're out in front of things. That is a good thing!

On the other hand, Mexican public health people said in a press conference tonight that the number of new cases has been declining each of the last three days. But like everything, it's all in how you manipulate the numbers. The official WHO tally for Mexico stands now at 26 confirmed with seven deaths, but that number appears to be coming from the CDC and differs from the tally the Mexican health minister has out there (110 reported today and overall death toll over 150). Both of those numbers seem quite low for a country that has closed the capitol city and every school from coast to coast; suffice it to say that I do not put much stock in the accuracy of those numbers. Actions speak louder than words, and the actions of the Mexican government and the Mexican people (Mexico City looks about as dead as Terlingua, TX on TV) paint a far less optimistic picture. Nevertheless, maybe this thing is not catching fire, despite the earnestness coming out of the CDC and WHO and the extraordinary actions in Mexico.

There are no reported or confirmed American deaths that I have been able to find, but the acting director of the CDC, Dr. Richard Besser, says, "I wouldn't be overly reassured by that. There are many reasons that could explain that...I expect that the spectrum of the disease (in the U.S.) will expand."

The media, of course, are overhyping this and working everyone into a frenzy. If you get a few confirmed or even suspected cases in your metro area you can expect the deluge to follow. Three very basic, very easy, things to remember to keep you and your crew healthy: wash your hands compulsively (soap or alcohol-based sanitizer), don't get within six feet of anyone if you don't have to (ESPECIALLY dyspnea patients), and don't be shy with the masks (N95 for you, surgical mask for the patient, even if he's on O2).

The Texas Department of State Health Services has some good personal protection guidelines specific to first responders.

More Web 2.0 Swine Flu stuff

In addition to the Twitter sites I mentioned in the last post, this new Google map of suspected and confirmed cases is interesting to follow. We should remember that user-generated content is often (usually?) unreliable, but the more widely it is disseminated the quicker inaccuracies are debunked and salient points reinforced. Firegeezer has written several times about having an Internet Intelligence Officer at the command post for very large, very public incidents. Twitter and RSS readers can keep you updated very quickly from a tremendous amount of sources and go a long way toward maintaining situational awareness using a resilient and durable platform.



View H1N1 Swine Flu in a larger map

Swine Flu in New York, Kansas

New York public health officials are confirming around 200 cases in Queens* centered around a school and CNN has reported cases in Kansas. Texas Department of State Health Services is closing certain schools around San Antonio and recommending people avoid public gatherings in those areas.

This is a great case for Twitter. Go sign up and follow @BreakingNews, @Veratect, and @CDCEmergency for some really bleeding-edge coverage.

I sent a memo up my chain of command this morning recommending a few actions.

1. Locate and inspect our previously issued N95 HEPA masks
2. Consider writing a standing order, to be issued later, ordering company officers and battalion chiefs to relieve from duty any members reporting sick (our guys hate using sick leave for actual sickness!)
3. Send someone to the store to stock up on Purell now (the City buys this, but they probably don't have a lot of reserves in the warehouse)
4. Issue a standing order directing members to wear their N95's when treating dyspnea patients and to wash hands after every EMS call, regardless of actual patient contact
5. Issue a standing order banning members from lingering in public places until further notice
6. Suspend all public ed and PR events until further notice

Don't hang out close to a patient if you don't have to, wash your hands frequently and thoroughly (or use alcohol-based sanitizer), and, if your patient is not on a NRB and has a respiratory problem then put a surgical or dust mask on his/her face.

This is the sort of thing that can push this teetering economy into a depression as business' continuity of operations begin to strain. That will definitely include fire departments, since this appears to be something that disproportionately affects healthy adults (vice kids and the elderly and infirm).

Oh, one other thing. When you sneeze, sneeze in the crook of your arm and not your hands (that actually is a CDC recommendation!). Sneezing on your hands just transfers that crap to doorknobs, keyboards, mice, and light switches

* (UPDATE at 15:20 on 4/26): That number has come down significantly, with under 20 being confirmed but others suspected.

Ad astra per porci?

