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September 11, 2010

September 11, 2010...

There will be hundreds, perhaps thousands, of blog postings and podcast discussions today. Many will have titles like "Always Remember" or "Never Forget". While even more will talk about the details of time and events from 9-11-01. There will also be ceremonies and services featuring memorials and testimonials. Where were you when...will be a popular conversation.

I, however, will take a slightly different path behind the keyboard and mic of Mitigation Journal on September 11, 2010.

With the greatest of reverence and everlasting memory of those who died in the attacks of 9-11-01, I will ask those responders who remain to reflect on where we are now and what we'll be doing tomorrow.

Are we better prepared in 2010 than 2001? Prepared to do what, you well you should.

Can you remember the public enthusiasm that greeted the responders who flooded into New York City in the days following 9-11-01? Can you picture the signs that read "Thank You"? The ones the read "Our Heroes" as lines of ambulances and fire apparatus drove by? Can you still picture the crowds welcoming responders of every color uniform and vehicle?

Can you remember the stream of funding in the months that followed as we suddenly realized that weapons of mass destruction training was needed? And the awakening that one spore could kill?

The American Fire Service could seemingly have anything needed as our nation realized the need for its First Responders. And we got it. There was money for training classes and protective clothing. There were funds for apparatus and buildings.

Is the fire service better prepared in 2010? Prepared to do what, you well you should.

How much as been spent and squandered on dysfunctional apparatus and worthless "WMD" and terrorism training?  How much of that training and apparatus was never put to use because it did not fill any real firefighting function outside of terrorism? Nearly everyday we're reading about firefighter line of duty deaths from cardiac disease or from entrapment, collapse, or apparatus crash.  How much "preparedness" have these topics gotten? What can the fire service point to as a measure of preparedness in the wake of all this terrorism and WMD training? Protection of infrastructure in our communities? No. In a level of audacity never before heard, the American Fire Service told hospitals that, in case of chemical or biological attack, your local fire department is going to be too busy...better get ready to deal with those contaminated self-referrals on your own. For the first time in our history, the fire service is telling someone "we're not coming".

Recently, legislation aimed at aiding those responders and rescuers who worked at Ground Zero and are now dying from pulmonary diseases...failed. Almost without a whimper. No crowds, no signs, no aid. Cities in every state are faced with demands to cut fire department budgets, reduce staffing, cleave benefits. On September 12, 2001, the American Firefighter was still a hero. In 2010 the fire service is another taxation anchor wincing under the public scrutiny and shouts for tax cuts.

Is our emergency medical services system better prepared in 2010? Prepared to do what, you well you should.

EMS as a whole received a scant amount of preparedness dollars in the wake of 9-11-01. When asked why, one legislator remarked "aren't the ambulance drivers part of the fire department"? Despite changes to the National Response Plan, now the National Response Framework, EMS remains on the fringes, fragmented and without any nationally recognized leadership. Despite increases in training and education paramedics, who are allowed to give injections to a variety of sick people in the back of an ambulance, have been barred from assisting a flu vaccination clinics during the Swine Flu pandemic of 2009...adding to the nauseatingly slow vaccine distribution at some public vaccine clinics. EMS is the service that should be best able to identify an unfolding biological event. In 2010 we still ask "aren't the ambulance drivers part of the fire department"?

Is our public health system better prepared in 2010? Prepared to do what, you well you should.

Hospital preparedness, surge capacity, resource triage, and sufficiency of care were all buzzwords after 9-11-01. The buzz has faded into annoying tinnitus as many hospitals and public health organizations go through the motions of checking the boxes on the Joint Commission list...functionality optional...check mark required.  Decontamination precautions remain unworkable at many health care facilities. Issues of surge capacity continue to dog hospitals as over crowding forces patients into the halls waiting hours to be seen by a doctor. Discussions on the triage of limited medical therapy (ventilators, for instance) is hotly debated and unsettled. Oh, and that pesky flu...even after 9-11-01, SARS and the Avian Flu threat; we fall short of vaccine production and distribution capability...even when given months warning as in the case of Swine Flu.

As I've written and said many times before...It is time to stop training for WMD terrorism events. It is also time to stop living in the "post 9/11 era" and start living in the pre (insert next event here) era.We must recognize the need for all-hazards training. This training must be delivered in a way that puts the material into context, so the skills and knowledge can be used every day. Our readiness for natural disasters must also improve.

Never forget. Always remember. Are we better prepared in 2010? Prepared to do what, you well you should.

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