The September 11th attack
City's crisis planning began before Sept. 11

By Robbie Dingeman
Advertiser City Hall Writer

There was skepticism four years ago when city Emergency Medical Services Director Salvatore Lanzilotti started working on a plan to improve O'ahu's emergency response system in the wake of the Oklahoma City bombing.

Now, that early planning is helping city officials cope with the threat of terrorism.

Chris Ano of the city and county's Emergency Medical Service holds a "sniffer," which tests the air for anthrax contamination, among other things. It will be used at sporting events and other large gatherings. Bruce Asato • The Honolulu Advertiser

"We've been dealing with these issues for four years, just in the background," Lanzilotti said.

Probably the most visible action came in 1999 when the team helped coordinate one of the largest emergency preparedness drills ever staged in Hawai'i.

That "Island Crisis '99" exercise was based on a chemical terrorism attack, with 100 would-be victims pretending to be contaminated with the nerve gas Sarin — the chemical that killed a dozen people in a Tokyo subway attack in 1995.

But low-profile meetings have perhaps been even more central to improving O'ahu's emergency response system. Those meetings have brought together fire, police, emergency medical services, state health, military, city and state Civil Defense, National Guard, the FBI, Tripler Army Medical Center and civilian hospital officials, Lanzilotti said.

"We've been trying to keep it in the background because you don't want to scare people," he said.

So on Sept. 11, the communications links already in place made it easier to review procedures, look for areas that needed improvement and act more quickly than officials from places where terrorism had been considered a remote threat.

One of the best things the team has done is bring the key responders together, including officials that earlier had very little communication, said Donna Maiava, chief of state Emergency Medical Services.

"I think it helps a great deal," Maiava said. "We know what their resources are, they know what ours are."

As an island state, Hawai'i faces challenges of limited resources and can't rely on neighboring states to dispatch a few trucks full of supplies.

"All of our backup would have to be flown in," Maiava said.

The Metropolitan Medical Strike Team and Response System has provided training and exercises and looks forward to doing more.

"It's a work in progress," she said.

The city received about $600,000 from the federal government to help with the system. An initial grant was used for Tyvek suits and other protective gear for fire, police and others who would be first to respond to scenes.

Honolulu was one of the first 25 cities to apply and get the grant, Lanzilotti said. Federal authorities had seen what happened in Oklahoma City, at the first World Trade Center bombing and at the Olympic bombing in Atlanta.

That planning gave the city a leg up in purchasing the latest test equipment available, including the anthrax field test machines that were used at a Bethel Street architectural firm last week. Although the tests produced a false positive, Lanzilotti said the city stands behind the machines as 95 percent accurate.

Over the weekend, the city began using an air sampling machine that looks something like a blow dryer and can help detect the covert release of chemicals, Lanzilotti said.

He wants people to get used to seeing the machines at sports events, concerts and other large gatherings.

"We're just checking the air. This is preventive," Lanzilotti said. "We want to be there unobtrusively taking air samples."

With hospitals struggling to remain financially sound in a competitive market, Lanzilotti said it was sometimes difficult to persuade their staffs of the need to prepare for potential terrorist acts. For example, he said experts recommended development of decontamination units that could handle 50 people at a time in a tent outside local hospitals. With no assurance that such gear would ever be needed, that kind of spending was difficult for some to envision.

Another idea that came from the response team was a series of surveillance systems designed to quickly identify any medical problem through a central data analysis coordinated through local hospitals and the state Health Department.

Such systems can detect not just anthrax but tuberculosis or pandemic flu, so that a number of people showing up with similar symptoms could be identified early and treatment might begin during those crucial early hours of exposure.

That's especially a concern with anthrax, which doesn't show symptoms until it's so far along that it may already be fatal by the time it is identified as anything beyond a common flu.

Lanzilotti said the system was tested during the May Asian Development Bank meeting and has been in use since Sept. 11.

Lanzilotti and Maiava said the skepticism they saw in the early days of planning after the Oklahoma City bombing began to fade as people started seeing the importance of preparation.

"The city was not only physically prepared, it was mentally prepared for such an act and we were able to put a plan into place," Lanzilotti said.

Reach Robbie Dingeman at rdingeman@honoluluadvertiser.com or 525-8070.