Category Archives: Emergency Response

How will America be Protected from Our Developing Police State Subculture?

A danger exists in America that cultural shifts occurring below the surface of our daily lives can take away our freedoms without our knowing that these shifts exist or without our even having the chance to defend against them. I have argued that global capitalism is a subculture that has severed jobs and that has lowered America’s expected future economic growth. Recent events have demonstrated that Homeland Security initiatives could also have already restricted America’s freedoms more than we even know without our knowledge. Seemingly rogue incidents of excessive force by a few officers in disparate police forces across America could be early indications of an unseen sea change of police powers that has restructured America since 9/11.

9/11 warned America that our way of life could be forever stolen by a terrorist nuclear detonation in our nation’s capital or financial center. Because such an event could debilitate the future of hundreds of millions of people not only in America but around the world, it necessarily called for the accelerating escalation of detection, surveillance, deterrence and reactionary capabilities to minimize the chances that any such cataclysmic threat could ever occur. As a result, America has spent billions in new technology, systems, personnel, training, integration, and interoperability on local, state, and federal police and intelligence communities to increase the capability of the United States to stop terrorist acts before they occur.

The activities taken under the umbrella of Homeland Security to interweave our domestic defense community have tested our nation’s perspective of constitutional freedoms and their appropriate restrictions in the name of security. In attempting to balance freedom and security over the past ten years, our nation has created a security subculture. Many Americans were shocked recently to see the public face of that subculture’s rationale demonstrated by police forces in response to Occupy Wall Street’s peaceful exercise of democracy. Did Occupy Wall Street expose the camel’s nose under the tent of too great a removal of America’s Constitutional freedoms as we are becoming inculcated to new security measures deemed necessary by those in authority?

A gradual acceptance of perpetual defense against terrorism can itself create authoritarian tyranny. America is not immune to such gradual changes occurring underneath the view of our consciousness. As an example, while the Moral Majority amassed public power in the 1980s, underneath the surface, America became less attached to its views. Ultimately, America reacted in a way unexpected by the Moral Majority showing that a subculture had grown below the political surface. If this social subculture ultimately was exposed by an unexpected and unrelated fluke event, then perhaps well ahead of any definitive proof that an undercurrent of a building police state could be happening now without America’s knowledge or consent, Occupy Wall Street could also be a fluke event that exposed America’s growing tolerance of excessive police actions. This point is just a cautionary tale of the potential of abuse if America is not diligent in our pursuit of freedom.

My last post highlighted America’s potential to miss the subtleties of change, by comparing the unnoticed but real effect on our nation of the last ten years of structural police enforcement integration with the structural social changes that occurred during the 1980s and 1990s that went unnoticed by some in political movements of the time. Specifically, I compared the potential for police state changes in the 2000s with the changes in tolerance of sexual behavior that went unnoticed by the socially conservative political movement of the previous two decades.

I came of age in the time of the rise of the evangelical Christians as a political force. In 1976, Jimmy Carter, a self professed evangelical, was elected president. In that same year, Jerry Falwell introduced the idea of actively mixing religion and politics. Encouraged by Jesse Helms to rally the “Silent Majority” of millions of televangelist TV viewers to become active in the political arena, Falwell founded his political organization “Moral Majority” in 1979. The idea of organizing this evangelical group of millions of Americans into a political force was at the time a fairly radical sea change in harnessing the strength of coalitions in America.

Under the leadership of Falwell and Helms, the Moral Majority coalesced into a political force, influencing politics throughout the 1980s. It brought a sizable voting minority in the United States, perhaps 25%, that viewed “Religious Right” issues as the critical factor in their choices of political candidates, to the firm support of the Republican Party. Historians point to the Moral Majority’s influence in the election of Ronald Reagan in 1980, his subsequent reelection, and a revision of the Republican Party’s platform on issues such as school prayer and abortion, leading some to believe that the Republican Party would have a sizable majority for decades to come.

Yet even as its influence grew, the Moral Majority did not recognize that its political strength was ultimately eroding during the 1980s because of several factors including the rise and subsequent fall of Televangelism. The concentration of wealth and power that television had afforded ministries played out in the highly publicized fall from grace of such powerhouses as Jimmy Bakker in 1987 for his alleged rape of his secretary Jessica Hahn, and Jimmy Swaggart for his tryst with a prostitute in 1988. The fall of the Moral Majority was heightened by Pat Robertson’s bid for President, which subsequently deteriorated the power of his broadcast ministry, and Reverend Falwell’s power struggles as he disavowed Pat’s bid for President, supporting George Bush instead, and Falwell’s seedy grab of power from Jimmy Baker’s organization in 1989.

