Homeland Security Watch

News and analysis of critical issues in homeland security

November 20, 2014

Ebola — no sitrep — but an update

Filed under: Biosecurity,Preparedness and Response,Public Health & Medical Care — by Philip J. Palin on November 20, 2014

One Wednesday the World Health Organization released a new update on the situation in West Africa.  The rate of new transmissions has continued to decline in Liberia and Guinea.  But the curve is continuing upward in Sierra Leone.

I have not seen a persuasive analysis to explain the difference between the three neighboring nations.  But there is some indication that too many social-networks in Sierra Leona may still be in denial.  Community engagement and organization are widely thought to be what turned-the-curve in Liberia.

On Tuesday a subcommittee of the House Foreign Affairs Committee held a hearing on fighting Ebola in West Africa.   You can see/hear a video of the hearing and read the prepared testimony at the committee’s website.

I probably will not prepare a new sitrep this weekend as I have the last few weekends.  A couple of new “day job” assignments are going to take a serious commitment through mid-February.  I may be a bit AWOL from HLSWatch.  We’ll see.

November 6, 2014

Local conditions, globalized consequences

Filed under: Biosecurity,Preparedness and Response,Public Health & Medical Care,Strategy — by Philip J. Palin on November 6, 2014

The following appeared in the November 3 edition of FrontPageAfrica, a leading Liberian news outlet.  The story was reported by Stephen D. Kollie.

As previously noted in Ebola Source Sitrep 3, there seems to have been an unexpected slowing of the Liberian rate of transmission. There are new reports this week, however, of increased transmission rates in neighboring Sierra Leone.  Here is the most recent WHO update.

There has been a remarkable absence of US broadcast media attention to Ebola as most of those treated for the disease in the United States have survived.  The “press” — digital and paper — has been much more attentive.

Late yesterday, President Obama requested a $6.18 billion special appropriation to combat Ebola.  According to the White House website, the funds will be used to

  • Fortify domestic public health and health care systems
  • Contain and mitigate the epidemic in West Africa
  • Speed the development and testing of vaccines and therapeutics
  • Establishing the capacity of vulnerable countries to prevent, detect, and respond to disease outbreaks before they become epidemics that threaten the American people.

–+–

Vahun, Lofa County – Barely seven months after the deadly Ebola Virus hit Lofa County, Liberia’s fourth most populated county (2008 national census) life seems to be returning to normal, but fear that the disease will resurface, exists among residents of the county. Schools remain closed, nonessential staffs working for the government; continue to remain home, while the culture of handshake, hugging and all forms of bodily contact is still prohibited.

At the crossing point, which connects Lofa and Bong counties, travelers are compelled by security officers to get of vehicles, wash their hands and undergo temperature screening. Those with high temperature levels are prevented from entering the Lofa County and refer to the local health authority for additional medical checks.

In Voinjama, the provincial capital of the county, posters of Ebola awareness messages are prevalent. Community radio stations still boom with anti-Ebola songs and messages. This, they say, is to remind residents that Ebola epidemic is not over yet. Many, including non-government agencies believe the disease spread because people did not believe in the existence of the virus.

“No one could listen when it was announced that Ebola is in town,” said Isaac Ballah, a local NGO worker in Voinjama City. Ballah told FrontPage Africa that nearly everyone in the city came to terms with the disease when a man showing signs and symptoms of the virus was seen lying at the entrance of the Lofa County Community college.

Ballah narrates that the suspected Ebola patient was lying helpless, vomiting and openly defecating as locals went to take a glimpse at the first apparent case, which signaled the coming of dark days. “After that morning, we all went home silently, with so much worried. The next day everyone picked up their clorax bottles and we stopped shaking hands and touching each other,” he said. “Few weeks later you could only hear the sound of ambulances everywhere and at the same time, see two to three pickups filled with dead bodies.”

All this epitomized the agony the people of the county were subjected to for months said Ballah. But for several weeks now, not many cases relating to the Ebola virus have been reported in the county. But residents are still taking safety seriously to prevent any widespread occurrence of the disease. They are skeptical in ruling out a new outbreak considering the county’s closeness to neighboring Guinea and Sierra Leone with which it shares borders.

Nationwide, the numbers in Ebola cases seems to be declining as has been acknowledged by the World Health Organization (WHO). The WHOs Bruce Aylward on Wednesday confirmed the decline in the number of Ebola cases in Liberia.

“The actual number of newly reported cases is beginning to decline in Liberia and the government is driving a multi prone investigation, looking at multiple strands of evidence to try and understand, is this real, is this reporting phenomenon or is this care seeking phenomenal that’s changing? So far based on the information received today… it appears that the trend is real in Liberia,” he said.

Despite this good news authorities and citizens of Lofa are taking the good news with a bit of caution. In Voinjama, all general markets remain closed to prevent public gathering. Residents are forced to sell their produce during regular weekdays instead of Fridays, which is recognized as the official market day.

Zangota’s Patient zero

In Zangota, a small town just 45 mins from Voinjama City, where over thirty deaths were reported, the Ebola nightmare began with Krubo Mamaie, who traveled to the town for medication, says 33 year-old Luana Korvah, a mental health supervisor who was actively working with the county’s Ebola task force.

According to Korvah, Mamie had cared for her sick husband in Voinjama who died of Ebola and later left for her town when she also fell ill. She was referred to the Konia Health Center by local officials in Zangota, but died en route to the Foya Ebola Treatment Center because her condition had turned for the worse.

Said Korvah: “She and her husband had burial activities in Guinea, when they went back into the community the husband fell sick.” “She was then caring for the husband and later the man died. They took the man to Letisu for burial and those that took part in the burial ceremony, who did the bathing and all the other traditional things died.”

Korvah said many residents in the area did not believe it was Ebola rather they held the general opinion that their wells were poisoned and thus causing them diarrhea and other illnesses. The residents’ failure to accept the virus existence left nearly 70 persons dead in Zangota and the numbers continued to increase spreading to nearby towns and villages.

Now, after nearly eight months battling the deadly virus, it seems Ebola has taught many lessons in the county. Precautionary measures are the order of the day. Hand washing, no handshake is just a few preventive methods that are still being religiously practiced even though infections have slowed in a County which has lost nearly 200 persons.

Careful barbing

At a local barbing shop in central Voinjama, barbers use hand gloves, bleach and other disinfectant before barbing. Not many people are allowed to sit in the barbing shop to avoid bodily contact. “We are still scared and are doing everything possible to ensure that no one get infected in this shop,” Mohammed Sore, owner of the two brothers barbing shop told FPA.

He says while there has been no case of Ebola reported in the county for the past few weeks, he and his colleagues have not stopped the preventive measures and will continue until the country is declared Ebola free. “We will stop using the gloves and chlorine when we hear that Ebola is not in the country again,” said one of our fears is that we are close to the border and people are still coming in from Guinea,” he said Sow.

