DAVID ALEXANDER

- 7 June 2005 - Terrorist Attacks

on London: Lessons for

Civil Protection

Objectives of this talk:

...examine the emergency operations after the 7 July 2005 explosions in terms of...

• their efficacy and efficiency

• lessons to learn in order to improve response to similar events in the future

• new event scenarios and new models of emergency response.

The Blitz of 1940-1: a period of history still fundamental to London culture

18,44 hrs, 8 September 1944 a supersonic rocket

falls on Staveley Road,

Chiswick, W. London

3 dead 22 seriously injured 6 houses demolished

....but the organisation of seach and rescue and civil defence was truly rudimentary in those days.

Train crash at Harrow-and-Wealdstone October 1952: first use of triage in the UK

London:

• 300 languages regularly spoken

• 8.2 million inhabitants (25 million in the Home Counties)

• occupies and area of 1,584 km2

• 4 police forces.

Wandsworth

H&F K&C

Camden

Westminster City

Richmond Richmond Richmond Richmond Richmond Richmond Richmond Richmond Richmond

Islington Hackney

Tower H

Southwark

Waltham F

Lambeth

Kingston

Lewisham

Greenwich

Barking & D

Brent

Hillingdon

Hounslow

Barnet

Bexley

Bromley

Croydon

Ealing

Enfield

Haringey Harrow

Havering

Merton

Newham

Redbridge

Sutton

Greater London: 33 local authorities

The emergency services:

Fire Brigade

Police

Emergency planning

Health services

The police usually take the role of "lead agency"

Emergency planning: London Resilience (www.londonprepared.gov.uk)

Wandsworth

H&F K&C

Camden

Westminster City

Richmond

Islington Hackney

Tower H

Southwark

Waltham F

Lambeth

Kingston

Lewisham

Greenwich

Barking & D

Brent

Hillingdon

Hounslow

Barnet

Bexley

Bromley

Croydon

Ealing

Enfield

Haringey Harrow

Havering

Merton

Newham

Redbridge

Sutton

[zonation]

Planning and statutory instruments

Transport emergency managers

Providers of basic services

Military forces

Health Protection

Unit

Recovery Mgt. Units

Local authorities

Police: Met./BTP/ CoLP/MDP

Chairman (Met. Police)

Fire service LFB

National Health Service

Ambulance Service LAS

Co-ordination of information to mass media

Mass media

representatives

London Government

Office

Crisis Unit of National Civil

Protection (COBR)

"Gold"-level Co-ordinating Group

LESLP

Bronze - operations

Silver - tactics

Gold - strategies

[Platinum - COBRA]

UK: 3 commands, 4 levels Police - Fire Brigades - Medical Services

The response environment

LEAD GOVERNMENT DEPARTMENT

Media

Centre

Media

Liaison

Point

Temporary

Mortuary

Survivor

Reception

Centre

Relatives’

Reception

Centre

Local Authority

Emergency Centre

Strategic Co-ordinating Group

Police Local authority

Fire Military forces

Ambulance Government advisors

Other agencies

Strategic

level

Voluntary

Agencies

Casualty

Bureau

Public

enquiries

OUTER

CORDON

Receiving

Hospitals

Body

Holding

Area

Ambulance

Loading

Point

Casualty

Clearing

Station

Vehicle

Marshalling

Area

Incident Control Point

Police

Fire

Ambulance

Liaison

Tactical

level

INNER CORDON

Site of Disaster

Police

Fire

Ambulance

Specialist advisors

Operational

level

Pedestrians only

Cordon III for traffic

control Multi-agency operations command.

Public assembly area

Rescuers' assembly point

Points of access to cordoned off areas

Only rescuers

Cordon I

Only authorised personnel Cordon II

Incident

Time

Resp

onse

Emergency isolation phase

Major incident declared

Consolidation phase

Recovery phase

Investigation

Stand-down

Funerals Debriefings

Anniversaries Plan revision

Inquests Public enquiries

Trials Awards

Memorials Training

Court cases

Anatomy of a major incident

The bombs (rudimentary construction,

hydrogen peroxide base)

London has 40 years'

experience of metropolitan terrorism

0947 hrs: explosion on no. 30 bus in Upper Woburn Square: it is full of

passengers displaced from the Underground.