By 1992, the Moral Majority’s influence on moral and ethical issues had clearly divided the country along conservative and progressive social lines. Yet thirteen years after the opening of China to Western businesses and banks, China was beginning to impact the economy of America leading the 1992 Clinton campaign to emphasize “It’s the economy stupid” and Ross Perot’s third party to vigorously oppose NAFTA. Perot pulled enough conservatives away from the Republican Party, by some estimates, to give President Clinton the win. Clinton’s subsequent support of liberal policies following his election however, continued to galvanize those supporting the Moral Majority’s philosophies against him.

In 1994, Newt Gingrich and Dick Armey, who later would be instrumental in the founding of the Tea Party, created the “Contract with America” six weeks before the election to win over the electorate to the Republican majority. The Contract stayed clear of social issues raised by the Moral Majority, instead emphasizing economic issues supported by the majority of most Americans such as a balanced budget, the line item veto, a moratorium on regulations, welfare reform, term limits, social security and tort reform. The Republican Congress handily won the election based on the public’s vote for economic reforms.

Because the Republican Party de-emphasized the relative importance of social issues in the campaign, the subculture of social shifting at the time went unnoticed. The election, however, set the stage for the appointment of Kenneth Starr to continue the Clinton Whitewater investigation, ultimately leading to Clinton’s Impeachment.

The political buildup before Clinton’s impeachment trial fed the Moral Majority’s frenzy of disapproval of Clinton’s ethical authority to lead America. The coalition believed that the American people were solidly in favor of punishing Clinton’s behavior through censure or ultimately removal from office. When the charges ultimately came down to perjury and obstruction of justice by Clinton’s self testimony in his sexual harassment trial, the public sided with the President and let the air out of the Moral Majority’s perceived leadership on this issue.

The Moral Majority had not recognized that an undercurrent of change had occurred, that many Americans perceived the economy as a more important issue, and that Clinton’s moral failings did not rise to the level of removal from office. The hypocrisy of the Republican Party members tasked with leading the impeachment proceedings also highlighted the public’s shift away from judgmentalism. Former House Speaker Newt Gingrich made the plea that it wasn’t hypocritical of him to lead impeachment proceedings against President Bill Clinton in the 1990’s, even though he was having an extramarital affair at the time, because the impeachment case was “not about personal behavior.” Yet the public disagreed with Gingrich’s argument regarding Clinton’s lying in front of a judge about his sex acts.

For those holding to moral ethics regarding Clinton’s moral failings, Billy Graham, a registered Democrat, who was voted the most revered man in America at the time, and who had stayed above the televangelist fray refusing to join the Moral Majority saying, “I’m for morality, but morality goes beyond sex to human freedom and social justice and evangelists …have to stand in the middle in order to preach to all people, right and left”, took the steam out of the moral pursuit when he said, “If [President Clinton] is guilty, I would forgive him and love him just the same because he’s a remarkable man. He’s had a lot of temptations thrown his way and a lot of pressure on him.” Later in the interview, Graham added, “I know the frailty of human nature and I know how hard it is — especially [for a] strong, vigorous young man like he is. He has such a tremendous personality that I think the ladies just go wild over him.”

With what many viewed as Billy Graham’s shocking appeasement completed, the nation shifted its focus away from Bill Clinton’s dalliances only to be thrust into focusing on our nation’s survival three years later. The public has argued that during the past ten years since 9/11, we have given up freedoms to gain the security enabled by such tactics as placing troops in Iraq and Afghanistan, enhanced interrogation, increasing invasion of privacy such as wire taps, TSA, and surveillance of private records. Yet these changes occurred under the surface in the subculture of security. America has talked about these increasing losses of freedom but we have not noticed them on the surface until Occupy Wall Street, as a fluke, drew them out from their clandestine cover.

Now that our security subculture has been exposed, barely breaking the surface of America’s collective consciousness, many Americans have denied seeing the changes for what they may actually be, suggesting that these rogue elements of abuse are either a result of a lack of political leadership regarding the Occupy movement, or a lack of training regarding policing of such movements. If, in actuality, these rogue incidents are just the surface of a much deeper, ingrained police state subculture that has developed to protect America from our enemies, both foreign and domestic, how do we ensure that America will indeed be protected from what now seems to be an undercurrent of our own developing police state subculture?