At the over 80-bed facility run by the medical charity group Medicines Sans Frontieres in Foya, all patients have been discharged with zero cases reported so far. All schools in the county remain closed as part of President Ellen Johnson Sirleaf’s directive on the prevailing state of emergency in the country.

Non-governmental Organizations such as the Pentecostal Mission Unlimited (PMU Liberia) is moving in to help with preventive materials and support to many health facilities, as residents wait quietly to see a total eradication of the deadly disease. Residents of Lofa have seen hell; Ebola killed and obliterated entire families. Cultural and religious practices helped to rapidly spread the disease among community members who were also in strong denial of the virus according to residents.

Now, the numbers of cases being reported are few and no much news of suspected deaths in Lofa County. Hand washing buckets are still placed in nearly every household and those that cannot afford the bucket travel with a bottle of chlorine water just for protection against the deadly virus, which has killed a total of 2413 persons and infected 6535 individuals in Liberia alone.

November 5, 2014

RIP Former Boston Mayor Thomas Menino: The Public Health Mayor

This week Boston laid to rest it’s longest serving mayor, Thomas Menino.  He served as mayor in Boston for 20 years.  Yes. That’s right.  Twenty years.

To his admirers he was known as the “Urban Mechanic,” as the Boston Globe describes, “leaving to others the lofty rhetoric of Boston as the Athens of America, he took a decidedly ground-level view of the city on a hill, earning himself a nickname for his intense focus on the nuts and bolts of everyday life.” To some of his detractors (and even his supporters) he was referred to as “Mumbles,” for his less than soaring rhetorical skills.

This humble man from the Hyde Park neighborhood of Boston rose to national prominence, with former President Bill Clinton paying his respects before the funeral procession and Vice President Joe Biden attending the ceremony. Impressive for a politician recognized to have no political ambition beyond running his city.

What does this have to do with homeland security? For some time I’ve heard from various colleagues that preparedness, particularly health-related preparedness, had an unusual amount of political support in Boston. Public health and EMS were not simply the minor leagues to law enforcement and fire service major league players. But it became vivid when I read the following description from a food-orientated homage to Mayor Menino from The Atlantic food critic Corby Kummer:

But aside from the coddling and special treatment any mayor who shows up gets, Menino cared about food for exactly the reasons today’s food-movement activists do, and long before it was fashionable to embrace what food can and should mean: access to fresh produce for everyone of every income level; gardens as ways to unite and repair communities; and, most importantly, fresh food as a route to better health. The mayor told everyone, including his biographer, longtime Atlantic senior editor Jack Beatty, that he wanted to be remembered as “the public-health mayor.” That made him work particularly closely with my spouse, John Auerbach, who served 10 years as Boston’s health commissioner. 

So….apparently I missed this self-appointment.  After the fact it was easy to find further evidence of Menino’s interest in public health.  See the videos I’ve posted below.

Again, how is this related to homeland security? Two points that at least I think of are interest. 

 

A lot, if not the majority, of public health work does not seem to fall into the category of homeland security. Expanding access to fresh produce in low income communities, anti-smoking efforts, childhood vaccination campaigns, etc.  It’s not always about responding to the next Ebola outbreak.  Yet when taken as a whole, improving the health of the community in general improves overall resilience.  Healthy people fare better during and following disasters than unhealthy ones.  People with access to health insurance are more likely to visit a primary care doctor than the emergency room for common maladies, thereby not taking up vital resources during events like the Boston Marathon bombing. A healthier community is a more resilient community.

Menino’s attention to public health underscores the importance of political leaders in homeland security. I have often heard professionals complain about meddling politicians (along with the annoying press) and how events can be run more smoothly when they are absent.  Yet not only do they play an important role in communicating with the public during and following disasters, they make or influence the choices made in a community before there is a bad day.  Menino’s focus on public health not only improved the overall health of Bostonians, but contributed to the competence exhibited during the response to the Marathon bombing, from the existence of a Medical Intelligence Center to the cooperation between city agencies such as Boston EMS and Public Health with the private hospital systems.

It is comparing apples and oranges, but in thinking about this I could not help but contrast Boston’s situation with that of New York City.  Size and resource issues aside, NYC has spent the most energy on security instead of general preparedness since 9/11.  I am not arguing that there has not been a lot of resources directed towards preparedness and response activities and organizations, only that it is lacking when compared with the radical changes enacted in the NYPD and other agencies charged with preventing a terrorist attack. I think I could make the case that Boston, under Menino’s leadership, took a more all hazards approach while NYC, under Mayors Giuliani and Bloomberg, remained primarily focused on terrorism. That is not a value judgement, but simply an observation.

If you are interested, the following video highlights many of Mayor Menino’s accomplishments in public health.  From the Boston Public Health Commission (which Menino created in 1996):

 

If you have a little more time, here is a longer discussion held at Harvard’s School of Public Health with Menino shortly after he left the Mayor’s office.  For those more security minded, at the beginning of the discussion he is asked and replies with a lengthy description of his point of view about the events surrounding the Boston Marathon bombing.

 

 

 

November 1, 2014

Ebola source sitrep 3

Filed under: Biosecurity,Preparedness and Response,Public Health & Medical Care,Strategy — by Philip J. Palin on November 1, 2014

The World Health Organization released a new data summary late on October 29.  A few highlights:

The growth rate of transmission in West Africa seems to have slowed, especially in hardest hit Liberia.  This has surprised most close observers who suggest it is either the result of unrecognized and under reported transmissions or is a temporary trough in what can be a wave-like pattern on the part of the virus.

The region’s anti-Ebola capacity is much stronger now than at the beginning of October.  Several new diagnostic labs and treatment facilities are now in place (see map below).  Clinical personnel are more numerous and better equipped. Some have suggested the reduced transmission rate is the outcome of interventions — educational, clinical, and logistical — put in place over September and October.

Ebola Treatmentt

Despite this good news — or pause in worse news — a new scientific analysis published on Thursday concludes, “Under status quo intervention, our projections indicate that the Ebola outbreak will continue to spread, generating a predicted 224 (95% CI: 134 – 358) cases daily in Liberia alone by December…”  For the week ending October 25 fewer than 50 probable cases were reported in Liberia.

The key factor may be “status quo intervention”; how much effort, targeted where, will have the most effect?  It is widely recognized that the West African outbreak is the result of a failure to intervene early and effectively, before the virus was able to spread in dense urban environments.  The best evidence for this analysis being what has happened with an unrelated, but parallel, cluster of Ebola cases in the Democratic Republic of the Congo.

The first Ebola death in the DRC was on August 11.  The role of Ebola was identified before the end of August.  Aggressive public health measures were taken to isolate and treat those with the virus.  (Other factors probably helped.)  There have been a total of sixty-six cases and forty-nine deaths.  It has now been eighteen days since the last new case was identified.  The transmission cycle was contained and has apparently been stopped.

