Gabe Kelen, chair of Emergency Medicine, is accustomed to dealing with crises. But for him, Sept. 11, 2001, was a wake-up call. In the event of an unfathomable disaster like a smallpox outbreak, would Hopkins be prepared? Could it protect its employees--and could it step in as a leader in a regional or national effort?
For a year, he has been working to make sure the answer would be yes.
On July 1, the School of Medicine professor and emergency physician-in-chief at the hospital, was named director of Hopkins' new Office of Critical Event Preparedness and Response, a unique enterprisewide entity that will oversee endeavors to prepare for and respond to an extensive impact disaster, particularly from potential terrorist action.
The concept of CEPAR was conceived post-Sept. 11 in recognition of Johns Hopkins' potential to play a primary leadership role in the event of a major calamity in the region, such as an outbreak of anthrax or the city being enveloped in a radioactive cloud.
The new office will bring together expertise and resources from both the university and health system and serve as the "official and unified voice" for Hopkins in disaster planning and response.
In announcing the initiative, university President William R. Brody said, "We recognize and embrace our special responsibility to assist local, regional and federal organizations in this [homeland security] endeavor. CEPAR is the tangible manifestation of our commitment to the safety and well-being of our fellow citizens and to being prepared to respond to disasters, both within Johns Hopkins and in the broader community."
Brody added that "the tragic events of Sept. 11 have shown us that disasters can strike swiftly and without warning. It is imperative that all our private- and public-sector resources prepare for the once unimaginable."
The permanent office was recommended by the Mass Casualty Task Force that was convened in October 2001.
"We knew our response had to be long-term. Terrorism wasn't going to go away, and we weren't going to be able to tidy up our planning in six months," says Kelen, who chaired the group. "That is what really gave birth to the whole CEPAR idea Š . Our job is to look at all the vulnerabilities across the entire Hopkins enterprise, to see what needs shoring up."
Specifically, CEPAR has been granted authority to direct planning activities, conduct drills and exercises, develop policy, oversee public educational outreach programs and coordinate funding and grant opportunities. In the event of a disaster, the office will serve as an incident command and control system that will "direct traffic" in terms of bringing Hopkins' resources together and be a single point of contact for government agencies, including the Department of Defense, the Federal Emergency Management Agency, the Maryland Emergency Management Agency and city and state health departments.
Kelen says that in creating CEPAR, Hopkins has broken new ground.
"This is a major and unprecedented initiative," he says.
Part of the university's larger emergency management effort, CEPAR will work in tandem with the now two-year-old Crisis Response Team. Whereas the CRT was created to manage the response to a crisis that would be outside the ability of an individual school or functional unit to handle--such as an outbreak of meningitis or a laboratory fire that destroys a campus building--CEPAR will coordinate the enterprisewide response to a critical event that is outside CRT's scope.
CEPAR is headquartered at 201 N. Charles St and will initially be staffed by eight full-time employees from Emergency Medicine, APL and The Johns Hopkins Hospital. It will report to a board of directors currently composed of President Brody; Steven Knapp, provost and senior vice president for academic affairs; Edward Miller, dean of the School Medicine and CEO of JHM; Alfred Sommer, dean of the Bloomberg School of Public Health; Ron Peterson, president of JHH and JHHS; and Richard Roca, director of APL.
Christina Catlett, an assistant professor in Emergency Medicine, will serve as deputy director of CEPAR. Catlett currently serves on JHH's Disaster Committee and has a background in disaster planning and domestic preparedness for biological, chemical and nuclear warfare.
For its first year of operation, CEPAR will have a budget of $1.2 million, funded by President Brody's discretionary account, Johns Hopkins Medicine, the Department of Emergency Medicine and the APL Partnership Fund, a new vehicle designed to encourage projects between APL and other components of the university. Kelen notes that APL, the Johns Hopkins Health System and the School of Medicine have already invested roughly $1 million in CEPAR's precursor efforts.
"Long term, we hope to have most of our funding external because we hope that the type of work that we do is of value to local, state and federal governments, and so forth," he says. "Ultimately, we hope to create a planning template that, if successful, other large metropolitan jurisdictions can use for their own cities, not just in the United States but abroad."
Kelen says that CEPAR will have a "continued up-front presence" at both the university and public level. Currently in development is a comprehensive Web site, scheduled to go live before year's end, that will be the organization's mouthpiece.
To date, CEPAR has begun an examination of the individual disaster plans of each Hopkins division, developed a chemical and biological attack response for the Johns Hopkins Health System, developed an incidence command system with varying states of alertness, canvassed all Hopkins entities for disaster planning and response expertise, and conducted four major training exercises at APL's War Analysis Laboratory. Participants in the exercises were officials from the state, Baltimore City, the Maryland Emergency Management Agency, the Department of Defense, the National Disaster Medical System and the Maryland Institute for Emergency Medical Services Systems.
In the coming months, Kelen says his office will, with the assistance of APL personnel, analyze all the disaster plans, looking for uniformity of approach and policy; conduct a survey of Hopkins' ability to handle large numbers of sick and injured; and further refine its communication systems.
"We need new and better ways to be in communication with all our many entities," he says. "There needs to be a single line of communication along with redundancies in case that system fails. That is just a big show stopper if we're not all on the same wavelength."
Kelen says that with such an extraordinary amount of expertise on the medicine front and in policy planning at Hopkins, CEPAR needs to do a "second pass" on identifying who can help the office prepare for and respond to a critical event.
"Things have evolved since Sept. 11," he says. "We have a much better idea today of what experts we need and under what conditions."
While much has been accomplished in the past several months, Kelen says so much more needs to be done.
"It's an understatement to say that there is a lot of training and preparedness to do," he says. "We have a lifetime of work ahead of us."