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Filed under American Governance, American Politics, Bureaucracy, Emergency Response, National Security, Occupy Wall Street

Washington D.C. Requires a Step Change in Evacuation Capability

Last week U.S. officials accused the Iranian government of plotting to assassinate the Saudi ambassador to Washington, with a plan to employ Mexican drug traffickers to kill the diplomat with a bomb as he ate at a Washington restaurant. This potential act of war highlights the brazenness to which state sponsored terrorists have risen and also raises multiple homeland defense and emergency response issues that have been previously discussed but take on new character now that the alleged plot involves a known developer of nuclear weapons that has raised a terror threat against our state, an illegal crossing our national borders, a plot to involve drug organizations that have networks throughout our country, and a planned attack within our capital.

Overlaying this incident with the recent gridlock in DC caused by a minimal earthquake and it elevates the task of improving the status quo evacuation capability of our nation’s capital region to a higher priority. A year ago, I spoke extensively with state leadership in Virginia, Maryland, West Virginia and emergency leadership of Washington DC about developing a comprehensive evacuation and sheltering plan to dramatically improve the region’s evacuation capability. The plan would include the evacuation of hospitals and other medical facilities as well as shelters in the capital region.

The discussions I conducted entailed achieving a step change in capability by a comprehensive, interagency review of impediments and development of an interagency strategic plan for systematically eliminating these roadblocks through a prioritized method over a multi-year period to significantly improve the region’s capabilities. An overview of the concept can be found on under ASCEND.

Leadership of each state at the time understood and agreed that the vision I laid out could significantly improve the region’s capabilities and was needed. Most also conveyed that the work involved and the coordination to achieve such results would be significant. In the end, the task seemed potentially overwhelming to some given the difficulty of financing, commitment of time, coordination of efforts, and legislative changes that might be required, and the difficulty of raising the priority of the project to all agencies across state lines. The momentum to overcome status quo inertia seemed insurmountable to many of the leaders given the substantial efforts that had already been consumed to achieve the status quo.

The recent earthquake that caused gridlock in DC clarified more than ever that the corridor is in need of a comprehensive evacuation process that mitigates the mountain of impediments existing in the current system. The idea of hardening the capital for in-situ response is feasible for many disasters but leaves it extremely vulnerable to others.

We know that DC is a terrorist target and that those intent on terror have witnessed the same gridlock that America saw in the aftermath of this minimal earthquake. Apply any number of insidious or natural events that make evacuation imperative and we now know that the status quo will not achieve what is necessary to affect the safe and orderly evacuation of the capital region for all citizens. Apply the brazen attempt to bring a bomb into the district and it heightens the urgency to act.

Every time a real test of our emergency response capabilities shows the limitations of our integrated system, it calls for a widening of scope and scale of strategy and tasks within our imaginations of what can be achieved. The DC earthquake is no different. And now that the world is imagining from this real life event what might be achieved against America’s capital, it is imperative that the emergency community get on with redefining a step change evacuation goal for the capital region.

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Congress’s FEMA Fight Should Not Forego Federal Recovery Funding

Americans have not yet recovered from Congress’s brinksmanship over the debt ceiling. We thought we might escape a repeat until November 23rd when the super-committee must present its recommendations for budget cuts to be voted up or down. However, the harrowing Congressional votes of August 2nd only raised the debt ceiling. Now Congress must vote prior to October 1st for a continuing resolution to keep funding our government that has not passed a budget since April of 2009. This round of votes is guaranteed to include fights for additional agency funding reductions.

This deadline crisis budget reduction battle is the external discipline that has been chosen to force a divided Congress through small, painful steps toward achieving a balanced budget. America will need to grow thick skin as we endure the coming months while Congress whittles slivers from a bulging budget that must shrink an unbelievable 43 percent. Last week, Congress attempted to whittle a tiny sliver, $1.6 billion or 0.04 percent, from the $3.6 trillion dollar federal budget. The choice offered for vote was to supply an additional $1 billion in disaster recovery funds to FEMA only if the funds are offset by removing a portion of an auto industry loan program from the federal budget, a curiously political tradeoff.

Because FEMA’s funding will run out today without a compromise, funding for emergencies has once again become a battlefield of political partisanship. FEMA’s deadline will be used to elicit crisis compromises from a divided Congress. Even if we don’t question why Congress needs external triggers to reduce their budget, should we at least question the appropriateness of placing our nation’s emergency preparedness squarely in the middle of brinksmanship negotiations?