Public education and community involvement are, many emphasize, fundamental to this sort of success.  The same analysis projecting potential exponential growth in the number of West African Ebola victims found that four behavioral adjustments could produce a rapid decline in transmission (see chart below).  Of particular importance is a change in burial practices.  The “status quo” being studied was the situation in mid-September. Several of the practices have been increasingly adopted since.  Already enough to produce the recent declines?

Ebola 4 Interventions

Since the West African Ebola cases first emerged, many at HLSWatch have suggested that for the United States this is mostly an opportunity to “run the traps” for a much more easily transmitted, much less treatable infectious disease.  Important issues have surfaced related to early identification and treatment, clinical protocols, clinical training, and quarantine policy, strategy, and practice.

Some potentially less obvious lessons:

Isolation matters:  The economic isolation of eastern Guinea produced a level of poverty that resulted in hunting bats for food.  When a child and then his family members died of bat-borne Ebola they did not receive medical attention. The virus was given time to multiply.  In urban Monrovia the poverty-stricken West Point slum has been the epicenter of transmission.  The population’s lack of connectedness with wider society has impeded the application of effective public health strategies.

Culture matters:  Washing, caressing and otherwise honoring the body of dead family members has been a particularly virulent vector for transmission of the disease.  Working respectfully within the culture it has been possible — with remarkable speed — to adjust cultural behaviors.

Community matters:  Connecting those who were disconnected and building trust where there was little or none has been a precondition to adjusting population behaviors and bending the transmission curve.  Facilitating and supporting community self-organization has again and again been a big part of the public health approach.

Media matters:  Mass media and social media can significantly influence the velocity of public attitudes for both good and bad.   How to influence the velocity of media attention is, I suggest, quite similar to how we effectively engage the virus itself.  Think about it.

Reasoning matters:  Chris’ Tuesday post — and Haidt’s claim — have clearly been on my mind all week.  For what it’s worth, I perceive Haidt was mostly critiquing a tendency by some to perceive reason as self-evident and to dismiss those too stupid to recognize the obvious.  In this regard I agree with Bellavita and Haidt.  The noun can be pretentious.  But the verb — reasoning — when undertaken in a way that embraces culture, community, and respectful communication is the best tool we’ve got.

Maybe this is an opportunity to run the traps on more than the next infectious disease.

October 30, 2014

Big bad but not even a CAT 1

Filed under: Disaster,Preparedness and Response — by Philip J. Palin on October 30, 2014

Sandy Track

Sandy taught important lessons.  Maybe not every student who encountered her teaching has learned as much as she offered, but few went home without a bit more wisdom.

There are several of Sandy’s students — especially after a couple of beers — who will explain the difference between a local emergency and a regional disaster.  Some will admit that after Sandy they see how a disaster, especially in a dense urban context, can detonate the whole web of modern interdependencies.  Just a few more two years ago and very bad might have become catastrophic.

A tough teacher in the school of hard knocks.  But some — enough? — are better prepared for the worse still to come.

October 26, 2014

Embracing diversity

Filed under: Biosecurity,Border Security,Preparedness and Response,Public Health & Medical Care,Strategy — by Philip J. Palin on October 26, 2014

obama pham(Official White House Photo by Pete Souza)

None of us much like what we perceive as mixed messages.  But many of us seek out diverse sources of information.

I am — as regular readers know too well — a big fan of diversity.  It is an intellectual and aesthetic preference, almost certainly a personality predisposition.

Diversity is also a key characteristic of resilience.  The more diverse a system the less prone it is to catastrophic collapse, the more creative combinations that exist the more likely the system (or sub-system) is to resist and, if necessary, rebound from challenges.

I am personally skeptical of most efforts to reduce variance, increase consistency, and especially any tendency to reserve decisions for some centralized authority.  I am aware such approaches can generate benefits.  But there are also trade-offs and I perceive we too often accept the trade-offs without recognizing what we are giving away.

Since Thursday I’ve been in Newark and New York.  The confirmation of Ebola in a physician who returned to New York after treating patients in West Africa has caused concern.  On Friday Governors Christie and Cuomo, acting more on their political instincts for advancing the common good than expert medical advice, announced a strict quarantine requirement for health care workers returning to JFK and Newark International airports.  This exceeds federal requirements. (Illinois soon followed for those arriving from West Africa into O’Hare.)

I was busy, but as I watched the local news a bit and read the reports I was pleased to see this diversity emerge.  I like it when state and local leaders exercise their best judgment and authority.  I respect political judgment, especially when it relates more to how human social systems actually operate and less about the next election.  I found the non-partisan, reasoned rhetoric of the Governors and Mayor de Blasio mostly helpful.  Medical therapies and social therapies can diverge.

At just about the same time, or at least during the same news cycle, President Obama was purposefully — and a bit awkwardly to my eyes — hugging nurse Nina Pham (above) who has recovered from the Ebola she contracted at her hospital in Dallas.  The intended message was, I hope, clear enough.  For the more literal minded, the President followed up explicitly in his weekly media message.

Meanwhile… Kaci Hickox a nurse arriving at Newark from Sierra Leone, asymptomatic, and according to a preliminary test virus-free, is nonetheless being kept in a 21-day quarantine against her will.  She writes in the Saturday Dallas Morning News:

I am a nurse who has just returned to the U.S. after working with Doctors Without Borders in Sierra Leone – an Ebola-affected country. I have been quarantined in New Jersey. This is not a situation I would wish on anyone, and I am scared for those who will follow me.

I am scared about how health care workers will be treated at airports when they declare that they have been fighting Ebola in West Africa. I am scared that, like me, they will arrive and see a frenzy of disorganization, fear and, most frightening, quarantine… (The nurse continues with a rather horrific story of her welcome to the United States.  You should read it.)

The epidemic continues to ravage West Africa. Recently, the World Health Organization announced that as many as 15,000 people have died from Ebola. We need more health care workers to help fight the epidemic in West Africa.  The U.S. must treat returning health care workers with dignity and humanity.

The ACLU has announced it will take action challenging the New Jersey quarantine order.

Then as if to put into even sharper contrast the different angles on reality alive in Trenton, Albany, and Washington DC, on Sunday morning I read our UN Ambassador Samantha Power is in West Africa.  She has already visited the Ebola wards.  Should she be quarantined in isolation on her return?  Or in deference to separation of powers, will a sanitary cordon of the Ambassador’s residence at the Waldorf be sufficient?

Thursday and Friday I was mostly impressed with how New York local-media was handling the story. Saturday I was too otherwise engaged to notice. Now early on Sunday morning there is a nearly palpable urgency to take sides… or, if one does not feel confident/competent to choose sides, to bitterly complain regarding the incompetence of the “authorities” who should have had this sort of risk fully thought-through.  “It’s not tight”, the President himself has complained.

