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Emergency Management Policy Analysis:
An Investigation of the Preparedness and Response Policies
of Counties along Interstate-40/85 Corridor in North Carolina
Prepared by Kevin J. Bourgault, M.P.P.
August 1, 2002
Executive Summary
The terrorist attacks of Fa112001 illustrated to the nation the vulnerability of our citizenry
to attack. The investigations that followed showed emergency management communities that
local and state agencies might not have the personnel or the equipment required for response to a
mass casualty event or a weapon of mass destruction (WNID). Though the results were extremely
horrifying and disturbing, the effects could have been much, much worse. Had the attacks been
more virulent or widespread, the effects may have resulted in the crippling of further response
and the possible destabilization of the United States.
This study is examines current response and preparedness situations along the Interstate-
40/85 corridor in North Carolina. The study examines potential threats, targets and limiting
response factors. Additionally, policies of evacuation and quarantine are examined, providing
identification of mitigating factors. This study identifies that:
^ Counties along the Interstate-40%85 corridor do not have adequate licensed bed
space available to triage and treat WMD events within the first week of a
catastrophic event.
^ Total evacuation of counties within one week in the study area is possible, but is
not likely to occur within 24 hours.
^ Large-scale quarantines will not work for large dispersed rural areas or heavily
populated urban areas.
Bed Snace
Table 1 Study area licensed beds measured in potential casualties identified and treated within one week
Response Asset County Licensed Beds Potential Casualties
Treated
Beds Oran a 578 Licensed Beds 578
Durham 1,294 Licensed Beds 1,294
Wake 1,203 Licensed Beds 1,203
Chatham 68 Licensed Beds 68
Alamance 182 Licensed Beds 182
Guilford 291 Licensed Beds 291
Johnston 160 Licensed Beds 160
Total 3,776 Licensed Beds 3,776
Counties along the Interstate-40/85 corridor do not have adequate licensed bed
space available to triage and treat WMD events within the first week. A WMD event will
infect hundreds if not thousands, and affect thousands if not tens of thousands. For every actual
casualty identified, there will also be multiple others convinced that they have been infected or
exposed and that they are facing imminent death. Without the ability to immediately diagnose
potential patients, hospitals and care centers will be forced to house and process all patients that
present signs or complain of symptoms.
Under optimal conditions, the study area has 3,776 beds licensed beds. However, the
actual figures for the availability of these beds is in reality much lower. First, some of these beds
are already in use by other patients. Current occupancy rates for these beds hovers around 50%.
Second, some of the licensed beds are currently used for other purpose (i.e., storage and office
space). Though assets could be easily reclaimed, it might take up to 48 hours. Third, not all beds
are identical substitutes. An OB/GYN or a psychiatry bed is not equivalent to an Emergency
Department (ED) bed. Finally, in cases of virulent biological infections (e.g., smallpox) each bed
must be separated in a negatively pressured environment, further depleting availability of this
resource.
Evacuation
Table 2 Study area populations by county 2000 Census
Coun Po ulation
Orange 118,227
Durham 223,314
Wake 627, 846
Chatham ~ 49,329
Alamance 130,800
Guilford 421,048
Johnston 121,965
Total 1,b92,529
Total evacuation of all counties in the study area is possible within one week, but is
not likely to occur within 24 hours. Using the North Carolina Department of Transportation
estimate of 2,000-passenger cars/lane/hour on a 3-lane Interstate, total evacuation would take S.f
days, assuming that all interstate lanes would be directed for outbound traffic. Evacuation
schedules could be accelerated if traffic flows were directed away from a central impact area
allowing populations the choice to leave from either direction or if only a partial evacuation was
implemented. However, it is likely that recent commercial and residential development would
create gridlock areas and drastically hinder any attempt to leave.
Other problems are also likely. Fleeing populations do not know where to go after they
have been directed to leave. To date, destination centers for displaced urban areas have not been
identified or prepared. Additional difficulties occur in the cases of nuclear and radiological
emergencies. In these situations populations would need doses of Potassium Iodide (KI)
distributed either through regional centers or through personnel at key interstate sites. While the
medication is available, distribution plans are undeveloped.
Quarantine
Large-scale quarantines will not work for large dispersed rural areas or heavily
populated urban areas. Quarantine requires massive amounts of funding and logistical
resources (e.g., law enforcement personnel). At present the study area does not have the law
enforcement or financial resources at its disposal to perform quarantine. Coupled with the facts
that there are over 200 identified egress routes, a percentage of the population is armed, and that
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M law enforcement agencies do not regularly exercise quarantines, it is doubtful that law
enforcement agencies within the study area could manage a quarantine in an area any larger than
a housing complex or small rural community.
The study area needs to examine and advocate for an amendment to the Posse Comitatus
M Act, specifically concerning biological infections. This act currently prevents military forces
from performing domestic law enforcement actions. Without the aid and manpower from military
resources counties within the study area will not be able to maintain law and order or deliver vital
services to those in need.
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