Congress’s trawling for deadlines caught this year’s FEMA recovery efforts in its nets and may continue to do so for years because our nation’s economy is in crisis, our federal budgets will be reduced, and our budget battles are now locked in forced deadline negotiations. Until a balanced budget is reached, funding for FEMA, HHS, DOD, the VA and other departments tasked with disaster response, will continually face budget cuts. America’s monetary collapse and lack of political unity on how to correct it suggests that budget uncertainty will get much worse before it improves.

Yet our nation cannot afford such budget uncertainty for emergency preparedness, response and recovery. Even as federal funding for emergencies is being threatened, our country is experiencing a surging escalation of emergencies and an increasing financial impact from such emergencies. We know that to leap frog our current federal capability we will need a more certain source of funding. Japan’s insufficient tsunami response from what many perceive as the world’s most prepared nation is a beacon for what will be required here in America.

Congress’s FEMA funding debate should serve notice to our nation’s leaders of emergency agencies that America’s disaster preparedness, response, and recovery must now find funding outside the political arena. Now is the time to press for secure funding outside of Congressional mandates directly from potential users of mass disaster emergency services. Funding should come from current users of EMS services, hospital beds, nursing and other facilities through mandated per bed use fees or other means to support ongoing preparation, response and recovery efforts.

America should have disaster response and recovery insurance that is also capable of funding the steady preparation efforts of our industry, and it should not be subject to the ups and downs of politics. Our national emergency insurance, perhaps through CMS, should instead fund the steady hand of a disciplined multiyear, forward looking process that can be counted on by the American People when disaster strikes, no matter the political processes of our time.

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NDMS’s 96 Hour Response Time Should Now be Reengineered

In his remarks on June 21, 2011 to the National Press Club, former FEMA head Michael Brown stated that Americans should not expect FEMA to save them. The purpose of his speech was to inform Americans that they must prepare to be without government assistance immediately after disasters. He rightly stated that Americans should prepare to help their neighbors during the 96 hour lag of federal response.

In fact, given our current national capability to respond to national disasters, expectations should go beyond 96 hours. Most Americans have no clue that the planned initial federal response to emergencies is 96 hours. 96 hours is beyond the golden hours of emergency response, those 72 hours when many victims can potentially be saved. 96 hours after the levees broke in New Orleans, the city was under siege. By 96 hours, most Haitians had died under the rubble. After 96 hours, otherwise savable victims of Japan’s tsunami had perished.

While Mr. Brown was correct that FEMA is not the agency that will save Americans during the golden hours after an emergency hits, FEMA is however one of the group of agencies that make up the National Disaster Medical System, NDMS, that does respond to federal emergencies. Current NDMS planning calls for initial response at 96 hours, 24 hours after golden hours of response have expired and NDMS can no longer have a material impact on a community’s golden hour survival. Thus NDMS was designed with a fatal flaw.

NDMS was created in 1984 to respond to cold war mass evacuations, when our emergency medical response systems were just two decades old and at a time when our country expected less from our federal government. Since 1984, America’s emergency medical response capacity has grown significantly, technology has dramatically improved, and Americans’ awareness has accelerated. As a result, the 96 hour NDMS response time is simply no longer acceptable.

While Mr. Brown praised Director Fugate during his speech for “doing a fantastic job lowering America’s expectations “of what FEMA can do, his praise was misplaced. America should instead raise its expectations of what more FEMA can do to significantly improve FEMA’s role within NDMS, and What NDMS can do to significantly reduce its response time to support local agencies who are charged with saving lives during the golden hours.

After interviewing emergency managers of 2,500 hospitals, my company, EPI-Center, found that even America’s hospitals, institutions that are considered critical to our communities’ emergency medical response, are vulnerable to significant loss of life after 24 hours if left unassisted. That is why we built a commercial medical evacuation capability to evacuate an entire hospital in just 24 hours, called HELP (read about HELP at The system was successfully tested in 2008 during Hurricanes Gustav and Ike and demonstrated that 96 hours is much too great a response impediment.

The concepts we operationalized can quickly and cost effectively be recreated within NDMS to build a national rapid response capability. Our country’s ambulance companies can double the effective capacity of NDMS and can be organized to much more effectively support local agencies during the golden hours of emergency response. NDMS can be reengineered to respond much more quickly to national disasters.

America has placed an immense responsibility for saving victims of national crises in the hands of agencies such as FEMA. Mr. Brown is correct that more will be done by individuals to help their neighbors in the coming American crises than should be expected from our federal government. Nonetheless, if NDMS will now commit to significantly reducing its 96 hour premise, its mitigation of this federal impediment will directly improve our states’ and local communities’ response capabilities, and will go far in underpinning America’s trust in FEMA.