In my experience reality is seldom tight. At a certain point working to make it tight strips the threads and even breaks the head.  Can we learn to engage diversity affirmatively, creatively, even systematically, as a potentially positive — in any case, persistent — aspect of reality?  In dealing with complex risks, I have found this to be an especially productive option.

MONDAY UPDATE:

According to several news sources, New York will “loosen” its screening protocols.  Here’s a bit of the AP report:

Gov. Cuomo back peddled Sunday on his insistence that medical workers returning to New York from Ebola-stricken countries would have to undergo a mandatory 21-day quarantine at a government-regulated facility

The governor, in a joint news conference with Mayor Bill de Blasio, said health care workers and citizens who have had exposure to Ebola patients in West Africa will be asked to stay in their homes for the 21-day quarantine.

During the 21 days, the quarantined person will be checked on twice a day by health care professionals to take their temperature and evaluate their condition, Cuomo said.

Here’s the official statement from the Governor’s office.

Constant change in response to feedback, adapting to new information (new expressions of reality) is another feature of diverse and resilient systems.  And just to be clear: in the most resilient systems while change is constant a core-coherence persists.  Which highlights the big difference between consistent and coherent, between control and collaboration…

SECOND UPDATE:

According to NJ.com and other news outlets, Nurse Kaci Hickox will now be allowed to quarantine at home in the state of Maine. The New Jersey Governor’s office released a transcript and video to provide context for this shift.

October 23, 2014

Ebola source sitrep 2

Filed under: Biosecurity,Preparedness and Response,Public Health & Medical Care — by Philip J. Palin on October 23, 2014

This is the second in an irregular update on efforts to slow and eventually stop the rate of Ebola virus transmission in west Africa.  The risk of transmission in the United States is a function of the rate of transmission at the source.

It is important to acknowledge issues with data quality.  Over the weekend a piece in Science magazine noted, “… it’s widely known that the real situation is much worse than the numbers show because many cases don’t make it into the official statistics. Underreporting occurs in every disease outbreak anywhere, but keeping track of Ebola in Guinea, Liberia, and Sierra Leone has been particularly difficult. And (as) the epidemic unfolds, underreporting appears to be getting worse.”

Still the data that is collected can help us understand some broad dynamics of transmission.

Yesterday afternoon — October 22 — the World Health Organization released a progress report on their response roadmap.  It provides details through the end of last week for all known cases of Ebola, but focuses primarily on the situation in Guinea, Sierra Leone, and Liberia.  Following is a timetable for transmission of the virus in Liberia and metropolitan Monrovia. Similar charts are available for Guinea and Sierra Leone in the online report.  The report also provides updates on treatment centers and other interventions underway.

WHO_liberiaClicking on the image will generate a larger version

CITYA.M., the City of London business publication, has produced a helpful visual analysis of the Ebola outbreak in Liberia, so far the hardest hit of the the three nations at the epicenter of the outbreak.  These maps communicate the crucial role that population density plays in transmission. They also suggest how the virus moved along human networks from the index case in southeastern Guinea into Lofa County and quickly to the economic/social/political center of metropolitan Monrovia.

Liberia density and number

Liberia per 100,000

MORE from CITYA.M.

While US media focus on early indications that transmission has been contained in the Dallas case, at least as important is the news that the Nigerian public health system has successfully contained an initial set of transmissions in densely urban Lagos.  Fundamental to this Nigerian success was a well-organized existing public health infrastructure and network of human expertise. An effective anti-polio process was essentially repurposed to rapidly contain a new infectious threat. Strategically it is important to recognize this was the adaptation of an existing capacity, not an ad-hoc insertion of a special or reserve capability.

According to the Associated Press, in Nigeria “Health workers tracked down nearly 100 percent of those who had contact with the infected, paying 18,500 visits to 894 people.”

The absence of such an existing capacity has been a principal cause of the outbreak in Liberia and its neighbors.  Sunday U.S. Army Maj. Gen. Gary J. Volesky, commanding general of the 101st Airbone Division and his thirty member command team arrived in Monrovia to assume leadership of DOD contributions to Operation United Assistance. The Army is sending approximately 700 Soldiers from the 101st, including members of the division headquarters staff, sustainment brigade, combat support hospital and a military police battalion. Another 700 troops will be deployed from multiple engineering units to build 17 100-bed medical treatment units and a 25-bed hospital. MORE.

New cases of transmission in Nigeria — the United States and elsewhere — are likely.  Until we can bend the exponential growth of transmission in Liberia, Sierra Leone, and Guinea, a networked and increasingly densely populated planet will be vulnerable.  (A few hours after the original version of this post appeared, a new case of Ebola was confirmed in New York City.)

The Foreign Affairs Council of the European Union met on Tuesday.  Despite some additional progress, the readiness and urgency of the European response will depend on the results of a summit of EU leaders that opens today in Brussels.

October 19, 2014

Who is my neighbor?

Filed under: Biosecurity,Preparedness and Response,Public Health & Medical Care,Strategy — by Philip J. Palin on October 19, 2014

EBOLA_James harris

I perceive it is prudent — as well as accurate — to make the case that the best way to mitigate Ebola risk in the United States is to significantly degrade the risk in West Africa.

Recently Thomas Frieden, Director of the CDC, felt it was politically necessary to say, “I am not protecting West Africa. My number one responsibility is to protect Americans from threats.”

Over the last few weeks at HLSWatch we had cause to consider the potentially warping effects of self-interest too narrowly conceived or fatally denied.

Last week The Telegraph (London) offered a gallery of online photographs entitled, “Survivors: Portraits of Liberians who recovered from Ebola“.  Above is James Harris, age 29, who recovered after two weeks at death’s door.  He is now a nurse’s assistant in a Doctors Without Borders treatment center in Paynesville, Liberia.

October 18, 2014

Ebola source sitrep 1

Filed under: Biosecurity,Preparedness and Response,Public Health & Medical Care — by Philip J. Palin on October 18, 2014

This is the first in an irregular update on efforts to engage Ebola’s center-of-gravity.  As noted previously, I am concerned US media is not giving sufficient attention to fighting this disease where it matters most for all of us.

If the rate of transmission can be suppressed at the source, then the risk to the United States will be substantially mitigated.  If the rate of transmission in West Africa cannot be significantly reversed in the next 60-to-90 days some epidemiologists are concerned Ebola will establish itself well outside it’s historically native range.

Data collection in Guinea, Sierra Leone, and Liberia — the current outbreak’s epicenter — is far from state-of-the-art.  But following is the best information now available from local health agencies as aggregated by the World Health Organization:

Ebola Chart

These numbers will get worse — probably much worse — before they get better.  Current projections suggest 10,000 new cases per week by December.

But there is also some encouraging news.  The Ebola transmission cycle in Senegal and Nigeria has evidently been successfully interrupted and contained.

Ebola survivors who have developed an immunity to the disease are now involved in caring for other patients and may be the source of life-saving blood transfusions.

Population behaviors, such as burial practices, are adapting to the risk.

