Katrina was a perfect storm, all right. Multiple mistakes at multiple levels, compounding and multiplying and cascading into one of the deadliest disasters in American history. There are postmortems yet to be done and after-action reports still to be written, of course, and hearings and investigations and recriminations aplenty to come. But for EMS-any arm of which might face an off-the-scale disaster of its own tomorrow-it's prudent to start asking "what went wrong?"
It's a complicated issue to sort out. The Katrina response involved a complex patchwork of local, state and federal resources, with scopes of responsibility containing both gaps and overlaps. Information infrastructures were shattered, making reliable facts hard to come by. The weeks after the storm saw plenty of finger-pointing, ample "he said/she said," and only rare admissions of error. Historians will write the final verdict. But it's clear there's blame to go around.
THE LOCAL LEVEL
Failures were perhaps most acutely felt at the local level, where they began well before landfall.
Since 2002, New Orleans has received $18 million in federal funds to plan, train and equip for disaster. But its $16 million command center wasn't due to open until 2007, and plans to upgrade power and water supplies at the Superdome, the city's designated "shelter of last resort," hadn't progressed beyond the talking stage. Accepting evacuees at the facility, as officials knew from housing residents there during Hurricanes Georges in 1998 and Ivan in 2004, would likely bring problems with supplies and keeping order.
Evacuating the city was started too late. The Hurricane Pam drill of 2004 showed planners that a full evacuation of New Orleans could take up to 72 hours. But Mayor Ray Nagin announced a voluntary evacuation just 48 hours before Katrina, and made it mandatory less than 24 hours before. And city officials well knew of the estimated 100,000 mostly poor residents without their own transportation.
By Monday morning, the storm pounded ashore and the first levee breaks occurred. But with communications down, the Army Corps of Engineers had no way to tell anyone, and Nagin had no way to reach Washington. As the waters rose, public- safety providers relied on to save lives instead had to save themselves. An estimated 250 police officers- 15% of the city's force-vanished from the job. Police headquarters had to be evacuated. The department itself had only limited gear and no swiftwater rescue capability.
Fire and EMS forces faced similar destruction, despite the heroic efforts of dozens of EMS providers who stayed or were stuck in the city following EMS EXPO. In New Orleans, 21 of 30 fire stations were destroyed or severely damaged, and 30% of firefighters were unaccounted for almost a week after the storm. In other areas, entire departments were wiped out.
This, it quickly became apparent, is a major flaw that imperils a lot of emergency plans: They depend on emergency providers who may become incapacitated.
"The New Orleans fire and police departments just imploded," says flood/swiftwater rescue expert Jim Segerstrom, who was in the city as Katrina approached to train local public-safety personnel looking to form a water-rescue task force. "I don't think anybody took into account that those people would be concerned about taking care of their own families in this kind of event."
As a potential remedy, Homeland Security Secretary Michael Chertoff has raised the idea of training military troops to respond in such a circumstance, but Pentagon leaders are said to favor expanding regional mutual aid agreements.
Elsewhere, with communications out, providers still on the job had little idea what was happening around them. Calls for help went unanswered. Information was passed via couriers and note cards. Four years after 9/11, disaster responders once again found themselves unable to communicate.