Has the long-awaited influenza pandemic begun in the tinderbox of Mexico? Yesterday the Canadian equivalent of the CDC issued a BOLO to Canadian customs people for travellers returning from Mexico. This morning the World Health Organization announced that upwards of 900 people have become infected in Mexico City and surrounding areas and later in the morning Mexico City shut down its schools. Cases of swine flu in San Diego and San Antonio may be related, but no one is sure yet. Please note that "swine" flu, like "avian" flu and "Spanish" flu, can infect humans without any contact with pigs, birds, or Spaniards. They're just named after their natural reservoirs or wherever they were first noticed in people.

The unusual (read: scary) thing about this strain is that, like the 1918-19 near-apocalypse, it affects primarily people in the prime of life. If SARS and its attendant hysteria was any indication, this could turn into a nightmare for fire departments and EMS agencies around the country and especially in the border regions.

Things to think about:

1. Lots of dyspnea calls, many of which will require ventillatory support
2. Our own workforces may be hard hit and you may have to make do with holding people over on shift
   
3. The economy runs on Just In Time inventory systems; a pandemic that hits healthy adults the hardest could cripple the JIT system, possibly delaying or making unavailable things like food in the grocery store, HEPA masks at the pharmacy, Lysol and Clorox, and parts for your vehicles
4. In 1918-19 things collapsed, and that was with more local resilience (local food and dairy, local craftsmen, and inventory) and fewer people dependent on the fire department for their healthcare

If this thing takes off it could be a real adventure for the fire service.

Or it may fizzle out, but even if it does you should use it as a teaching moment about preparedness.


CDC's running swine flu updates here.

Still around

Obviously I haven't posted much lately; given the small audience here I suspect it doesn't matter. I've been busy with school and work, but will return in May. Until then, be careful and take it easy.

Are the cops our friends? Are we our friends?

In the homeland security world we are all in the race for the big pie, the federal dollars. That's why it's especially disconcerting to see a national LE figure say something like this: “All my community policing grants turned into fire trucks, and homeland security became the monster that ate law enforcement.” Really? Really?

For starters, I don't believe that is true. Predictably, I believe the fire service doesn't get enough (or the right kind of) attention from the feds when it comes to homeland security. I also believe the cops get too much and want more. They want more money and more control, from street cops who want to tell the fire department when they can disregard a scene to the police chiefs who want to tell the fire chief what is and is not a hazmat incident. Federal grants have only accelerated the power grabs, with LE agencies all over the country moving into fields for which they are not qualified, trained, or experienced. From patrol cars with Level B CPC they don't know how to maintain or put on to police department rescue squads competing with fire department rescue squads, there is a disturbing trend of mission creep for them and marginilization for us.

Budgets are zero-sum games where each agency has to make a convincing argument that it deserves as much or more money as the next. When it comes to fire vs. police we start out at a disadvantage. Few people are scared of fire, but everyone is scared of being mugged (broad generalization). Your agency has to develop a strategic communications plan that combines smart leadership with clear illustrations of public worth. There are a lot of reasons the cops beat us at budget time (they bring in ticket revenue, the public is scared of crime, they market themselves better, etc.), but I think one of the biggest is a fire service-wide strategic problem. Namely, fire chiefs aren't as professional as police chiefs, as a group. We don't have dozens of undergraduate and graduate degree programs at legitimate universities and we don't have numerous truly peer-reviewed journals producing quality research. The fire service needs to stop thinking of itself as a great alternative to college for people "who just don't like school." A fire chief with a technical certificate from a community college or bachelor's from an internet-only school is at a significant disadvantage next to a police chief with a master's degree in CJ from a brick-and-mortar university.

I realize this is an unpopular and maybe inflammatory opinion. Let me be clear: firemen are smart. We all know that, but firefighters aren't always studious or intellectual. I've heard a lot of firefighters complain about being treated like garbage men. To that I'll ask a question: what do you have on your resume that sets you apart from the garbage men? And a hint: weekend NFA extension schools don't matter.

Disorder on the Doorstep*

* I stole this title from a chapter of John Robb's intriguing book on the future of terrorism and globalization.