Several new treatment centers are under construction.  Early identification, isolation, and effective treatment of those with Ebola will cut transmission rates and improve survival rates.  This week US military operations to expand local capacity got seriously underway. (Further details)

There will, almost certainly, be more cases of Ebola presenting in the United States.  The best way to reduce vulnerability is to eliminate the threat at its source.

 –+–

Editorial Note:  It has long been my personal opinion that “homeland security” is most meaningful when it offers its legacy professions, policy-makers, and the public a strategically integrated angle on risk.  The risk environment is usually complicated, often complex and even chaotic.  There are important roles for an array of specializations, threat-specific strategies, operational expertise, and tactical competence.  Homeland security will be more successful to the extent it is well-informed of these related domains.  But homeland security delivers added-value when it can stitch together these diverse elements into a coherent — ideally mutually amplifying — whole.  Strategy, at least in my use of the term, is especially concerned with how risks can be intentionally engaged in a manner that deploys the threat against itself and reduces self-generated vulnerabilities.

What is the most effective strategy for the risk of Ebola?

October 17, 2014

Less czar than troika

Filed under: Biosecurity,Media,Preparedness and Response,Public Health & Medical Care — by Philip J. Palin on October 17, 2014

CNN, the New York Times, and others are reporting the imminent announcement of a White House “Ebola Czar”. The man-of-the-hour is Ron Klain.  The former chief-of-staff to Vice President Biden (and Vice President Gore) has been in the private sector since January 2011.

The appointment responds to a burgeoning cry of “who’s in charge?” from the news media and others.

It’s a very primitive question, not well-suited to an infectious disease emerging into a highly-networked global system.  Mr. Klain will, I perceive, actually be part of a troika involving Lisa Monaco and Susan Rice.  He is very experienced riding the back of both the “interagency” and the media. Despite rough rides in the past, the tigers have not yet eaten him up.

Hold on and best wishes.

October 16, 2014

Adjusting our signal to noise ratio

I am currently involved in planning three different tabletop exercises.  Each are efforts to enhance “whole community” involvement.  My particular role is to enhance private sector involvement.  Currently the news media is not targeted for participation in any of these exercises.  In my several years of being involved with various homeland security training and exercises I can only recall two occasions when news media have been involved as participants.

There are several impediments to involving news media in these sort of activities, including:

  • Effective exercises are designed to expose gaps and shortcomings in order to improve preparedness.  News media are inclined to expose gaps and shortcomings in order to increase readership/listeners/viewers.
  • Many public sector participants tend to be “authoritative” or “officious” or “control-freaks”.  This is troublesome enough with other private sector participants.  With members of the media it can be explosive.
  • News media participation can discourage the involvement of other private sector parties due to fear of exposure (see first bullet).

But it seems to me increasingly clear we must find a way to involve news media in preparedness activities or continue — and deepen — the risk of serious mis-communication and public mistrust on the very worst days.  While major media are no longer the only or even primary sources of information, they are a significant source of amplification and confirmation.  Too often they are amplifying and confirming misleading information.  An ongoing example:

The media’s attention to symptoms can obscure attention to the source of problems.  I am astonished by the extraordinary attention given to a few instances of Ebola in the United States in contrast with lack of attention to sources of the problem in West Africa… despite clear and consistent and, at least to me, very reasonable analysis that until the source of the problem is better managed the risk to the United States will only grow.

On Tuesday afternoon the United Nations coordinator for Ebola response told the Security Council that the world basically has sixty days to contain the virus or face a serious risk of pandemic.  In much of the world, this was the Wednesday morning headline.  Not in the United States.

Below are two screenshots.  The first is for the Google News US edition.  The second is for the UK edition.  According to Google, “articles are selected and ranked by computers that evaluate, among other things, how often and on what sites a story appears online.”  The source stories can be found in US media, but too often buried beneath the symptoms.

Google US edition

UK edition

In my judgment a similar symptom vs. source issue is endemic to most US media coverage of terrorism, urban wildfire, flooding, and many aspects of border security.  It even erupts in how longer-term electrical outages are reported.

I am not arguing against news coverage of symptoms.  The attention given to the series of false steps in Dallas has clearly facilitated enhanced readiness across the US health System. But these are tactical –symptomatic — issues, not strategic issues addressing the problem at its source.

When novel and especially deadly threats emerge, the failure to distinguish between symptom and source is at least distracting and too often misleading… in a manner that can undermine public health and safety and, certainly, competence.  Sources can be even more complicated to understand than symptoms, but this further underlines the need for insightful media coverage.

There are very few editors, producers, or reporters who can afford to specialize in any of the so-called “low-probability, high-consequence” risks that confront us.  That’s a problem for most of the private sector and across the public sector as well.  We all need help adjusting our standard-operating-procedures to these non-standard events.  We should start to do so in workshops and exercises before the symptoms explode.

Some possible discussion topics and exercise issues:

In dealing with “high-intensity-risk-environments” (HIRE), do not mistake ambiguity for inattention.  Recognizing ambiguity may be evidence of close attention.

In engaging a HIRE, do not confuse uncertainty with incompetence. The compulsion to sound certain in the midst of complexity is, in my opinion, a principal cause of incompetence.

In the midst of a HIRE, complexity and lack of control does not necessarily signal lack of organization or progress.  Efforts to control can escalate complexity and suppress resilient self-organization.

In a few months I should be able to let you know if I am successful in involving media in any of the exercises currently being planned.

–+–

And since I’m writing about attention to sources as well as symptoms, in regard to Ebola here are some potentially helpful sources on sources:

FrontPageAfrica – A Liberia based newspaper. (BTW, this is not the largest circulation Liberian newspaper, but some of its competitors have, in my opinion, their own serious noise-vs-signal problems.)

The Concord Times – A Sierra Leone based newspaper.

The Telegraph – A Sierra Leone based newspaper.

Doctors Without Borders Guinea News

Guinea (Conakry) Guinee Focus (French)

World Health Organization Africa Regional Office

US Department of Defense Africa Command

CDC Ebola Hub

Resources from the London School of Hygiene and Tropical Medicine here and here and here  (and it’s worth looking for more)

FRIDAY UPDATE:

Thursday evening NPR broadcast an interview with Dr. Lewis Rubinson.  An intensive care physician with the University of Maryland Medical Center, Dr. Rubinson spent three weeks in September serving Ebola patients in Sierra Leone.  The full interview (with transcript) is, I suggest, a good example of well-informed, realistic thinking about dealing with symptoms.  Following is an excerpt:

RUBINSON: There are nearly 6,000 hospitals in the U.S. It wouldn’t have made sense to me that every single facility would have the ability to be honestly prepared. It doesn’t mean that there doesn’t need to be an appropriate level of the ability to identify patients and provide early treatment and keep staff safe. I think that’s really on every institution because we can’t control where patients present. But I think out in West Africa, we got very, very good at being 100 percent all of the time. You had to. In the U.S. there’s no technological fix for this. We can’t buy a widget and just solve it and give it to the hospital and say, you’re prepared right now. Most of this is about diligence, it’s about discipline and it’s about 100 percent adherence. And I think, again, that’s very hard to imagine that every facility could do that. Not because they aren’t good facilities, it’s just there are other priorities that they need to be taking on at the same time. Again, every facility needs to be able to identify the patient, take care of the patient early, keep the staff safe, but I think it’s very hard to imagine that every facility would be good at managing a patient throughout their course of the disease, especially if they get very sick, like had happened in Dallas.

