Lessons learned from Katrina, 9/11, SARS, and other disasters
We've also rebuilt our lab big time. We've opened up a 20,000 square foot BSL-3 facility in what was in our lab, which really has state-of-the-art technology. But we've also got agreements with other BSL-3 high level – Bio-Safety Level 3 – laboratories in the city that we can use their laboratories in case of a crisis where our laboratory is not available. So it's really emphasized our need to introduce redundancy facilities in as many of our operations as we can.
SHUTE: Thanks. Ben, what do you do when you lose half the hospitals in a city, including the one level-one trauma center?
DEBOISBLANC: I think Frank Peacock hit the nail on the head in the previous discussion; that is, we've got to be able to use resources outside of the city. There was absolutely no way that you could bring healthcare providers in to help us. There were no - you couldn't get into the city. The USS Comfort showed up five, six days after the event and by that time, the city was empty. It was a ghost town. The first four days were the critical days, and all we did was grab-and-go. It was an evacuation. And we needed a place to send those patients.
Baton Rouge took about 25,000 patients. They triaged at the Pete Maravich Assembly Center there, the largest field hospital in U.S. history. The Superdome housed some 30,000 of patients of lower acuity that being able to distribute these patients nationwide during the type of disaster that we experienced, I think, is critical. That's where we need to focus attention, because having neurosurgeons and trauma surgeons come to New Orleans would have been absolutely useless. They would have stood around, not been able to get in, and all the patients within three or four days would have been distributed outwards. So I think it's that evacuation that is key.
And along those lines, the first casualty of a disaster is always command-and-control communication. And without communication, all of these pyramid plans we have of how to disseminate information, how to control an evacuation are lost. World War II was one by sergeants; it wasn't won by generals. What you need are people in the trenches who are empowered to make decisions that will have a real effect on people's lives; that we haven't given a lot of attention to. We've set up these elaborate emergency preparedness algorithms, but we need to empower people at the lowest levels to make decisions that will have a real effect on how people receive care.
SHUTE: I don't know about you; I'm calling Wolf Blitzer. [Laughter.]
We have an Army colonel here who I think might be able to help us out on some of our command-and-control issues. Dr. Franz?
FRANZ: Well, exactly – and mirroring what Ben has said. And I wrote down quickly what would have been the ideal person for us to take with us to help out in Katrina. It would have been probably a former enlisted military because they know how to take orders. They'd have an MPH – so they'd know public health – background. They would be a social worker; they'd also be a chaplain because these are force-multiplier-type professions. They can talk to anybody, and they can help in any situation.
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