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Top Ten Reasons That Hospitals are Not Prepared to Evacuate in a Large Emergency

When natural emergencies disable a hospital, inhibiting its ability to provide care to its patients such as recently occurred when a tornado devastated the St. Johns Regional Medical Center in Joplin, Missouri, the emergency community rushes to its aid. Acting on years of training and planning, they quickly evacuate its patients and victims to safety. However, in large scale disasters affecting multiple hospitals within a region, the overwhelming emergency resources required to evacuate a single facility may not be available for days.

During regional emergencies, hospitals are much more dependent on their own emergency and evacuation plans and resources to save lives. Having reviewed several hundred hospital evacuation plans, I can attest that while the hospital industry has made major strides in emergency preparation during the past decade, a majority of hospitals in America are unprepared to evacuate in a large scale emergency. As a brief summary, I have listed ten reasons:

1. Insufficient transportation resources – During a large emergency, local, state and federal resources place hospitals at a lower priority of evacuation. Most hospitals do not have alternate sources of transportation nor have they considered the number and type of resources that would be required to adequately respond to their emergency.

2. Undeveloped receiving facility resources – While most hospitals have mutual aid agreements and MOUs with other hospitals in their region, many have not developed detailed procedures for emergency acceptance and admittance. Most do not have agreements that go beyond their region in the event that their MOU receiving facilities are affected by the emergency.

3. Limited tracking – A large scale evacuation of several hundred patients in the span of 24 hours entails the potential use of dozens of ambulances, helicopters, and aircraft as well as the coordination of hundreds of personnel. In addition, internal and external tracking of patients, medicines, charts and personal belongings must be managed and tracked to mitigate the effect on patients and their families. Most hospitals do not have systems to accomplish this feat.

4. Lack of Coordination with Emergency Community – A majority of hospitals have reviewed their emergency and evacuation plans with their emergency management, EMS, police and fire departments. However, many have not relayed the weaknesses of their facility, nor have they clearly delineated the expectations they have of their local emergency providers. In the event that local providers are unable to assist, most hospitals have not detailed what is required to bring in outside providers. In addition, most have not detailed the communication plans that must be in place between the facility, their providers, and the emergency community.

5. Unclear triggering strategy and methodology – JCAHO standards outline minimum rationale for evacuating a hospital, yet realistic criteria are more complicated. Because of conflicting management issues, most decision criteria are not well delineated, creating confusion amongst the implementers of evacuation policies.

6. Undefined communication system – While most hospitals have acquired adequate communication hardware, including multiple backup methods, most have not defined the detailed communication processes that must be in place to implement a realistic evacuation. Rapid mass coordination of admission to receiving hospitals is one example.

7. Limited triage plan – Most hospitals have basic triage methodology to fit specific vulnerability analyses. However, many hospitals’ triage procedures have not considered realistic timing limitations of known transport resources and receiving facilities as well as a realistic rate of patient and personnel evacuation.

8. Undeveloped patient preparation plan – While much work has been done by most hospitals to develop detailed vertical and horizontal evacuation plans that correspond to required fire safety protocols, many hospitals inadequately rely on this planning to fulfill emergency internal evacuation processes. As an example, in most cases, vertical evacuation should be coordinated with the arrival patterns of transportation vehicles.

9. Lack of cost tracking – To be reimbursed by the Federal Government after incurring emergency expenses during a federal emergency, the hospital must provide detailed time and cost records for all personnel, materials, and vehicles used in the emergency. Most hospitals do not have adequate procedures or capacity to account real time for costs, potentially forfeiting millions of recovery dollars as a result.

10. Inadequate funding – The United States has access to 70,000 ambulances, enough to overwhelm even most large disasters. However, many hospitals rely on the Stafford Act to fund their rescue, limiting access to available resources. Most have not planned for alternate funding mechanisms to draw upon during an ongoing emergency.

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Tornados Plus Drought Equal Active Hurricane Season

Robert Brookens, President of Hurricane Hollow Weather Corp, Host of the Barometer Bob Show in Jacksonville, Florida shared with me that Florida has an old saying. A dry May indicates an active hurricane season for the state. Extremely interesting old saying!

