When is an MCI MVA not an MCI MVA?

On a busy weekend shopping day two weeks before Christmas, 2008, somebody dropped two bottles of acid out of a tall building in Hong Kong. Forty-six people were injured and if anybody ever figured out whodunnit, I didn’t hear about it. The BBC reported that the bottles were each 750ml in size and contained an unknown acid.

Whether this was a terroristic attack, simple criminal mischief, or a mere accident, it demonstrates one of the most overlooked, least spectacular, threats we face in the United States. I am out of the loop on the zeitgeist in Hong Kong but I’ll wager that if something like this happened here in the middle of the big shopping season we’d be hearing about it for weeks. If it happened more than once in different places, thus demonstrating that it is some sort of coordinated attack, it would probably lead to the sort of hysteria not seen since Amerithrax. Specific to this case, I can see engine companies running all over town to identify Coke somebody poured out on the sidewalk or a spilled bottle of water in the mall.

I’ll take it a step further, though. In 1976 an anhydrous ammonia tractor-trailer fell off an overpass at US Hwy 59 and I-610 in Houston, killing six, hospitalizing 78, and injuring around 100 more. That’s close to 200 casualties from one truck with no explosives. Just like the bottles of acid, we would treat this as a standard chemical release/MCI and it would be mitigated fairly straightforwardly.

The point is that terrorism doesn’t have to be a belt bomb in a restaurant or a plane into a building: it can be something small, improvised, and dual-use. Some people argue that al Qaeda set the bar so high with 9/11 that they won’t attempt anything less spectacular for fear of looking like their capacities have diminished. Even if this assesment is accurate we still have to worry about myriad domestic threats and other Islamist groups. No matter what law enforcement and the military do to preempt threats, some means will always be there for those with the intent in our open society. The public and TV wonks have a touch of selective hearing when it comes to this ugly truth and so we don’t get as much attention on the mitigation side as those on the prevention side do.

While we can’t stop the most dedicated and resourceful threats, we can prepare for the familiar on a larger and scarier scale. When is an MCI MVA not an MCI MVA? When it is coordinated and purposeful- then it’s a terrorist attack and people freak out. It may not make much of a difference in how my company or your company handles the scene, but it does mean we are more likely to see greater numbers of casualties with more complications than an accidental incident of similar nature. The takeaway is that two of the absolute, most essential, real world steps we can take to prepare for improvised terrorism is to brush up on our decon skills (no pun intended) and make sure we have our triage and MCI systems practiced and organized. And don’t for a second doubt that the foundation of succesful MCI management is strong ICS.

To repeat: the most important first steps you can take for operational preparedness, with little expense and time, are to practice your mass decon and ICS/MCI SOP’s. (Assuming you already have mass decon, ICS, and MCI SOP’s and use acceptable PPE; if you don’t you have bigger problems than terrorism).

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