The need for quarantine stations at U.S. borders was on the decline - until SARS & bioterrorism created a need for more stations on a continuing basis. Dulles International Airport (first one), has achieved much success & is a template for future use.
"Just in Case" has been trumped by "Just in Time." One result is that there is no surge capability that emergency managers can call on in times of major incidents. Unless, of course, an EMS Task Force is waiting in the wings.
Many first-responder agencies routinely use "4x4 volunteers" to help out in hazardous-weather situations and other emergencies. This solution to community problems must be handled with care and requires careful planning by state/local decision makers.
For most U.S. hospitals, planning for a mass-casualty disaster is an administrative afterthought. The result, frequently, is a counterproductive "game plan" based on rosy optimism and unproven assumptions.
Preparing for an emergency is like packing for a long trip: Focus on the essentials first, and always consider the possibility of a worst-case scenario. Unfortunately, some communities and hospitals are making cost reductions their highest priority.
Three modes of operation, two of which might strain the trained EMS personnel resources immediately available but would not overwhelm them. Preparing for the third mode, a sudden mass-casualty scenario, must be done carefully and thoughtfully.
Defeating the threat posed by biological weapons requires a mountain of relevant information, collated and translated into actionable data, and distributed to a broad spectrum of potential users.
When it seems likely that explosives have been used in a mass-casualty incident or "event," the personnel responding must remember that additional, and bigger, explosions might soon follow and that they, the first responders, may be the target.
The setting of national standards for the personal protective equipment worn and training received by first responders working in a hazardous-materials environment is a positive step forward.
The era of "us versus them" is over. In times of disasters affecting the entire local population, all private-sector as well as public agencies must pool their resources in a common effort.