MORE

SECOND UPDATE:

In regard to sources rather than symptoms, here’s “top of the fold” attention being given British operations in West Africa.  According to Friday’s Telegraph,

Ebola is the “biggest health problem facing our world in a generation”, David Cameron has said, as he urged foreign leaders to “step forward” with more resources to fight the crisis.

The Prime Minister urged other leaders to “look to their responsibilities” to help tackle the Ebola epidemic ravaging parts of West Africa… 

He said: “Britain, in my view, has been leading the way. The action we are taking in Sierra Leone where we are committing well over £100 million, 750 troops, training 800 members of health staff, providing 700 beds; we are doing a huge amount.

“I think it is time for other countries to look at their responsibilities and their resources and act in a similar way to what Britain is doing in Sierra Leone, America is doing in Liberia, France is doing in Guinea.

“Other countries now need to step forward with resources and action because taking action at source in West Africa is the best way to protect all of us here in Europe.”

MORE

October 9, 2014

Retrospectively, it is often so clear

The Ebola outbreak is, almost certainly, a precursor for a future pandemic that will be much worse.

The current California drought is, almost certainly, a precursor of more to come.

The recent series of cyber-attacks are, almost certainly, a precursor of many more — and much worse — to come.

The intention of Australian terrorists to undertake random attacks is, almost certainly, a precursor for such attacks there and elsewhere.

In each case a current threat-vector is amplified by human behavior, especially increased population density and mobility.  Ebola is naturally occurring. Until the last four decades its natural range was isolated from humans and, especially, human networks.  Drought is naturally occurring in the American West and Southwest. Until the last six decades, this region was sparsely populated. Never before has so much monetary value been so concentrated and (at least virtually) proximate. Violence is naturally occurring in human populations, its mimetic mutations now facilitated by many more of us in communication, contact, and perceived competition.

In the case of Ebola, the rapidly increasing population of Guinea (Conakry) —  up 220 percent since 1960 —  has created substantial ecological and economic stress.  This has been especially the case in the forested uplands of Eastern Guinea neighboring Liberia where the current outbreak first emerged.  With about 70 people per square kilometer this region has twice the density of the Virginia county where I live.  It’s less than 300 miles to Monrovia, the capital of Liberia, which has a population density of 600 per square kilometer.  No wonder Monrovia has been hit so hard.

Macenta Epicenter

We don’t know precisely when or how the virus was transferred to humans in this epidemic, but consumption of bushmeat infected with the virus is a good guess.  That has been the origin in several previous — but much smaller — outbreaks in Congo and Gabon.

Mid-March is when I first read about what has unfolded into the Ebola outbreak:

(Reuters) – An outbreak of hemorrhagic fever has killed at least 23 people in Guinea’s southeastern forest region since February when the first case was reported, health authorities in the West African nation said on Wednesday.

At least 35 cases have been recorded by local health officials, said Sakoba Keita, the doctor in charge of the prevention of epidemics in Guinea’s Health Ministry.

“Symptoms appear as diarrhea and vomiting, with a very high fever. Some cases showed relatively heavy bleeding,” Keita said.

“We thought it was Lassa fever or another form of cholera but this disease seems to strike like lightning. We are looking at all possibilities, including Ebola, because bushmeat is consumed in that region and Guinea is in the Ebola belt,” he said. No cases of the highly contagious Ebola fever have ever been recorded in the country. (March 19)

Well into summer I assumed this Ebola outbreak would be contained as others have been contained.  I neglected to notice that this  time the threat had emerged in a region much more densely populated than previous outbreak zones (and with much easier access to even more densely populated areas).  I overestimated the vigilance and capacity of the World Health Organization. I underestimated the power-amplifiers of human need and social interaction and fear… multiplied exponentially as the vector penetrates more deeply into the matrix.

This is how it happens.  Prior success encourages undue confidence.  And maybe you’re  a bit distracted. The threat morphs and emerges into — then out of — a different context.  So it may not initially be recognized. The critical contextual cues are unnoticed.  The threat is given time and space to strengthen.  This is especially likely to happen with places or people already neglected.

What worked last time is not quite calibrated with the new context.  Besides, for many of those engaging this threat, this is their first time.  Former lessons have not been learned, are being re-learned.  This threat in this place is in many respects unique — at least in the experience of those who confront it this time.

It is a threat that, if recognized early-on, might be quickly suppressed or contained. But instead it proliferates, filling the void opened by neglect. Thus amplified the threat is much more likely to find and exploit vulnerabilities; even those that until the threat’s  emergence were seen as strengths. Which is typically how tragedy unfolds, when what had been strong makes us weak.

September 24, 2014

AmeriCorps: “When did you serve?”

Filed under: General Homeland Security,Preparedness and Response,State and Local HLS — by Arnold Bogis on September 24, 2014

This past weekend as I sat on the T (that’s shorthand for the subway in Boston) three young ladies sporting City Year jackets took seats across from me. From the snippets of conversation I could hear it was easy to tell they were excited about some ceremony they took part in earlier that day.

All of a sudden a voice was raised from the end of the subway car, “Congratulations girls.  How big was your class?” A little surprised by the question, one of them slowly answered “270.”  Picking up on the situation rather quickly, another of the City Year participants asked the woman who questioned them, “when did you serve?”

That struck me. Throughout my life, and especially since 9/11, that particular question has always been wrapped up with military service.  Not to take anything from those who serve in that capacity, but I was moved to consider that perhaps AmeriCorps/City Year participants deserve some of that same respect. These young people are serving our country in their communities, strengthening our collective resilience everyday from the ground up.

So don’t stop saying thanks or buying a round for the men and women who serve(d) in the armed forces.  Perhaps just consider doing the same for AmeriCorps members too.

Some background on AmeriCorps:

AmeriCorps engages more than 75,000 Americans in intensive service each year at nonprofits, schools, public agencies, and community and faith-based groups across the country.

Since the program’s founding in 1994, more than 900,000 AmeriCorps members have contributed more than 1.2 billion hours in service across America while tackling pressing problems and mobilizing millions of volunteers for the organizations they serve.

AmeriCorps Programs

AmeriCorps programs do more than move communities forward; they serve their members by creating jobs and providing pathways to opportunity for young people entering the workforce. AmeriCorps places thousands of young adults into intensive service positions where they learn valuable work skills, earn money for education, and develop an appreciation for citizenship.

