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How Prepared is Maryland? Homeland Security and EMT Training in Maryland

Q&A with Rick Bissell
Associate Professor and Graduate Program Director
UMBC Emergency Health Services (EHS) program

As the U.S. presidential election draws near, homeland security remains a top concern for Maryland’s voters. Many Marylanders are curious about what government agencies and first responders have learned since Sept. 11, 2001, and how well prepared the state is for future emergencies.

UMBC Research News spoke with Rick Bissell from UMBC’s fast-growing Emergency Health Services department on the state of homeland security and emergency readiness in Maryland. Bissell discussed how UMBC EHS is working with state, local and federal government agencies to make sure Maryland’s emergency first-responders, hospitals and health departments are well-trained for disaster scenarios.

UMBC EHS also has an extensive online training program for emergency workers through the National Disaster Medical System, part of the U.S. Dept. of Homeland Security. To date, UMBC EHS has created more than 200 courses and trained more than 16,000 physicians, nurses, paramedics and logistical staff in emergency preparedness and disaster response.

What is UMBC EHS doing currently to help Maryland first-responders be better prepared?

We have a two-year contract with the Maryland Department of Health and Mental Hygiene to provide disaster-preparedness training for both directors and line personnel in hospitals and health departments statewide. These are day-long sessions covering everything from potential terrorist threats to location-specific emergencies like snow collapsing a building roof after a blizzard.

What are some specific areas where Maryland needs to improve?

The main problem in the past has been that the health sector—both public health departments and hospitals – weren’t well integrated into the state’s emergency management system. When we do these training sessions, we often find that the health sector isn’t always coordinated with non-health sector resources like police, fire, state and county emergency management agencies. It’s not so much the fault of the health sector, it’s just that in Maryland, like a lot of states, prior to 9/11, the health sector wasn’t integrated in a meaningful way with emergency management.

Is there a terror scenario that Maryland is not well prepared for?

The worst-case scenario today would be the breakout of a new infectious microbe with a long incubation period. This could be caused by either bioterror or a natural incident. With a long enough incubation period, the damage would be done before infected people start showing up and hospitals or health departments realize that an attack or outbreak is underway.

The absolute worst probable case we think about is a scenario where terrorists release an infectious microbe in a crowded space like a convention center. Less probable but truly catastrophic would be the detonation of a nuclear weapon in a populated area. There is no good response to that scenario; only prevention works.

So what is Maryland doing better than before 9/11?

Well, we’re better off than we were before 9/11 and Maryland is better off than many states, mainly thanks to a new statewide emergency information-sharing system for the health sector. This system allows health sector workers from across the state to post surveillance findings or odd clinical findings in real time to share with other officials.

For example, if a case that looks like bioterror shows up at a hospital ER in Garrett County, people in Baltimore will know there’s a problem virtually immediately. This system is also helpful for more day-to-day needs like immediate access to hospital capacity information so a full hospital can steer incoming patients to a nearby facility with more bed space available.

Second, and perhaps most important, hospitals are now training with emergency responders. Hospital workers now know who to contact for all kinds of scenarios. Everybody is learning their roles, who they’re supposed to work with and how information is supposed to be transmitted, and that’s real progress and a dramatic change from the pre-9/11 days.

Has 9/11 raised awareness of and funding for emergency health services in America?

Yes, definitely, but most of us in the field feel that we’re on top of a bubble and that much-needed funding isn’t getting to first-responders as fast as it should. Everywhere I travel across the U.S., there is frustration among emergency health workers, from the county level on down, because lots of money funded for local application never got there.

In many cases, it’s because the states are still holding onto the funds. EMS is probably the most egregiously treated area, with lots of money promised but virtually nothing trickling down to the local level.

So how scared should people be of another terror attack in the U.S.?

I think it’s important to remember that weapons of mass destruction like chemical and biological weapons are much harder to use than people think. The famous example is the Aum Shirinkyo cult attack with sarin gas on the Japanese subway several years ago, which was quite ineffective at wreaking mass destruction, and the cult had tried to use bioweapons for years before that attack with no results. What’s interesting is that Aum Shirinkyo was a well financed group with well qualified scientists.

What about preparing a personal safety plan? What can people do to feel better prepared?

I recommend following Department of Homeland Security and Red Cross guidelines—having a family plan for emergencies that parallels preparation for a hurricane or blizzard. A common-sense approach of having a battery-powered radio, bottled water, some canned food and so on available is always a good idea. Go to www.ready.gov for more information.

But most of all it’s important to have a family communication plan and to never panic. My best advice on a personal level is to carry a small penlight or pocket flashlight on your person—maybe on your keychain or in your purse. That way in any scenario, whether it’s a simple weather-related blackout or something more serious, you have a comforting and common-sense way to guide yourself and others out of any potential danger.

Posted: November 14, 2005, 12:00 PM