The September 11th attack
Hawai'i assesses terror readiness

By Johnny Brannon
Advertiser Staff Writer

Hawai'i's strong spirit of cooperation, large military presence and experience at responding to natural disasters all put the state in a better position than many of its Mainland counterparts to handle a terrorist attack.

Honolulu firefighters used their hazardous chemical training Wednesday after an unknown substance was reported in Pawa'a near the Beretania Street Foodland and a tabernacle. Richard Ambo • The Honolulu Advertiser

"We're in pretty good shape, but not in as good shape as we want to be," said Toby Clairmont, chairman of the Healthcare Association of Hawaii's Emergency Preparedness Committee. The group represents most of the state's 31 hospitals, and it assessed their capabilities after the Sept. 11 attacks on the World Trade Center and Pentagon.

"Several of the hospitals still do not have all the equipment needed to decontaminate patients in the event of a chemical attack," he said, and much of the special gear is clustered around Honolulu, rather than spread out among the state's population base.

That could be a problem if, for instance, a cruise ship or jetliner were attacked on a Neighbor Island, Clairmont said. But some other states have virtually no decontamination equipment and can't get it now because the Sept. 11 attacks triggered a huge rush to prepare for the worst, he said.

"Ever since Sept. 11, things have been literally flying off the manufacturers' shelves," Clairmont said.

Analyzing data

The Healthcare Association of Hawaii is analyzing the data collected after the attack and could request federal money to make sure all of the state's hospitals are equipped, he said, and by that time more gear should be available.

A biological attack could pose problems as well. Hospitals keep limited supplies of certain drugs, and it could take 12 hours or more to secure more from the federal government's National Pharmaceutical Stockpile.

"What we need to have is more on-island and in each hospital to bridge the short gap," he said. "We're not sure we have enough, and we're a little worried about that."

If a serious attack or disaster occurred today, between 200 and 300 hospital beds would probably be available immediately throughout the state, but that number would jump to between 800 and 1,000 within hours because elective surgeries would be postponed and some patients would be discharged early, Clairmont said.

An existing shortage of nurses could make things difficult, but additional nurses, who may be retired or on extended maternity leave, could be contacted through a list that is maintained for emergencies, he said.

"The nursing shortage is a big issue," Clairmont said. "The big problem would occur in the weeks and months that followed, and that could require moving some patients to the Mainland."

Dr. Patricia Hastings, deputy director of the Honolulu-based Center of Excellence in Disaster Management and Humanitarian Assistance, said Hawai'i is better prepared than many other states to respond to a biological attack because of its state health department.

Public health systems in some states were all but eliminated in recent decades after major communicable diseases were eradicated, but Hawai'i's remains intact.

"One of the most important parts of being prepared is a good public health system, and Hawai'i has one," said Hastings. "It's one of the greatest strengths here in Hawai'i."

History of preparedness

Hawai'i medical and disaster officials also have a good history of preparedness and cooperation because of the risk of natural disasters, such as hurricanes and tsunamis, she said, and that provides a solid foundation for building the capacity to respond to other emergencies.

"People have been looking at these issues for a long time behind the scenes," Hastings said. "Five minutes before the party is not the time to learn to dance."

Honolulu's status as a port city has also kept it more prepared for dealing with chemical emergencies than other locations, she said.

"We've had to prepare for chemical spills and industrial accidents for a long time, because this is a shipping zone where there are lots of industrial chemicals," Hastings said.

And the military is a huge asset, she added. The Pacific Regional Medical Command is based here, and civilians could access Tripler Army Medical Center if needed.

The medical command's Special Medical Augmentation Response Team, a group of about 40 medical specialists and support workers, can quickly respond to civilian authorities' requests for assistance.

In July, the team participated in a joint exercise on Midway island with more than a dozen government and civilian agencies. The exercise simulated the crash landing of a jetliner and the treatment of multiple casualties.

"There are a lot of big cities that don't have near the resources that Hawai'i does," said Dr. Thomas Crabtree, the team's founding medical director "Hawai'i is well prepared, but not prepared enough, because no one can ever really be prepared for what happened in New York and Washington."

Reach Johnny Brannon at jbrannon@honoluluadvertiser.com or 535-2431.