Since 1960, Florida has had 10 years with drought like conditions during the month of May. This indicator appears to have been highly reliable as a precursor to late season, high category, landfall hurricanes. Combined with peak tornado seasons, it portends an active fall. Thanks to Bob for sharing:

tornado hurricane comparison2
Data PDF

The correlation of data is significant:
9/8/1965 – PEAK tornado year – Hurricane Betsy, Category 4, FL, LA
9/20/1967 – PEAK tornado year – Hurricane Beulah, Category 5, TX
9/14/1982 – PEAK tornado year – Hurricane Debbie – Category 4, PR, BM missed mainland
9/22/1989 – Hurricane Hugo – Category 5, SC
10/1/2000 – Year after PEAK tornado year – Hurricane Keith – Category 4, MX missed U.S.
8/3/2004 – PEAK tornado year – Hurricane Alex Category 3, NC
8/13/2004 – PEAK tornado year – Hurricane Charley, Category 4, FL
9/5/2004 – PEAK tornado year – Hurricane Francis, Category 4, FL
9/16/2004 – PEAK tornado year – Hurricane Ivan, Category 4, FL, Category 1 TX
9/26/2004 – PEAK tornado year – Hurricane Gene – Category 3, FL
8/21/2007 – Hurricane Dean – Category 5, MX missed U.S.
9/4/2007 – Hurricane Felix – Category 5, NI missed U.S.
9/1/2008 – PEAK tornado year – Hurricane Gustav – Category 4, LA
9/13/2008 – PEAK tornado year – Hurricane Ike – Category 4, TX
10/16/2008 – PEAK tornado year – Hurricane Omar – Category 4 VI missed U.S.
11/14/2008 – PEAK tornado year – Hurricane Paloma – Category 4 Cuba dissipated before striking FL
August – October 2011. – PEAK tornado year – Drought conditions signal Heightened Hurricane Alert (HHA)

All residents who choose to live along our coasts should be prepared for hurricanes. It is part of our civic reponsibilities. In 1969, my grandmother, who had lived on the Gulf in Gulfport, Mississippi for 80 years had seen her number of storms and felt “old and wise” enough to ride out Camille. Thank God my aunt pulled her out of her antebellum home the day before Camille hit. Two days later, we returned to the site where the house had once stood for 120 years. It was gone but for the front steps.

Unfortunately, human nature is involved. Florida, for example, has escaped real dangers since 2004 and while our net population has only grown by 2 million since then, the turnover has been much greater, meaning perhaps 25 of the population did not experience the hazards of 2004 and do not even have those experiences to drawn upon.

Since 1995, hurricane potential has been above average and forecasters have rightly stated such. The prognostications, however, have begun to sound like our terrorist threat levels. Not only do our average citizens get complacent but, facing our country’s recession, our businesses, some that have responsibilities for life and limb, have made lax choices between current budget items and hurricane preparation expenses that endanger their preparedness and those for whom they are responsible.

The simple correlations that I have shown are enlightening that even in a higher multi-year period of expected heightened activity, there are indications that may help to alert those who have lessened their preparedness. They also point to patterns that should be explored more in depth by those in the field.

The joke that if meteorologists could really give five day forecasts, we would only need to see them once every five days is funny but fails to give credit to a profession that has made great strides in accuracy during the last few decades. However, that said, I expect that just as most did not foresee the advancement of computers when I was a boy, there are yet undiscovered methods of meteorological science that will eventually dramatically improve our ability to predict weather, including the seasonal patterns to which I have alluded.

We will need them to be better able to financially and operationally rapidly respond to large scale disasters and save more lives with limited resources and great geographies. The current post Katrina method of mounting large response forces near expected landfall, as an example, is extraordinarily expensive and draws resources away from coastal areas less probabilistically endangered. The potential exists that as Katrina becomes more a distant memory and budgets more a political reality, that the choice of massing assets ahead of hurricanes will wane. Given current forecast capabilities, probabilistic choices regarding life and cost are being made. New discoveries will make response capabilities more sustainable in the long run.

All that said, the correlations that I have shown do point to a heightened probability above what has been traditionally discussed. It is up to this body to decide how to use the data. Having seen its correlation, I will share it with my customer base as I have gladly shared it here. Given the human nature we have discussed, perhaps it will seasonally have someone in need respond as my aunt did the day before Camille.


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2011 Tornados Predict a Major Hurricane Landfall

Joplin, Missouri, the scene of the deadliest tornado in our nation’s history, with winds exceeding 190 mph, left a path of destruction ¾ of a mile wide and 4 miles long through the heart of the city. In the aftermath, we have seen America’s traditional shelters of protection, hospitals and schools, destroyed in Joplin. With entire communities mourning the loss of 116 lives thus far and miles of seeming unearthly destruction, America is unnerved. Our thoughts and prayers are with the families of Joplin, and community now involved in their rescue under extreme conditions.

