History Fo Civil Defense in the United States 1945 - Present

History of Civil Defense in the United States 1945- Present

History of Civil Defense in the United States 1945 - Present

Civil Defense History

The purpose of this paper is to outline the development of civil defense in the United States from 1945 until the present. Also addressed are selected medical aspects of civil defense and lessons learned from prior civil defense initiatives. Civil defense is defined as "activities organized by civilians for their own protection in time of war or disaster" (Hyperdictionary, 2004). Civil defense became a major issue during World War I as the conduct of war between nations expanded to include attacks on cities, factories, and civilians that were essential to war in the industrial age. Civil defense became even more important during World War II. The explosion of the Soviet Union's first atomic bombs signaled the fact that civil defense would remain a permanent fixture of the Cold War

(Dobbs, 2001). Between 1945 and 1949, various agencies undertook studies of civil defense (Tennessee Emergency Management Agency, 2004).

During the 1950s, American civil defense was characterized by a city-evacuation system (Dobbs, 2001). The American city-evacuation plan called for citizens in highly populated areas to put distance between themselves and the explosive effects and fallout of a nuclear attack. In their original incarnation, Civil Defense programs sought to develop sheltering capabilities to house people in attacked cities. Civil defense planners were also developing mass evacuation plans for supposed targets of the USSR. During the 1953-1958 time period, there continued to be arguments over whether evacuation or sheltering was to be the nation's policy regarding response to a nuclear attack. President John F. Kennedy, sensing that the overwhelming majority of state and local governments were doing little if anything to develop a sheltering capability, decided to make civil defense preparedness once again a central issue. A full-fledged nationwide shelter program, funded by the federal government was developed.

In the early 1970s, federal level organizations moved toward allowing the dual-use of civil defense funds and equipment to be utilized for natural disaster preparedness. For a brief period of time, the federal government allowed the states to treat natural disaster preparedness as their primary role with respect to the use of federal civil defense funds. This changed again, however, following the ascendancy of Gerald Ford to the Presidency, and once again, states were required to treat planning for a nuclear attack as their primary function. President Jimmy Carter created the Federal Emergency Management Agency (FEMA) in 1979 and consolidated several dozen, disparate emergency preparedness and civil defense functions into a single entity. Its function was supposed to be the coordination of federal response to disasters and the provision of planning and programmatic assistance to state and local governments in the development of mechanisms to protect the civilian population from all threats. However, FEMA directors through the first Bush administration steered the agency toward national security programs (Tennessee Emergency Management Agency, 2004).

With the end of the Cold War in 1991, attention shifted from the national security and attack preparedness end of the threat spectrum to focusing on disasters (Federal Emergency Management Agency, 2004). In 1992, President Bush signed a revised civil defense policy that recognized changes in the order and range of threats and placed emphasis on response preparedness to the consequences of emergencies regardless of the cause (Federal Emergency Management Agency, 2004). The terrorist attacks of 2001 once again shifted the focus of FEMA to a civil defense rather than a disaster relief orientation. The events of September 11, 2001 also prompted the creation of the Department of Homeland Security. This organization is an umbrella for many federal agencies having civil defense responsibilities (White House, 2004).

Key Medical Aspects of Civil Defense

Historically, with few exceptions, civil defense has received little support or funding at the federal level. Preparedness, including medical preparedness, suffered accordingly. Recent events, including the terrorist attacks of September 11, 2001 have served as catalysts for changing this situation. Three key elements of national medical preparedness are early detection, emergency preparedness and response and a stockpile of essential medical supplies. These three elements are briefly discussed.

The Centers for Disease Control and Prevention asserts that the most critical component for bio-terrorism outbreak detection and reporting is the frontline healthcare profession and the local health departments. Preparedness should emphasize education and support of this frontline as well as methods to shorten the time between outbreak and reporting. Efforts should include education of frontline public health workers. Clinical laboratories should have the capacity and legal latitude to use all appropriate testing. Existing national health surveillance systems should be modified or strengthened to increase their effectiveness in identifying bio-terrorism (Ashford, et al, 2003).

The Centers for Disease Control and Prevention and the Agency for Toxic Substances Disease Registry (CDC/ATSDR) have developed a national public health strategy for terrorism preparedness and response. This strategy highlights efforts that will continue building on agency competencies to bridge gaps for comprehensive terrorism preparedness and response services. Strategic imperatives chart the course by which CDC/ATSDR will prepare for and respond to terror-related public health emergencies. They will provide tools, resources and support that allow the CDC/ ATSDR organization to achieve its terrorism preparedness and response mission with greater efficiency and effectiveness.

In 1999 Congress charged the Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) with the establishment of the National Pharmaceutical Stockpile (NPS). The mission was to provide a re-supply of large quantities of