Nov 4 2013
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APHA 2013: The Boston Marathon and Preparing for the Unexpected

How do you prepare for the safety and health of 27,000 runners and 500,000 spectators? And how do you prepare for the unexpected—such as a terrorist attack—so that the public health response can be as swift and effective as possible?

That was the first topic of Monday's American Public Health Association (APHA) session, "Late Breaking Developments in Public Health." Mary E. Clark, Director of Emergency Preparedness Bureau at the Massachusetts Department of Public Health, presented on "Public Health and Medical Response to the Boston Marathon Bombing."

Discussing the particular difficulties of staffing an event such as the Boston Marathon, Clark noted that the route goes through 26.2 miles, crosses through eight different communities in Massachusetts and then goes straight into the city of Boston. Along the way, there are thousands of runners and hundreds of thousands of spectators.

"This presents us with medical and health challenges, as well as security challenges," Clark explained.

"This year was the 117th running of the Boston Marathon, and each year we plan this as a planned mass casualty event," Clark said. "We have to build on the work that has gone on in the 116 years before."

To do this, Clark said, the department takes at least four months of preparedness planning, with the assumption that at least 1,000 runners or spectators will need some sort of medical care.

But how did they deal effectively with the unexpected?

"We had a remarkably quick response to bombings," Clark said. She noted that less than a minute after the bombs went off, gurneys were heading to the victims. And in just 18 minutes, they were able to remove 30 critically injured spectators off the scene into ambulances. Massachusetts General Hospital received their first patient 14 minutes after the explosions.

Since the marathon bombings, though, Clark said, they have identified further needs—particularly in the areas of mental health.

"One of the key things that's happened since the Marathon is the recognition of the need for a robust mental health response,” she said. “We have created more mental health support systems for volunteers and staff.”

But her biggest takeaway from the tragedy and the response? "Lessons learned were the benefit of preparedness activities," Clark said.

"People did what they were trained to do and they did it very well."

>>NewPublicHealth will be on the ground throughout the APHA conference speaking to public health leaders and presenters, hearing from attendees on the ground and providing updates from sessions, with a focus on how we can build a culture of health. Follow the coverage here.

Tags: APHA, Disasters, Emergency care, Emergency preparedness and response