1. - 7 June 2005 -
Terrorist Attacks
on London:
Lessons for
Civil Protection
DAVID ALEXANDER

2. 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.

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

4. 18,44 hrs,
8 September 1944
a supersonic rocket
falls on
Staveley Road,
Chiswick, W. London
3 dead
22 seriously injured
6 houses demolished

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

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

7. London:
• 8.2 million inhabitants
(25 million in the Home Counties)
• occupies and area of 1,584 km2
• 300 languages regularly spoken
• 4 police forces.

8. Greater London: 33 local authorities
Enfield
Barnet
Harrow
Haringey Redbridge
Waltham F
Havering
Brent Hackney
Camden Islington
Barking & D
Hillingdon Newham
Ealing Tower H
City
Westminster
H&F K&C Southwark
Greenwich
Hounslow Bexley
Lambeth
Wandsworth
Richmond
Richmond
Richmond
Richmond Lewisham
Merton
Kingston
Bromley
Sutton Croydon

9. The emergency services:
Police
Fire Brigade Health services
Emergency
planning

10. The police usually take
the role of "lead agency"

11. Emergency planning: London Resilience
(www.londonprepared.gov.uk)
Enfield
Barnet
Harrow
Haringey Redbridge
Waltham F
Havering
Brent Hackney
Camden Islington
Barking & D
Hillingdon Newham
Ealing City Tower H
Westminster
H&F K&C Southwark
Greenwich
Hounslow Bexley
Lambeth
Wandsworth
Richmond Lewisham
Merton
Kingston
[zonation]
Bromley
Sutton Croydon

12. Planning and statutory instruments

13. Co-ordination Crisis Unit of
of information
to mass media
National Civil
Protection (COBR) LESLP
Mass Chairman London
media (Met. Government Fire service
representatives Police) Office LFB
Police: Ambulance
Met./BTP/ Service LAS
CoLP/MDP "Gold"-level
National
Co-ordinating Group Health
Military
forces Service
Transport Health Local
Providers Recovery
emergency Protection authorities
of basic Mgt.
managers Unit
services Units

14. UK: 3 commands, 4 levels
Police - Fire Brigades - Medical Services
[Platinum - COBRA]
Gold - strategies
Silver - tactics
Bronze - operations

15. LEAD GOVERNMENT DEPARTMENT OUTER Strategic
Public
CORDON level
enquiries
Temporary Strategic Co-ordinating Group
The response
Mortuary Police Local authority
Fire Military forces Media
Ambulance Government advisors Centre
Casualty
Bureau Other agencies
Media
environment
Survivor Liaison
Relatives’ Point
Reception
Reception
Centre
Centre
Local Authority
Receiving Voluntary Emergency Centre
Hospitals Agencies
Tactical
level
Body Incident Control Point Vehicle
Holding Ambulance Police Marshalling
Area Loading Fire Area
Point Ambulance Operational
Liaison level
Site of Disaster
Casualty Police
Clearing Fire
Station Ambulance
Specialist advisors
INNER CORDON

16. Rescuers'
Points of
assembly point
access to
Public
cordoned
assembly area
off areas
Incident
Cordon I
Only
rescuers
Cordon
Only authorised
III for personnel Cordon II
traffic
control Multi-agency
operations
Pedestrians only command.

17. Funerals
Anatomy of a major incident Debriefings
Anniversaries
Plan revision
Inquests
Major Public enquiries
incident Trials
declared Awards
Memorials
Consolidation Recovery Training
phase
Response
phase Court cases
Emergency Stand-down
isolation
phase Investigation
Time

18. The bombs
(rudimentary
construction,
hydrogen
peroxide base)

19. London has
40 years'
experience of
metropolitan
terrorism

20. 0947 hrs: explosion on no. 30 bus in
Upper Woburn Square: it is full of
passengers displaced from the Underground.

21. 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.

22. 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.

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

24. Past disasters
March 1943: panic and crush
at Bethnal Green – 173 dead
Nov. 1987: fire at
Kings Cross – 31 dead
Feb. 1975: crash at
Moorgate – 43 dead

25. 7 July 2005
0900 hrs:
evacuation of
200,000 people
from the central
zone of the Tube

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

27. 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.

28. Blast injuries
Primary injuries:
• effects of blast pressure
directly on body tissues
• pulmonary barotrauma and effects
on hollow organs of the body
Secondary injuries:
• impact of flying objects and shrapnel
Tertiary injuries:
• people are thrown against
walls and objects.

29. Blast injuries
Various forms of injury:
• exposure to and breathing
in of toxic materials
• exposure to radiation
• thermal and chemical burns
• smoke-related asfixia in fires
• inhalaion of dust (including asbestos)
• crush injuries from collapse
of buildings and fitments.

30. 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.

31. 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).

32. An effective emergency mortuary plan was
an important part of the London response
The London temporary mortuary

33. 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.

34. Lessons of the London bombs
• injuries caused by bombs can
be very serious and complicated
• lack of parallels with other types of
incident (vehicle crashes - not much)
• hospitals should prepare for many
different types of trauma, complex
triage, long-lasting surgical operations.

35. Lessons of the London bombs
• bombs that explode in confined, crowded
spaces inevitably cause many injuries
• 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).

36. 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.

37. 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.

38. 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.

39. Lessons of the London bombs
• 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.

40. 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.

41. • 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).

42. Saint-Mary-le-Bow
Bow bells
"Now lettest Thou Thy servant depart in peace,
For mine eyes have seen Thy salvation."