So the Department of Defense is worried about Mexico and the news has finally trickled down to the AP. In short, a report that hopes to foresee looming and emerging strategic threats states "In terms of worst-case scenarios for the Joint Force and indeed the world, two large and important states bear consideration for a rapid and sudden collapse: Pakistan and Mexico," (36).

IF this were to happen what would be the fallout for the fire service in the border states? Affected Mexican states are burdened with mass killings on almost a daily basis, the police and military are under direct assault, and the legitimacy of local governments is in question. I doubt we'll see a challenge to legitimacy out of all this, but we could see the mass killings and direct combat with LE and the military.

For the fire service, I'd be more concerned by the flow of refugees coming across the border in case things get worse. The American fire service has never been on the front lines of a humanitarian crisis so I am not sure what it would look like. Along the border and the corridors leading from the border to places like Phoenix, LA, and Houston, you could have an influx of thousands (tens of thousands?) of people in a matter of days. This happened in the Houston and Beaumont areas during Katrina when people from NOLA packed hotels, four, six, ten to a room. EMS calls will go through the roof as you have poor people packed tight in unfamiliar surroundings under high stress. They won't have their meds, there will be assaults and other criminal activity, and multi-dwelling fires will take on added urgency.

Just something to think about an emerging potential threat for the fire service, and the report itself is interesting as general background.

When is an MCI MVA not an MCI MVA?

On a busy weekend shopping day two weeks before Christmas somebody dropped two bottles of acid out of a tall building in Hong Kong. Forty-six people were injured and if any progress is being made in the investigation the newspapers aren't reporting it. The BBC reported that the bottles were each 750ml in size and contained an unknown acid.

Whether this was a terroristic attack, simple criminal mischief, or a mere accident, it demonstrates one of the most overlooked, least spectacular, threats we face in the United States. I am out of the loop on the zeitgeist in Hong Kong but I'll wager that if something like this happened here in the middle of the big shopping season we'd be hearing about it for weeks. If it happened more than once in different places, thus demonstrating that it is some sort of coordinated attack, it would probably lead to the sort of hysteria not seen since Amerithrax. Specific to this case, I can see engine companies running all over town to identify Coke somebody poured out on the sidewalk or a spilled bottle of water in the mall.

I'll take it a step further, though. In 1976 an anhydrous ammonia tractor-trailer fell off an overpass at US Hwy 59 and I-610 in Houston, killing six, hospitalizing 78, and injuring around 100 more. That's close to 200 casualties from one truck with no explosives. Just like the bottles of acid, we would treat this as a standard chemical release/MCI and it would be mitigated fairly straightforwardly.

The point is that terrorism doesn't have to be a belt bomb in a restaurant or a plane into a building: it can be something small, improvised, and dual-use. Some people argue that al Qaeda set the bar so high with 9/11 that they won't attempt anything less spectacular for fear of looking like their capacities have diminished. Even if this assesment is accurate we still have to worry about myriad domestic threats and other Islamist groups. No matter what law enforcement and the military do to preempt threats, some means will always be there for those with the intent in our open society. The public and TV wonks have a touch of selective hearing when it comes to this ugly truth and so we don't get as much attention on the mitigation side as those on the prevention side do.

While we can't stop the most dedicated and resourceful threats, we can prepare for the familiar on a larger and scarier scale. When is an MCI MVA not an MCI MVA? When it is coordinated and purposeful- then it's a terrorist attack and people freak out. It may not make much of a difference in how my company or your company handles the scene, but it does mean we are more likely to see greater numbers of casualties with more complications than an accidental incident of similar nature. The take-away is that two of the absolute, most essential, real world steps we can take to prepare for improvised terrorism is to brush up on our decon skills (no pun intended) and make sure we have our triage and MCI systems practiced and organized. And don't for a second doubt that the foundation of succesful MCI management is strong ICS.

To repeat: the most important first steps you can take for operational preparedness, with little expense and time, are to practice your mass decon and ICS/MCI SOP's. (Assuming you already have mass decon, ICS, and MCI SOP's and use acceptable PPE; if you don't you have bigger problems than terrorism).