Relevant aspects:

• concentrated blast, directed upwards and sideways

• passengers on upper deck dismembered: difficult to reconstruct the bodies

• immediate availability of medical doctors with experience of emergency medicine.

London Underground ("the Tube")

• founded in 1868

• 12 lines (408 km), 275 stations

• 12,000 staff, 3 mn passengers a day

• divided between cut-and-cover lines (the earliest) and deep lines

• problems of access, maintenance, signage, safety procedures.

Oxford Circus underground station contains: • 25 stairways • 14 escalators • 9 km of walkways and platforms

Past disasters

March 1943: panic and crush at Bethnal Green – 173 dead

Feb. 1975: crash at Moorgate – 43 dead

Nov. 1987: fire at Kings Cross – 31 dead

7 July 2005 0900 hrs: evacuation of 200,000 people from the central zone of the Tube

Major incidents in the Underground: • diffusion of smoke • intense heat • lack of space and ventilation • long-lasting crisis.

Liverpool Street-Aldgate Kings Cross-Russell Square: the exit of passengers from two stations instead of one

made it seem that there were six incidents instead of four.

Primary injuries: • effects of blast pressure directly on body tissues • pulmonary barotrauma and effects on hollow organs of the body

Blast injuries

Secondary injuries: • impact of flying objects and shrapnel

Tertiary injuries: • people are thrown against walls and objects.

Various forms of injury:

• exposure to and breathing in of toxic materials

• exposure to radiation

• thermal and chemical burns

• smoke-related asfixia in fires

• crush injuries from collapse of buildings and fitments.

Blast injuries

• inhalaion of dust (including asbestos)

Effects of the Tube bombs: • blast contained and reflected off tunnel walls (rendered unstable) • concentration of blast force in confined space • derailment and crash of trains • fireballs and flashbacks.

Underground: the range of injuries • spontaneous amputation of limbs • deep damage to soft tissue, with exposure of internal organs • burns from flashbacks and fireballs • "compartment injuries", above all to lungs (barotrauma) • shrapnel injuries (transfiguration or penetrating laceration).

An effective emergency mortuary plan was an important part of the London response

The London temporary mortuary

Lessons of the London bombs

• rescue should not begin before ascertaining that the site is free of CBRN contamination: this will take about 20 minutes

• the delay in providing aid is critical and highly controversial.

• hospitals should prepare for many different types of trauma, complex triage, long-lasting surgical operations.

• lack of parallels with other types of incident (vehicle crashes - not much)

• injuries caused by bombs can be very serious and complicated

Lessons of the London bombs

• the seriousness of injuries increases exponentially with proximity to the location of the explosion (with complications caused by reflection of the blast from solid surfaces).

• bombs that explode in confined, crowded spaces inevitably cause many injuries

Lessons of the London bombs

• in a confined space such as a tunnel rescue operations will be slowed down by the need to ensure absence of CBRN contamination and secondary bombs (UXB)

• this requirement conflicts with the need to work with maximum haste in order to save the lives of injured people.

Lessons of the London bombs

• regarding underground emergencies, new means of finding out what has happened are needed and so are robust methods of informing the people involved

• new emergency planning methods are needed, with robust methods of identifying conditions in which a "red alert" needs to be declared.

Lessons of the London bombs

Lessons of the London bombs

• very seriously injured people need intensive pre-hospital case at the site before transport to hospital

• this requires new equipment and new emergency medical organisation

• blast and crush victims have an immediate need for fluids.

• even in deep tunnels in the midst of smoke and chaos, the incidence of panic is very limited: it is not a significant factor in emergency planning

• the site of the blast is also a "scene of crime" and should not be disturbed more than necessary in order to provide effective aid to victims.

Lessons of the London bombs

• an effective response to terrorist attacks requires excellent lines of communication between: - the intelligence services - the forces of law and order - civil protection services - emergency planners and managers.

Lessons of the London bombs

• passive response demanded of citizens ("go in, stay in, tune in") not appropriate?

• failure to declare major emergency in a prompt, synchronous way between emergency services

• failure of gold command to function effectively either in central London or Hendon (suburbs).

"Now lettest Thou Thy servant depart in peace, For mine eyes have seen Thy salvation."

Saint-Mary-le-Bow

Bow bells