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Re-establishing a command center

 

First responders faced many difficult challenges in the chaos that ensued in the days after September 11, recalls DOH’S Kelly McKinney, the first of which was the complete decimation of the city’s “command center,” when its Office of Emergency Management (OEM), which was displaced in one of the adjacent buildings that collapsed, as mentioned in Part 1.

 

As a result, the “incident command system” upon which emergency responders depend did not operate and took about 48 to 72 hours to reconstitute.

 

The OEM, a descendant of the city's Office of Civil Defense and the Police Department's Office of Emergency Management, includes personnel from the Police and Fire Departments, Emergency Medical Service, and other city agencies, and was designed to deal with catastrophes such as a chemical or biological attack or a "mass fatality situation." (However, until the attack on the World Trade Center, it had never confronted such a dire threat; previous threats included the much feared Y2K computer virus, an infestation of longhorn beetles, and an influx of rodents. Ironically, the day of the attack, the office had been focused on the potential dangers of hurricanes and power outtages. “It's Hurricane Season in NYC," announced its website.

 

For its part, the city Department of Health did follow an emergency response protocol that had been worked out in advance, including an incident command system: Laboratory, surveillance, epidemiology, medical and environmental response. “From the start, these plans and previously rehearsed exercises helped to organize the work and set priorities,” writes Susan Klitzman at the School of Health Science, Hunter College. (7)

 

By September 12, says McKinney, the department had already moved to a safer place and re-established a headquarters and a set of critical functions to communicate among staff, press and hospital staffers. Within 48 hours a new space was secured (first at the policy academy, then at Pier 92, a passenger ship terminal on the Hudson).

 

“The only other time the city had every had to deal with FEMA was an ice storm up state in which farmers had to be reimbursed for their cows.”

With a unified command, says Burger, “Everyone fell under Kelly and his staff.” But Burger’s help, says McKinney, was invaluable in terms of trying to navigate the array of bureaucracies and the protocol.

New York had much to learn, says Burger: “New York is typical of big cities, and think of themselves as equal to a state, so sometimes we needed to remind this city that it needed to get assistance from the state.”

 

A corollary to this: Localities have to make a request of the federal government before it can respond.

 

“This was a learning experience for New York City,” says Steve Touw, who was brought in as one of EPA Region II’s On Scene Coordinators (OSCs), to help with a full array of environmental-related expertise on everything from respiratory protection to hazard analysis to waste removal.

 

This was the first time that New York City had ever been through a national disaster, in which the Federal Emergency Management Agency (FEMA) would be called in. “The only other time the city had every had to deal with FEMA was an ice storm up state in which farmers had to be reimbursed for their cows,” says Touw.

 

The state had set up an Emergency Management Office charged with responding to disasters like this, such as a drought in the apple-growing district in the center of the state and hurricanes in the Hudson Valley, but before now the only emergencies had dealt with weather. The only exception was that the office broadened its purview to include “Y2K,” the much-worried-about computer fiasco that never happened. Even though the World Trade Center had already been target and seriously damaged with a bomb in 1993, the office was totally unprepared for the scope of the attack in 2001.

 

Nevertheless the State Emergency Management Office (SEMO) did rise to the occasion with a coordinated response, calling upon 31 emergency experts from 18 states to form the Emergency Management Assistance Compact (EMAC)—an agreement that was originally organized to help with natural disasters such as hurricanes, toxic-waste spills and also acts of terrorism. Although not formally part of EMAC, New York State quickly joined after the fact a few days after September 11.

Through SEMO, the city got help with 5,000 National Guard troops, 500 state troopers and K-9 units, 100 Federal Bureau of Criminal Investigation personnel and 2,500 crisis counselors. The State Department of Health also help bring in some 400 workers to help in issuing death certificates for families of victims, monitoring for air quality, and coordinating volunteers.

As part of activating its emergency response protocol, the Department of Health became a vital part of the city’s Emergency Operations Management command center. Re-established on Pier 92, it became the nerve center of the city’s response coordination, which included everything about responding to the disaster, from transportation to debris removal to protecting workers at the World Trade Center site.


Photo: Andrea Booher/FEMA News Photo

Federal officials like CDC’s Patrick Meehan were lavish in their praise for New York City’s quick recovery under the circumstances. Although the Emergency Management Agency lost everything and had to relocate quickly, and the health department also had to relocate, and had to work under very crowded, difficult conditions, they did a fantastic job, he says.

 

“They did a marvelous job in the early recovery,” says Meehan. “Everyone just rolled up their sleeves, worked together on the hardships they were facing and got the job done,” he says.


“Other than injury surveillance, everything else involving the Health department had to do with environment,” says CDC’s Ron Burger.

 

 

CDC initially worked with the New York City Department of Health on a range of health issues, from assessing hospital capacity issues and hospital needs to the environmental issues that, Meehan said, quickly rose to the top of the list.

 

“Other than injury surveillance, everything else involving the Health department had to do with environment,” says CDC’s Ron Burger, echoing Meehan’s comments.

 

With help from such seasoned advisors, the local city Health Department was able to effectively institute traditional public health measures such as sanitation, drinking water protections, and food safety monitoring and surveillance programs that helped protect the public from standard infectious diseases.