This is the broadest network of AmeriCorps programs. These groups recruit, train, and place AmeriCorps members to meet critical community needs in education, public safety, health, and the environment.
VISTA provides full-time members to nonprofit, faith-based and other community organizations, and public agencies to create and expand programs that bring low-income individuals and communities out of poverty.
AmeriCorps NCCC is a full-time, team-based, residential program for men and women ages 18-24. Its mission is to strengthen communities and develop leaders through direct, team-based national and community service.

A little bit of information on City Year:

At City Year, we’re working to bridge the gap in high-poverty communities between the support the students in the communities actually need, and what their schools are designed to provide. In doing so, our model is designed to support students as they progress from elementary through high school in order to continue to build the nation’s urban graduation pipeline.

Our progress can be attributed to a unique, holistic approach, which we call Whole School Whole Child. It’s based around a group of carefully selected, highly trained young adults—our corps members—who provide individualized support to at-risk students, while also establishing an overall positive learning environment in the schools throughout America that need us the most. It’s their dedication and hard work that’s helping students reach their full potential, while also having a positive effect on the community as a whole.

If you haven’t had enough yet, I’ve embedded a couple of videos below.  Former Presidents Clinton and Bush taped videos in celebrations of the program’s 20th anniversary this year, and President Obama spoke at this year’s swearing in ceremony in Washington, DC.

 

 

 

 

 

 

September 18, 2014

Johnson testimony: Worldwide threats to the homeland

Yesterday — Constitution Day BTW — the Secretary of Homeland Security testified before the House Committee on Homeland Security.  He was joined in giving testimony by FBI Director James Comey and director of the National Counterterrorism Center, Matt Olson. (Video and transcripts here)

Below is most of Secretary Johnson’s opening statement.  I hear a domestically-focused harmonic to the main counterterrorism melody performed by the President at MacDill (see prior post, immediately above).

Counterterrorism is the cornerstone of the DHS mission. And thirteen years after 9/11, it’s still a dangerous world. There’s still a terrorist threat to our homeland.

Today the terrorist threat is different from what it was in 2001. It is more decentralized and more complex. Not only is there core al Qaeda in Afghanistan and Pakistan, there is al Qaeda in the Arabian Peninsula – which is still active in its efforts to attack the homeland – al Qaeda in the Islamic Maghreb, al Shabaab in Somalia, the al Nusrah Front in Syria, and the newest affiliate, al Qaeda in the Indian subcontinent. There are groups like Boko Haram in Nigeria, which are not official affiliates of al Qaeda, but share its extremist ideology.

The Islamic State of Iraq and the Levant, or ISIL, previously known as al Qaeda in Iraq, is now vying to be the preeminent terrorist organization on the world’s stage. At present, we have no credible information that ISIL is planning to attack the homeland of the United States.

But that is not, by any means, the end of the story.

ISIL is an extremely dangerous organization. It has the elements of both a terrorist organization and an insurgent army. It kills innocent civilians, and has seized large amounts of territory in Iraq and Syria, which it can utilize for safe haven, training, command and control, and from which it can launch attacks. It engages in 30-40 attacks per month, has more than 20,000 fighters, and takes in as much as a million dollars a day from illicit oil sales, ransom payments, and other illicit activities. Its public messaging and social media are as slick and as effective as any I’ve ever seen from a terrorist organization.

Though we know of no credible information that ISIL is planning to attack the homeland at present, we know that ISIL is prepared to kill innocent Americans they encounter because they are Americans – in a public and depraved manner. We know ISIL views the United States as an enemy, and we know that ISIL’s leaders have themselves said they will soon be in “direct confrontation” with the United States…

From the homeland security perspective, here is what we are doing:

First, to address the threats generally emanating from terrorist groups overseas, we have in recent weeks enhanced aviation security. Much of the terrorist threat continues to center around aviation security. In early July, I directed enhanced screening at 18 overseas airports with direct flights to the U.S. Several weeks later, we added six more airports to the list. Three weeks ago we added another airport, and additional screening of carry-on luggage. The United Kingdom and other countries have followed with similar enhancements to their aviation security. We continually evaluate whether more is necessary, without unnecessarily burdening the traveling public.

Longer term, as this committee has heard me say before, we are pursuing “pre-clearance” at overseas airports with flights to the U.S. This means inspection by a U.S. Customs and Border Protection officer and enhanced aviation security before a passenger gets on the plane to the U.S. We now have pre-clearance at airports in Ireland, the UAE, Canada and the Caribbean. I regard it as a homeland security imperative to build more. To use a football metaphor, I’d much rather defend our end-zone from the 50-yard line than our 1-yard line. I want to take every opportunity we have to expand homeland security beyond our borders.

Second, the Department of Homeland Security, the FBI, NCTC and other intelligence agencies are making enhanced and concerted efforts to track Syrian foreign fighters who come from or seek to enter this country. The reality is that more than 15,000 foreign fighters have traveled to Syria over the last three years, including approximately two thousand Westerners. We estimate that more than 100 Americans have traveled or attempted to travel to Syria to join the fight there one way or another. We are concerned that not only may these foreign fighters join ISIL or other violent extremist groups in Syria, they may also be recruited by these violent extremist groups to leave Syria and conduct external attacks. The FBI has arrested a number of individuals who have tried to travel from the U.S. to Syria to support terrorist activities there.

Third, we are working with European and other governments to build better information sharing to track Syrian foreign fighters. Whenever I get together with my European counterparts, this topic is almost always item number one on the agenda. The importance of this issue is also reflected by the fact it will be a singular topic of discussion at a U.N. Security Council summit that the President will chair in two weeks. In the history of the U.N., this is only the second time a U.S. President has personally chaired a Security Council summit.

We are increasing efforts to track those who enter and leave Syria, and may later seek to travel to the United States from a country for which the United States does not require a visa from its citizens. There are in fact a number of Visa Waiver Program countries that also have large numbers of citizens who are Syrian foreign fighters. Generally, we have strong information-sharing relationships with these countries. But, with their help, we will enhance this capability. We need to ensure that we are doing all we can to identify those who, by their travel patterns, attempt to hide their association with terrorist groups.

We are encouraging more countries to join the United States in using tools like Advance Passenger Information and Passenger Name Record collection, which will help to identify terrorist travel patterns.

Fourth, within the U.S. government, DHS and our interagency partners in law enforcement and the intelligence community, are enhancing our ability to share information with each other about suspicious individuals.

Fifth, we are continually on guard against the potential domestic-based, home-grown terrorist who may be lurking in our own society: the independent actor or “lone wolf” who did not train at a terrorist camp or join the ranks of a terrorist organization overseas, but who is inspired here at home by a group’s social media, literature or violent extremist ideology. In many respects, this is the hardest terrorist threat to detect, and the one I worry most about.