Joplin is the most recent in a year of extraordinary weather that has recorded a historic flood height on the Mississippi, and a record super tornado outbreak. Patterns seem heightened causing concern for the upcoming June 1st start of the hurricane season. With May 22nd beginning National Hurricane Preparedness Week, Gerry Bell, forecaster at NOAA’s Climate Prediction Center, believes this hurricane season will compare to our most active. Does this deadly 2011 tornado season portend a major hurricane landfall in a season predicted to be above normal by Colorado State University?

Unfortunately, this year’s tornados do suggest the Atlantic and Gulf coasts will see their share of destruction in 2011. First, hurricane patterns do loosely follow tornados. While both form in warm, damp air when winds blow into each other from opposite directions, the localized drivers are quite different. However, seasonal, annual and global patterns correlate. In years during or immediately following peak tornado activity, major landfall hurricanes have occurred. Hurricane Betsy landed in 1965, Agnes in 1972, Andrew in 1992, Charley in 2004, Katrina in 2005, and Gustav and Ike in 2008, all correlating to peak tornadic activity. This pattern does not bode well for 2011, with Colorado State University predicting probability of hurricane landfall in 2011 at 72%.

Second, both tornadic and hurricane activity is escalating. In the ‘50s we averaged 400 tornados per year, in the ‘70s 800 per year, in the ‘90s 1,200. In 2004, the same year that Florida was ravaged by four hurricanes, we had over 1,800 tornados. Between the ‘50s and ‘80s, with the exception of 1969, the year of Camille, America had milder patterns of hurricanes. However, since then, hurricanes have been much more active, deadly, and costly. 2010 was actually a year of peak hurricane activity with an incredible 12 hurricanes that missed landfall due in part to La Nina.

Which brings us to our third forewarning, the expected ending of La Nina prior to this hurricane season. During years of La Nina, America has been blessed with mild hurricane landfalls, but in seasons immediately after La Nina, America has experienced major destruction including Betsy in 1965, Agnes in 1972, Hugo in 1989, and Ike and Gustav in 2008.

Finally, I would be remiss in not at least mentioning increasing sunspot activity. 2011’s active weather season follows several years of relative calm corresponding to unusually low sunspot activity, but the 11 year sunspot cycle has begun again. Scientists believe that increased sunspot activity causes the ocean’s surface to warm across the subtropical Pacific, leading to more evaporation and water vapor. The trade winds then carry this vapor to the rainy areas of the western tropical Pacific, fueling heavier rains and reinforcing active weather patterns.

Hurricanes Betsy and Hugo both occurred at the start of sunspot activity such as we are now experiencing. Sunspots along with other significantly correlating data points suggest an overactive hurricane season with the potential for major landfall in 2011. 2011, already a difficult year for America, may well be remembered for its major emergencies and America’s enduring response. God Speed.

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Why are Special Medical Needs Patients Political Hot Potatoes?

While great strides have been made to develop large-scale disaster evacuation plans for America’s citizens, our most vulnerable minorities have been left behind asking to be heard. Federal laws require equal and integrated treatment of persons requiring specialized medical assistance. However, our federal evacuation system has resisted development of a national capability, instead deferring responsibilities to the states.

The majority of states simply do not have the resources to implement full-scale evacuation of these populations during statewide disasters. Lacking viable options, many defer to local authorities who either incorrectly assume the federal government meets requirements or that certain populations fall outside the responsibilities of government. This passing of the hot potato between federal, state, and local governments needlessly delays the development of a critically important, national response capability for special medical populations.

While laws such as U.S. Code §753(b)(4) (A)(I) (ii)(iii) require equal federal treatment of these patients, instead of building a federal capability, the federal government has instead attempted to meet legal requirements by authorizing states through grant funding to provide implementable special patient evacuation plans. However, states have not been successful in meeting this requirement for large scale disasters, and federal laws have continued unabided for decades.

States have found that the complexity of the problem requires greater resources than can be obtained at the state or local level. They have cited several reasons for not solving special needs patient evacuations needs including insufficient:

• Transporters to quickly move all special needs patients.
• Specialized equipment to quickly transport all special needs patients.
• Receiving beds for certain special needs patients.
• Coordination for safe, effective and fast evacuation of all special needs patients.

