Frayed Preparedness

After last week’s attacks on the World Trade Center and Pentagon, Los Angeles officials ordered the police and fire departments to reassess how the city prepares for and responds to emergencies. But city, county and state leaders need to look beyond the security and response plans in place to the infrastructure that supports them--or fails to.

Even absent a disaster, just about anything to do with emergency care in the city and county can be coupled with the word “crisis.”

* The two dozen financially strapped trauma centers and emergency rooms still operating in Los Angeles are so overtaxed that patients wait for hours and ambulances get diverted up to one-third of the time.

* A severe nursing shortage has led to cutbacks in the number of hospital beds available, including those in intensive care units.

* The Los Angeles City Fire Department is short hundreds of paramedics.

* The city’s outdated, understaffed 911 dispatch system leaves thousands of calls unanswered and has been in need of an overhaul for more than a decade.

* Calls to 911 from cell phones, which featured prominently in last week’s disaster, slow response time even more because the technology is not yet in place to allow operators to track where the calls were placed, as they can with wire-based calls.

Any one of these shortcomings has the potential to disrupt responses to even day-to-day crises such as car accidents. They have all gotten worse since the city’s last major emergency, the 1994 Northridge earthquake.

Planning for disasters is no abstract exercise in Los Angeles, tested as we have been by earthquakes, fires and riots. The city’s community training program and search and rescue teams have been copied nationwide. But the people and facilities that support the city’s renowned disaster-response efforts have been allowed to deteriorate to the point that optimum plans may not get us through the next disaster. The best way to prepare for the suddenly very real threat of a terrorist attack would be for city, county and state leaders to begin repairing this fraying safety net.