How ready are we? Las Vegas’ preparedness for terrorist attack tough to measure

Friday, Oct. 19, 2001 | 4:20 a.m.

The ability of public-safety workers and medical professionals to respond to terrorism depends on the type and magnitude of the event and severity of injuries.

Emergency managers have plans that address explosions and the release of dangerous pathogens, but local preparedness is tough to measure because the Las Vegas Valley has never experienced terrorism.

"The reason it's an unknown is that we've never had an incident like that," Timothy McAndrew, Las Vegas emergency-management coordinator, said. "I might be able to easily handle more than 100 patients who are minor casualties, or I could have 50 casualties who are extremely critical and that could put the system in deep trouble. As the acuity level escalates it takes more resources to take care of the patients."

The federal government has primary responsibility for preventing terrorism through its intelligence and law enforcement agencies. But in the event of a terrorist attack, first-response duties fall on local agencies. And no local emergency manager is willing to quantify how safe the valley is from terrorism.

Mike Myers, who coordinates the local Metropolitan Medical Response System for mass-casualty emergencies, said planning is difficult because he cannot predict every type of terrorist attack.

"The emergency system is strained right now," Myers said. "We know that in the event of an attack it would be difficult and chaotic, but that's why we try to prepare for everything. We can't handle 2,000 to 3,000 patients and say that that will be easy."

There are limits to planning. For instance, no emergency plans exist to evacuate the entire valley. Old civil defense plans from the 1970s called on residents to be evacuated to lightly populated Lincoln County in the event of a nuclear attack, but that contingency has since been scrapped.

"We would likely develop a destination on the fly," McAndrew said. "I don't think we would run into the type of event that would be long-lasting. The immediate attack would be over relatively soon. But where on Earth would you put 1.3 million people? How can you plan for something like that?"

Arguably the most difficult form of terrorism to prepare for is the release of deadly pathogens such as anthrax or contagious viruses such as smallpox. That's because such preparedness relies heavily on early warning detection by medical professionals, most of whom have no experience with biological-attack victims. That was borne out in a Clark County Health District survey released earlier this month that revealed 93.6 percent of the local physicians who responded had no bioterrorism training.

Because of the Sept. 11 terrorist attacks, the health district immediately launched an early warning training program that wasn't scheduled to begin until January. District bioterrorism preparedness trainer Sunny Lucia said the goal is to train 2,200 physicians, nurses and emergency medical technicians by next year on how to spot patients who have contracted dangerous pathogens.

"Physicians are used to taking care of patients on their own," Lucia said. "We're asking them to report their suspicions to us and not wait for diagnosis. We want to move in and work with them quickly."

Myers and the health district are confident that local authorities can manage an anthrax outbreak since the bacterium is not contagious and can be treated with antibiotics. Their confidence is bolstered by the federal government's promise that it can deliver 50 tons of medicine and medical equipment to Las Vegas within 12 hours of a reported biological attack.

Health officials are less certain of their ability to contain a contagious virus, particularly in a tourism community that attracts visitors from all over the world. But Rose Lee Bell, health district epidemiologist manager, said a large number of residents can be vaccinated in a short period of time to help contain the spread of a virus such as smallpox. She referred to a 1947 smallpox outbreak in which 6.3 million New York City residents were inoculated in 28 days.

"For the initial people who get sick there isn't a whole lot that can be done," Bell said. "That's why the quicker we know what is going on the sooner we can notify the right people so that vaccines can be sent in."

In the case of the Florida man who died earlier this month after inhaling anthrax, authorities sealed off the building where he worked and notified his co-workers and known associates. It was not deemed necessary to alert the public.

But if an attack involved the release of slow-moving contagious viruses, local authorities would call a press conference to spread the warning.

Local officials would activate a command center on the ground floor of the Clark County Government Center in the event of a terrorist attack involving an explosion or chemical release such as nerve gas. The operations most likely would be commanded by a fire chief, although a Metro Police official could take charge if the situation called for it. The FBI, however, would run all terrorism investigations with help from Metro.

Clark County Emergency Manager Bob Andrews said he was about "70 percent confident" in the abilities of local authorities to coordinate a large-scale operation.

