At 8 a.m. on April 15, a war room of sorts was activated at a South End office of the Boston Public Health Commission, nearly seven hours before the bombs exploded near the Boston Marathon finish line.
As usual on a Marathon Monday, the city’s Medical Intelligence Center had geared up for a “mass casualty event,” with a dozen public health officials monitoring computer screens and radio transmissions. With moderate temperatures, they were not expecting a flood of runners or spectators at emergency rooms.
“It started out as such a slow day,” said Mary Devine, a liaison from the Conference of Boston Teaching Hospitals who was in the intelligence center that day.
Within a minute after the first bomb exploded, a Boston Emergency Medical Services staff member in a Marathon medical tent alerted the center; within 10 minutes, Devine sent an alert to all area hospitals after tuning into the EMS radio dispatches: “Explosion near Medical Tent A. EMS will be using red wristbands for patients. Multiple casualties reported.”
She and others would put in 15-hour days during the next two weeks in the 1,200-square-foot room with a 62-seat capacity, helping reconnect victims with their families, dispelling rumors about additional bombings, and coordinating every service needed by those affected by the attacks, from free airline tickets for family members to grief counselors for Marathon volunteers.
The Stephen M. Lawlor Medical Intelligence Center, the only one of its kind in the United States, is marking its fifth anniversary Friday with a visit from federal Homeland Security chief Janet Napolitano. It operates with money from city, state, and federal governments and stemmed from meetings that the city’s emergency response leaders first held in 2004 to plan the Democratic National Convention in Boston.
Napolitano praised the center in a statement Thursday, saying its “outstanding work” helped Boston respond “quickly, effectively, and comprehensively to an act of terrorism.”
The center’s vast computer networks virtually link hospitals, public health departments, and emergency services around the clock.
But on three planned days a year — the Marathon, New Year’s Eve, and July 4 — staff unlock the doors, switch on the lights and giant smart boards, and sit behind the long banks of desks equipped with phones and laptops. They can also open on a moment’s notice during weather and other emergencies, such as this past winter’s early flu epidemic.
“It’s kind of the coordinating hub with information coming in and going out,” said Barbara Ferrer, executive director of the Boston Public Health Commission. “It’s the one place in the city where you know you can call” after disaster strikes, she said.
Immediately after the bombing, the intelligence center fielded phone calls from health workers and volunteers who were helping desperate families to find injured loved ones. It sent out regular briefings, providing updates on patient injuries and law enforcement reports on security issues, and sharing information about services that were being offered or sought by those in need.
At 7 p.m., four hours after the bombing, the center’s briefing reported that 110 patients were known to be injured and that one hospital was experiencing a shortage of amputation kits and looking for more.
Representatives from nearly every public health entity helping victims — from the American Red Cross to the state health department to the federal Department of Health and Human Services — took a seat in the center at some point during those first days.
“There’s a benefit to having everyone in the room, sharing ideas,” said Boston EMS chief James Hooley, who was in and out of the war room, located in the same building as EMS headquarters.
Atyia Martin, who is director of the city’s Office of Public Health Preparedness and manages the intelligence center, revised the communication system last year, ripping up protocols with her team after realizing there were gaps.
“Our partners knew us personally, but needed to know that they shouldn’t be contacting Atyia or Mary during an emergency but whoever happens to be the point person at the center at that time,” Martin said.
Despite the careful planning, confusion ensued from time to time. Jammed cellphone networks in the hours after the attacks meant emergency responders had to communicate with the center by radio. Rumors flew that bombs were planted in parked cars outside hospitals. “We spent a lot of time investigating these,” Devine said.
And the Friday lockdown of the hospitals, when one of the bombers was still on the loose, was a nightmare, Ferrer said. One of the briefings sent out that day warned hospitals to be on the lookout for a man fitting suspect Dzhokhar Tsarnaev’s description, while at the same time advising them to inform their staff and patients who were ready to be discharged that they should remain in the hospital.
Center workers had to be resourceful. Two days after the bombing, Martin and her staff persuaded the managers of the Seaport World Trade Center to donate space for the victims and their families to meet privately with law enforcement authorities and get information on compensation and what role they would play in the criminal investigation.
More than 120 teams of grief counselors were deployed by the center to help 1,500 traumatized people, including race volunteers, first responders, staff who were working in stores and restaurants in the Boylston Street area, and health care providers treating victims.
Longstanding relationships among the people in the emergency response was key, officials said. Many had participated in 24-hour drills, including mock terrorist attacks, several times a year that involved use of the intelligence center.
“We all know each other,” said Meg Femino, director of emergency management at Beth Israel Deaconess Medical Center. “That connectivity is one big piece of why things went so well.”