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County Trains for Disaster

Mass vaccination exercise prepares emergency crews for biological attack.

On a cold Saturday morning, hundreds of people lined up outside Washington-Lee High School.

They weren’t there to take the SAT. Instead, they were volunteering to be sick, to pretend to be stricken with a deadly disease. There was a simple reason for that kind of turnout, Lisa Kaplowitz said. “You don’t want to first exchange business cards during a disaster.”

Kaplowitz, the state’s Deputy Commissioner for Emergency Preparedness and Response, was on hand at Washington-Lee on Saturday, Jan. 11, for a training exercise to test Arlington’s ability to handle an outbreak of infectious disease, or an attack with biological weapons. Local health and emergency personnel teamed with state and federal officials to simulate a vaccination clinic that could handle some 1,000 people in a single day.

Between 400 and 500 volunteers showed up, most of them staff from local hospitals, and many went through the process more than once. Volunteers watched a video about the vaccination process, then met with emergency medical personnel to discuss possible problems with the vaccine. Finally, they made their way to the vaccination station, where the simulation ended as medical staff injected oranges with a saline solution in place of the real vaccine.

It was an important exercise, said officials, because it allowed them to identify problems with a local health system that could be responsible for saving lives if disaster strikes.

The U.S. Department of Health and Human Services announced in December that it would team up with state and local governments to develop plans for dealing with a smallpox attack. Local jurisdictions are basing their plans on a model provided by the Center for Disease Control and Prevention.

Saturday’s simulation was the first of its kind in the state. Arlington leads the way in emergency preparedness because, as everyone learned on Sept. 11, the proximity to the nation’s capital makes it one of the areas most at-risk for attack, Kaplowitz said. “They got their lesson hands-on in Arlington, and we’ve taken that lesson to heart,” she said.

PREPARING FOR DISASTER takes time, and difficulties continue to arise as the dangers themselves change. “We’re trying to be as prepared as possible as we evolve,” said Bob Mauskapf, statewide planner for Emergency Preparedness and Response.

Exercises like the one on Saturday are an important part of the process, but there is still a long road ahead, said Mauskapf. “It’s all coming together, and it’s a nice logical progression I think,” he said

In addition to running test exercises, officials are vaccinating emergency medical staff at local hospitals, who would be responsible for vaccinating the public in an outbreak, and labs are increasing the stockpile of available vaccination.

Federal officials say there will be enough vaccine to treat the entire population in a smallpox attack. There is cause for concern, though, with a deliberate process.

“You would hope that an event would wait for [preparations] to happen, but we’re all real world people,” said Mauskapf. Simulations cannot replicate behavior patterns of people in an emergency situation.

“I didn’t notice a lot of [impatience],” said Steve Church, an emergency planner in the Fairfax County Health Department,. In an actual emergency, he said, officials could have more difficulty keeping citizens calm.

Analysis of Saturday’s simulation will probably show several crucial flaws, he said.

Church received the simulated vaccination as a volunteer Saturday, but was not involved in the offical planning process for the exercise. The most important information will concern the amount of time it took to process simulated patients at each of the four stations.

“Their forms probably needed some adjustment,” he said. “They need to make sure you’re not providing duplicate information and that it’s not confusing… I think people become frustrated with that kind of thing very quickly.”

Officials hoped to be able to process each patient in less than an hour, but Church said the time extended to about an 100 minutes for him. Despite the bottleneck that slowed the line, Church said he wasn’t alarmed about the problems encountered. “If they knew how long it would take, they wouldn’t need to do the exercise,” he said.

Ed Plaugher, Chief of the Arlington Fire Department, also expressed confidence in the county’s emergency personnel. As fire chief, he serves as the county’s emergency coordinator, and he said his department consists of “an army of people well-trained.”

Officials expect to refine emergency procedures. “We have no doubt we’ll learn a lot of valuable information from this exercise,” said Allan. But she does not anticipate having to make any large-scale changes in preparations. “If anything, we’re ahead of schedule,” she said.