"The biggest issue to prepare for possible terrorist events is good, solid coordination with everyone working together," he said. "New York City is the best-prepared city you can think of, and (its officials) couldn't begin to handle everything themselves on Sept. 11. But New York has a lot more access to regional resources, like in New Jersey, than we do.

"Here in Clark County we're an island. Suppose you had 6,000 casualties -- where would you send them? We don't have an answer. What we have to do is make sure we share our resources, and we're working toward that. We've got mutual aid compacts that we test daily."

The point of attack -- a hotel, arena or shopping mall, for instance -- would be sealed off from the public and a buffer zone to help guard against the spread of contaminants would be created. In public-safety lingo these zones would be known by colors or temperatures.

The hot or red zone would be open only to specially trained firefighters and other rescue workers who wear self-contained breathing apparatus. A warm or yellow zone that also may be contaminated would be worked by police wearing protective suits and be used to decontaminate victims and rescue workers.

The cold or green zone, an area believed to be free of contaminants and therefore harmless to the public, is where victims would receive immediate medical treatment. Myers said the county has three medical strike teams -- composed of 120 medical professionals each -- that could set up temporary treatment centers within four hours.

"Our goal is to deal with the walking wounded," Myers said. "People will run away and try to go to hospitals, but we don't want them at the hospitals."

The valley's 11 hospitals would be pressed to serve as many critically wounded patients as possible and could use their affiliated clinics to help treat the walking wounded. University Medical Center, for instance, has only 12 beds in its burn unit, but has the capacity to add more if necessary.

"You would throw the rule book out and do whatever possible to keep people alive," Rick Plummer, UMC spokesman, said. "We would start looking for patients who could really go home in case we needed those beds."

Authorities would issue warnings via television and radio to stay away from contaminated areas after an explosion or chemical attack. Those alerts would be followed by more detailed instructions, such as evacuation procedures and the location of emergency shelters. If necessary, those shelters would be protected by police or, in extreme cases, the Nevada National Guard.

Residents who live downwind of a contaminated area would either be evacuated at least a half mile to either side of the prevailing wind or would be ordered to stay home, turn off air conditioning or heating and close all doors and windows.

Emergency shelters would be run by the American Red Cross of Southern Nevada. Shelters that serve three meals a day would be open in places such as school gymnasiums and community centers where there is access to kitchens and restrooms.

Carolyn Levering, director of local Red Cross chapter services, said the organization can access about 400 cots. But she expressed confidence that local resorts also would provide rooms in response to an emergency. When airline passengers were stranded in Las Vegas after the Sept. 11 attacks, Levering said resorts donated more than 100 hotel nights to those individuals.

"The difficult part is finding the right shelter," Levering said. "Often we don't know where to open a shelter until we know the nature of the emergency. It usually takes about an hour to assess the situation and find an appropriate location."

The Clark County School District has various emergency plans, depending on the incident. With a fire, students are drilled monthly to leave classrooms within two minutes and are led through the corridors to safety outdoors. School corridors are designed to withstand fires from outside their walls for at least an hour.

If there was an outdoor release of dangerous chemicals, however, students and faculty would remain in the classrooms, all heating and air conditioning would be shut down and all doors and windows would be closed. Dave Broxterman, district administrative manager for facilities, said teachers also have masking tape to seal open spaces in door frames. This procedure, known as "shelter in place," is also exercised quarterly at each school and should take less than five minutes, he said.

"There would be no way to empty all of the kids out of a school before a cloud arrived," he said. "Instead, we would encapsulate a clean air bubble inside the school."

The role of maintaining order during an emergency falls on police. But Lt. Martin Lehtinen, Metro's emergency management coordinator, said the agency would have to call on outside help if more than half of Metro's 2,000 commissioned officers were needed to respond to a single event over the course of two to three days.

Local resources have to be exhausted before municipalities or the county could receive state assistance. But available financial assistance from the state -- which must be approved by the state Board of Examiners and the Legislature's Interim Finance Committee -- is sparse.

The State Disaster Relief Fund has only $5 million, and there is an additional $500,000 in an emergency-assistance account that represents interest accrued from the relief fund, according to Frank Siracusa, State Division of Emergency Management director.

"Obviously, if you are talking about something of the magnitude of what happened in New York City, that would deplete county and state resources and you would need federal assistance," he said.

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