OLYMPICS RESPONSE In that respect, please stop using CBRN
First Responders in Level-A PPE as ‘bell boys’ - doing everything from detection and sampling to carrying stretchers with victims and decontamination of casualties! This might be great for the mass media but proves ignorance of planners and responsible authorities.
State response Soon after a terrorist attack ordinary first responders (i.e. police and fire service) will approach the incident site and make the initial assessment. But what if it is a CBRE attack? Responding crews might become victims as well. The combination of the ‘1-2-3 rule’ and the provision of an escape hood could save lives. The moment it becomes evident that CBR
agents are involved, the state should respond in two ways: Given the above mentioned statistics (20%-80% - 1:5 ratio) it is advised to deploy a wide control circle around the incident site, stop and deviate traffic according to a plan, direct escapees to certain directions (i.e. hospitals) and supervise evacuation of population living inside the circle. A portion of CBRNE first responders will be
headed to nearby hospitals in order to fortify their defence capabilities or give them time
in the chaotic environment of a real CBRNE attack it might be proved valuable and a good antidote to mindset blockade during the initial critical moments – the ‘Golden Hour’ of response.
Current status An outsider surely lacks inside information on CBRNE planning. Open-source information reveals some insights on preparedness of certain key-players: State sector: police and fire service is
well prepared/trained to deal with CBRNE emergencies; Medical sector: London Ambulance
Service (LAS) – via their HART Teams – is well prepared/trained/ equipped to deal with CBRNE events. On the other hand, there is scarcity of information regarding NHS hospitals’ CBRNE preparedness - with only Homerton Hospital known to be an Olympic Hospital. In all international CBRNE-related conferences LAS presence is evident but NHS absence is also worth mentioning. Either their preparedness is a well-kept secret (for obvious reasons) or there is a gap that needs to be fixed as soon as possible. It is very important to keep the CBRNE
superficial involvement that will not suffice in a real incident. The preparation period for the 2012 Olympics is almost over, but these are lessons for the Games and beyond. State authorities must realise that a real
terrorist event of any type might last a few hours and then end. On the other hand, CBRN medical consequences will last for weeks, months or even years – personal opinion of the author following his OPCW (Organisation for the Prohibition of Chemical Weapons) training at the Military Hospital of Tehran (2003, preparation for the 2004 Olympic Games in Athens), where there is a small clinic within the hospital managing the chemical victims of the Iran-Iraq war of the 1980s, when chemical warfare agents were used by both sides. These victims (more than 20,000 active files at that time) were small children when their city or village was attacked and continue to suffer various medical conditions as adolescents or adults. Most probably no real terrorist CBRE
incident will happen at the London Olympics. If this is the case, this article will address the days and years beyond the events. If all the preparation achieved during the last few years is left to fade and State attitude declines
“Hospital CBRNE defence is like a foreign language – if you do not practice it often soon you will forget it!”
to deploy their assets if available. At the same time, other CBRNE first responders facing the heavy traffic burden will arrive on scene and do what they are supposed to do given the time limitations of their (usually Level-A) PPEs – that is inspection of incident area, sampling, detection and reporting accordingly to Incident Commander or Operations HQ. An idea the writer proposed but which did not materialise during the 2004 Olympic Games was the ‘Rule of 16’ derived by the four main and secondary wind directions (= 8) multiplied by day and night operations (8 x 2 = 16). So for each target we must compose 16 plans covering all operational possibilities. If the real event happens, one only needs the wind direction and the time of the day in order to start giving orders to various response agencies involved. It might take a lot of effort and time in order to compose these plans - but
M.I.S.E.R
Motivate medical/nursing personnel to be actively and continuously involved Include ‘medical/hospital CBRNE preparedness’ into the curricula of university medical/nursing schools
Support fixed decontamination stations for all hospitals. They cost less than you think and all it takes is a good plumber and inspiration! Educate the populace and GPs in proper CBRNE response. Revise/improvise existing CBRNE emergency plans on an anthropocentric/interoperability/compatibility basis
20 | CHEMICAL, BIOLOGICAL & NUCLEAR WARFARE | 2012/02
response structure active and on high alert. Exercises of various kinds will promote readiness and maintain acclimatisation to protective equipment. Seminars and lectures will update knowledge and protocols and keep personnel’s’ interest alive. Plan updating and revision will incorporate solutions for the weak parts and gaps identified during exercises. Hospital CBRNE defence is like a foreign language – if you do not practice it often soon you will forget it! The medical/nursing community that
represent the weakest link in all preparedness plans needs to be addressed adequately and in an efficient way in order to motivate participation – at least in the critical specialties directly involved in CBRE terrorist incidents. Lack of relevant knowledge and specialised training produce fear and lack of confidence and discourage participation or promote
towards a new ‘Cannot Bother Right Now’ (CBRN) era, then a real incident in the coming years will be beyond an unpleasant surprise – it will be a most catastrophic surprise. If at the start of 2011 someone was proposing
a working scenario to include a massive earthquake, tsunami and nuclear catastrophe, the audience would consider it as sci-fi from outer space. And then it happened! In Japan! And we all witnessed the “unexpected that happened.” After this, nobody has the right to consider a terrorist CBRN release as science fiction. It might happen to us as well - tomorrow!
Brig. Gen. (ret’d) Ioannis Galatas (Hellas) is a Consultant in Allergy & Clinical Immunology, a medical/hospital/op CBRNE planner, and served as Commandant of the Olympic Hospital CBRN Response Unit for the 2004 Athens Olympics.
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