To address the domestic “lone wolf” threat, I have directed that DHS build on our partnerships with state and local law enforcement in a way that enhances community relationships. The local police and fire departments are the first responders to any crisis in our homeland. The local police, more than the federal government, have their finger on the pulse of the local community from which a domestic terrorist may come.

To address the home-grown terrorist who may be lurking in our midst, we must also emphasize the need for help from the public. “If You See Something, Say Something” is more than a slogan. For example, last week we sent a private sector advisory identifying for retail businesses a long list of materials that could be used as explosive precursors, and the types of suspicious behavior that a retailer should look for from someone who buys a lot of these materials.

Within DHS, we have outreach programs with communities who themselves are engaging youth in violence prevention. I have directed that we step up these programs and I personally participate in them. In June I met with a Syrian-American community group in a Chicago suburb. Next week I will meet with a Somali community in Columbus, Ohio. In October, the White House will host a summit on domestic efforts to prevent violent extremism, and address the full lifecycle of radicalization to violence posed by foreign fighter threats. The efforts highlighted at this summit are meant to increase the participation of faith-based organizations, mental health providers, social service providers, and youth-affiliated groups in local efforts to counter violent extremism.

Over the last 13 years, we have vastly improved this Nation’s ability to detect and disrupt terrorist plots overseas before they reach the homeland. Here at home, federal law enforcement does an excellent job, time and again, of identifying, investigating, arresting and prosecuting scores of individuals before they commit terrorist acts. But we continue to face real terrorist enemies and real terrorist threats and we must all remain vigilant.

Community-based, regionally — even globally — engaged, collaborative efforts to prevent, protect, prepare, mitigate, and respond.  Recovery and resilience are implied, but — as usual —  given a bit less attention.

September 9, 2014

Brush with national preparedness month

Filed under: Preparedness and Response — by Christopher Bellavita on September 9, 2014

The Yellow Point Fire is one of the fires burning in Oregon today.  It’s about 25 miles from where I live. The Oregon Department of Forestry (ODF) is doing a good job keeping people affected by this comparatively small fire aware of what’s going on. It is also posting information on a blog , Facebook,  and Twitter. The information helps people like me who want to know what’s going on.  It also got my wife to finally see the value of using Twitter. Maybe more importantly, the ODF social network efforts help the families of the people fighting the fires know what their family members are doing.

None of this is remarkable. In less than a decade, social media is as integral a part of disaster response as, well…responders.

My family is in three different parts of the country this week.  Since September is National Preparedness Month, the fire reminded me maybe it was time to review my family communication plan.  I did that and discovered I actually did not have a family communication plan.  I had one “in theory.” But not in reality.

I found this DHS website and advice  basic, succinct and helpful.

Identify a contact such as a friend or relative who lives out-of-state for household members to notify they are safe. It may be easier to make a long-distance phone call than to call across town, so an out-of-town contact may be in a better position to communicate among separated family members. 

Be sure every member of your family knows the phone number and has a cell phone, coins or a prepaid phone card to call the emergency contact. If you have a cell phone, program that person(s) as “ICE” (In Case of Emergency) in your phone. If you are in an accident, emergency personnel will often check your ICE listings in order to get a hold of someone you know. Make sure to tell your family and friends that you’ve listed them as emergency contacts.

Teach family members how to use text messaging (also known as SMS or Short Message Service). Text messages can often get around network disruptions when a phone call might not be able to get through.

Although I should have known about the other homeland security “ICE”, I didn’t.  I do now, however. My family also has a written emergency communication plan.

Thanks, Ready.gov

August 18, 2014

Hero or Victim: Encouraging Self-Dispatching of Off-Duty Police Officers to Active Shooter Incidents

Filed under: Education,General Homeland Security,Preparedness and Response — by Christopher Bellavita on August 18, 2014

Today’s post was written by Matthew Hanley.

Officer Smith receives the call he has been dreading his entire career, an active shooter at the local elementary school.

The 911 dispatcher provides the only description available of the shooter – a white male wearing a black shirt.  Officer Smith arrives in just under 2 minutes.

As he exits the vehicle, he hears a series of shots ring out.  He makes the decision to enter the school alone.  Down the first hallway he encounters the gunman – white male, black shirt, handgun.  He instinctively fires 3 rounds and the suspect falls to the floor.

As Officer Smith approaches the suspect, he recognizes the man as an off-duty police officer.

Shots continue to ring out in the gymnasium.

———————————————

This is precisely the scenario that could play out across the country if a new mobile phone application called Hero911 becomes widely adopted.

Hero911 is meant to reduce law enforcement response time to active shooting incidents at schools.  Schools purchase a service called SchoolGuard ($2500 setup fee and $99/mo).  Police officers voluntarily download the free Hero911 “social protection network” application.  (By the way, the phrase “social protection network” is trademarked.)

When an active shooter incident occurs, the school activates SchoolGuard (also trademarked) which immediately notifies nearby police officers, both on-duty and off-duty, of the incident.

(The Hero911 app is clearly meant to be used only by sworn police officers or “a qualified retired law enforcement officer.”  But one of the people who recommends the app on the Hero911 website — “To all sheepdogs, the Hero911™ Network can save lives, please put the app on your phone, I did.” —  is Lt Col (retired) Dave Grossman.  Grossman is a former Army Ranger, teacher, consultant, and author of On Killing, On Sheep, Wolves and Sheepdogs, and other publications.  He does not appear to be an active or retired police officer.  One wonders how many other knowledgeable, experienced, and weapons-smart non-police officers might also “put the app on” their phone.)

———————————————

Cleary seconds count when responding to active shooter incidents and law enforcement agencies should be exploring ways to expedite that response.  But these types of incidents are extremely chaotic and the response must be conducted in a coordinated manner utilizing best practices.

Encouraging the self-dispatch of off-duty officers is potentially dangerous.

Without the ability to communicate via radio, off-duty officers are not able to receive accurate suspect/incident information or able to communicate their location to other responders.  Without a uniform or clothing identifying the individual as a police officer, the likelihood of the off-duty officer being mistaken for a suspect is real and potentially deadly.

Hero911 does briefly address these concerns – somewhat –  on their website (FAQs).  Here’s an example (my emphasis):

Officers without proper training, skill and identification should not respond, but remain vigilant after receiving the alert. ….All laws, home agency policies and protocols must be followed.

Officer safety is a major concern during these catastrophes. Please consider purchasing a well-stocked “Go-Bag” for your personal vehicle. Hats and vests with bold POLICE markings are strongly recommended.

Applications like Hero911 are well intentioned and could potentially reduce response times to active shootings by creating a direct link between school officials and nearby police officers.

However, before law enforcement agencies endorse the use of such applications, policies and training should be developed to address the self-dispatching of off-duty officers.

Additional information can be found at www.hero911.org.

———————————————

Matthew Hanley is a senior executive in a state police agency.  The views expressed in this post are Hanley’s; they do not represent the opinions of any agency or organization.

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