Mass Gatherings and High Visibility Events:   Planning, Preparedness, and Operational Considerations for CBRNe Events

By Mr. Frank Rando, CBRNE - Protective & Biomedical Countermeasures SME, University of Arizona & Ms. Dee Ruelas, Clinical Specialist, U.S. Customs and Border Protection, USA

High visibility events (HVEs) and mass gatherings overall present unique and complex challenges to event planners, public safety agencies, emergency management/civil protection authorities, healthcare delivery systems, and public health stakeholders. By their very nature, large, highly populated, dynamic, and evolving, these events and occurrences call for careful, thoughtful, creative, and highly collaborative pre-incident planning and preparedness efforts, including the analysis of “lessons learned" from past events. There are a great many historic examples as case studies and after-action reports taken from a real-world operational experience which can be gleaned for their valuable and quantifiable data. The 1996 Atlanta Centennial Olympics bombing, Bali, India in 2002, Boston Marathon bombings, and the Las Vegas mass shooting, serve as stark examples of mass casualty critical incidents where much was learned from the operational responses. HVEs and other mass gathering events inherently require a multifactorial, comprehensive, and integrated approach and realistic planning and operational model based on a credible and realistic hazard vulnerability analysis (HVA) and threat assessments.

The ability to “think outside the box" is an advantageous characteristic and brainstorming scenarios and solutions should be welcomed. Operationally, there are a myriad of components and “cogs in the wheel” which need to be deployed, tactically and strategically staged, and integrated as a multidisciplinary response force. Interoperability in communications, equipment, terminology, and tactics is essential. The concepts and tenents of Command, Control, Coordination, Communications, and Intelligence (C4I) must be implemented and adhered to. Emergency communications should be interoperable, multimedia and utilize plain language and common terminology.

The news media must be handled and briefed by a designated trained Public Information Officer (P.I.O.) and regular press conferences held offering accurate public information and instructions. The Incident Command System (ICS) and its various components must be firmly established and adapted to the type, scope, and magnitude of the event. For example, a bona fide National Security Special Event such as the Superbowl will require more sophisticated security and counterterrorism capabilities than a local rock concert or sporting event.

Essentially, and simplistically, if one is giving a “party" (the event), the “party planner” must know:

1. Who is coming? 2. How many “guests"? 3. Who is hosting? 4. Who may want to “crash” the party (terrorists, subversives, protesters)? This requires credible intelligence gathering and threat assessments. 5. The “lay of the land” , i.e., the venue, which must be surveyed, and vulnerabilities assessed, including the peripheral environment, infrastructure, topography/ terrain, hazardous industries such as mining, chemical manufacturing, petroleum, and gas facilities, or processes nearby? 6. The nature of the activities planned? 7. The “turf" amidst geopolitical instability and international and/or national tensions. 8. Vetting individuals and vendors.

When it comes to actual incident management, the major principles are covered by the mnemonic “L.I.P”: Life safety Incident stabilization Preservation / Protection of environment and property

The overall goals are to minimize casualties and fatalities, mitigate or neutralize hazards, reduce damage and contamination, and prosecute the perpetrators/actors. The initial considerations include life and scene safety, hazard assessment, selecting and don appropriate P P E, conducting scene survey and determining additional resources, rescue, extrication, and lifesaving interventions, establishing incident command, establishing perimeters and zones ( e.g., “hot” / exclusionary zone ), maintain crowd control, public warning, risk communications, detection and agent characterization, decontamination, triage, treatment and transport, hospital / medical surge capacity and operational capabilities and disposition of deceased victims / mass fatality management.

Other considerations where planning and operational decision making may be dependent on include meteorological conditions, physicochemical properties of chemical agents, toxic industrial chemicals, or materials (TICs/ TIMs) or radionuclides utilized in the attack, collateral conventional attacks, multimodal/multifocal terrorist actions, venue capacity, and specialized CBRN resources such as Civil Support Teams and “no-fly” zones.

In the aftermath of a CBRNE event, forensic, medicolegal, and criminal investigations, as well as other attribution efforts which could result in a military retaliatory response or political and economic sanctions to take place. Post-incident environmental remediation and cleanup and ongoing individual and community-wide medical, epidemiological, and environmental health surveillance should also be included in the pre-incident planning, preparedness, operational, and recovery phases of the incident. A CBRNE incident at a mass gathering or high visibility event can be a high impact, high consequence occurrence with many variables, the magnitude of severity, national consequences, and possible international implications. The looming threat of CBRNE incidents in high visibility or mass gathering contexts continues to pose a grave danger to national and international security and the masses who attend such events and venues.

AUTHOR


Frank Rando currently serves as an allied health programs educator / lead instructor and healthcare emergency preparedness/medical readiness /public health preparedness and tactical, operational - disaster medicine and homeland security Subject Matter Expert , educator , instructor and curriculum designer. He has served in instructional, guest speaker and consultative roles for DHS-FEMA, various components of the National Domestic Preparedness Consortium , DoD, industry, academia , health , safety and regulatory entities, emergency services organizations and healthcare.

He recently served during the COVID-19 public health emergency as a clinician and clinical researcher and also served in medical and health care support as a clinician for US Customs and Border Protection.

Frank is also an experienced clinician, first responder and an occupational – environmental health scientist with real world experience in hazardous materials management , hazards and pollution control, biosafety, industrial ,environmental and inhalation toxicology, environmental epidemiology ,exposure and risk assessment and emergency response . Frank has also received advanced training in Integrated Biological -Chemical Response from the US Army -Dugway West Desert Test Center and the National Ebola and Special Pathogens Training Centers.

Frank’s experience includes public safety roles in law enforcement, pre-hospital medicine/EMS and military duty as a Nuclear, Biological and Chemical/CBRN Specialist, NBC medical defense instructor Special Forces Medical Sergeant, Dive Medical Technician, Intelligence Sergeant and Medical Intelligence Analyst.

AUTHOR


Dee Ruelas possesses over 35 years of dedicated professional experience in various roles in public safety/ emergency services, teaching and instruction, healthcare, environmental health and safety, emergency preparedness, community resiliency and Christian ministry. Dee was also a decorated public safety-emergency medical communications specialist for the City of Tucson Fire Department and worked for the Tucson Municipal Court, where one of her roles was serving as the Fire Prevention and General Safety Officer for the municipal courts system. Currently, Dee has been serving as a clinical specialist in COVID-19 testing and vaccination services and served as a medical and healthcare support specialist for US Customs and Border Protection.

Dee is the former Director of the City of Tucson Community Emergency Response Team (CERT) and is a DHS-Certified CERT Instructor, National Association of Emergency Medical Technician Tactical Emergency Casualty Care (TECC) Instructor and a Certified Stop the Bleed Instructor. Dee is also trained and serves as an experienced instructor and consultant in hazardous materials, incident command, explosives recognition, medical decontamination, active shooter countermeasures, emerging infectious diseases, mental health first aid, refugee medicine and general health and safety, including roles as a subject matter expert, guest speaker, and instructor for the State of Arizona Division of Occupational Safety and Health.

She has also been trained by the National Ebola Training Center and the Emory University Rollins School of Public Health Dee also is the owner and senior proprietor for Teach 2 Prepare, a consultancy and training entity.