During my discussions with most state agencies and many local ones, they have shared complex examples of special medical needs patients requiring solutions. Examples include:

• A neonate hospital on the Atlantic coast requires the ability to quickly evacuate 150 critical care neonates when a hurricane approaches, but no federal, state, or Emergency Management Assistance Compact capability exists to transport these children or to absorb them into capable receiving hospitals.

• A group of behavioral facilities along the gulf coast houses over 400 physically and mentally disabled patients who must permanently remain in specially made “lounge” chairs. Because of their odd sizes, the chairs cannot be transported by conventional ambulances or paratransit vehicles. No local, state, or federal service has been identified to transport these patients during an emergency.

• A verified burn center in the Midwest noted that because burn facilities run near capacity, no region can absorb a full evacuation of a center. Without a national transportation capability, most large-scale burn incidents continue to rely on lesser care options.

None of the many examples I have examined are insurmountable. All can be accomplished through current communication and logistical technologies. However, they require a collective will of our federal government and states to integrate specialized, rapid-response resources. We no longer have a reason to postpone answering the voices of our special medical populations. We no longer have a reason to leave the requirements of our laws unfulfilled. It is high time we develop a national evacuation capability for patients with special medical needs.

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Great Disasters Require an Accelerated Response

Most emergencies are resolved at the local level by professionals and volunteers who put the interests of their community above their own, and become our true heroes. When emergencies are large enough that they require the assistance of other communities, the state, the region, or our federal government, we rely on NIMS as a basis of escalating higher levels of support and control. NIMS provides order in the midst of disasters’ chaos and gives our nation’s emergency responders assurance that structured reinforcements will back up their rush into the heart of the disaster. As a basis for escalating support and control to large scale disasters NIMS needs our nation’s cooperation.

No matter the size of the emergency, however, all emergencies ultimately occur at the local level. If the emergency is large enough that if affects communities to either side of us, their emergency responders will be busy helping their own community, and we will be left to our own defenses. If our community prepares all of our defenses to work together, we will better survive the initial hours of a great disaster, and will be better able to help our neighboring communities that are worse impacted.

We are best equipped to help our community and those surrounding us when all our emergency response organizations share a vision of an organically integrated community response and have a collective desire to reach that vision. Organic integration is not a new concept. As an example, the United States has spent billions to implement the vision of integrating pre-hospital ambulance services, trauma helicopters and emergency rooms to act as one organic system that increases the survivability of accident victims during the golden hour.

Communities that create a vision of an organic mass medical evacuation system, capable of removing all their medically needy citizens from the disaster zone, will improve their citizens’ chances of survival during the 72 golden hours of an emergency. Many communities have begun to develop and implement their own shared vision that integrates their emergency management, security infrastructure, EMS and medical facilities into one organic community mass medical emergency response and evacuation system. However, while the idea seems elemental, creating and working toward shared community vision has proved difficult for most.

It seems that some in the community are less willing to commit to the effort than others. Yet all in our industry are drawn to the highest survival of our fellow citizens and desire to cooperate. Beyond cooperation, to bind all to a common vision requires that all parties believe that it will not harm their organizations. Invariably in moving toward a shared vision, impediments to participation arise that would harm individual organizations if not mitigated. Therefore, if all are to participate, a community must commit to create a shared vision that also defines and eliminate impediments that harm participation, that slow response, and that create inefficiencies in how our agencies, public, and private companies interact to save victims.

Without eliminating these inefficiencies, communities are still able to successfully respond to most emergencies we encounter, even if by brute force. However, the larger the emergency, the faster it will present itself and the more rapidly we must respond. Great disasters are measured in acceleration and our response must accelerate to meet them. The moment our community’s lack of integration is overwhelmed by the disaster’s acceleration, we learn that not eliminating impediments creates a failure point that could have been overcome.

Our impediments define the failure points of our community’s ability to respond to large disasters. Our neighbor communities are hampered by their own impediments and will be overwhelmed at some point in a disaster’s acceleration. Statewide and Federal impediments only serve to create additional complexities that thwart needed response acceleration. And our current NIMS structure, while our nation’s best escalation system, is also an anchor to acceleration. Its structure must also be revised to allow for rapid escalation.

National impediments entangle state responses, state impediments hinder local responses, and local impediments entangle our own forces from effectively and rapidly aiding our citizens. Ultimately, our nation must resolve to understand what can be achieved by eliminating historical, jurisdictional, legal, regulatory, operational, and financial impediments. All levels of government must commit to a deliberate process of determining a path forward and collectively eliminating impediments that limit our potential. Local, state, and federal governments must come together with private and public entities to create a shared vision of a future, accelerated response.

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