September 11, 2001 was to be a signature day for public health in Illinois as we looked to launch our state oral health strategic planning process with a meeting engaging experts from Illinois and the nation at the University of Illinois School of Public Health.  I was driving down Chicago’s Western Ave, a straight shot from my home to the meeting site, when I heard reports of first one then another plane crashing into the World Trade Center.  When I arrived at the conference, I realized how much our world had changed when the television in lobby showed the first tower going down. The soon to be cancelled conference would have to go on without me.

I was trained in Emergency Medicine and began preparedness work in 1978 while still at the University of Chicago.  After my appointment as Director of the Illinois Department of Public Health (IDPH)  in 1990, I got directly involved in our disaster planning work.  Springfield, Illinois, the state capital, was over 200 miles from my home in Chicago, but we had contingency plans if a major event occurred.  I proceeded to the City of Chicago Emergency Operations Center where a desk in the control center was reserved for me.  I was in constant contact with the State Emergency Operations Center and IDPH staff as the day progressed. I still remember the surrealistic scene watching the looping replays of the collapse of the Twin Towers on the five giant screen televisions and looking out at the Sears Tower, suddenly the tallest building in America.  I remember the anxiety wondering if that huge building would be next.

As a nation, we got through that day and all of us assessed what our post 9/11 would be like.  The next day, I drove to Springfield to coordinate our on-going response as we all wondered what would be next.  Immediately, IDPH was placed on the Public Safety Sub-Cabinet where I joined discussions with the State Police and National Guard about how to arm police officers protecting our nuclear power plants.  Days passed as we reviewed and re-reviewed our public health response plans.  Illinois is a state that has suffered a number of natural disasters from the major Mississippi river floods in 1993 to periodic tornados.  We had planned for the impact of a magnitude 8 earthquake in the nearby New Madrid fault and for acts of bioterrorism.  Back in the 1990s, when we formulated our bioterrorism plan and started our molecular biology lab, we believed that we would activate our earthquake plan before we would see an act of terrorism on our soil.  We also felt that it was important to plan for all hazards regardless.

Three weeks after the fall of the Twin Towers, our nation was again rocked as headlines announced that we faced another attack. This one was much more insidious because it came to its victims via the U.S. Mail.  Alerts were sent out to emergency departments across the state detailing the symptoms and treatments for suspected anthrax cases.  While we had plans in place to handle a mass exposure or a mass casualty event, we were not prepared for thousands of “white powder” calls to police and local health agencies.  Protocols were developed on the fly with the State Police, the FBI and the Emergency Management Agency.  Our laboratory was put on overdrive as the two-year-old equipment was run at full capacity.  While some of the calls seemed frivolous, like the calls about white powder at a changing station in a daycare center and white powder at a counter where powdered donuts were consumed, all of the calls reflected the fear and uncertainty of the time.  Each day, we implemented additional systems and procedures that are still in place today.  The improvements in the state laboratory prepared us for the huge demand when West Nile hit Illinois in 2002 leaving four dead and 71 sickened.

Some good things came out of this time of trial including a much stronger relationship with the Illinois Emergency Management Agency whose director, Mike Chamness, declared that every disaster had a public health component and public health needed to be at the table.  Our nation realized once again how important our public health system is to our health and well being and placed a priority on funding.

I look back on that time with mixed emotions, remembering the fear, uncertainty and the satisfaction that the IDPH was up to the task.  I also look back with regret as I realize that once again our country has forgotten the lessons of the past.  Health departments across the nation are being ravaged by budget cuts and layoffs.  I wonder that should we face the challenges that we faced in September and October 2001 today, will our battered, underfunded, public health community be able to respond?

John R. Lumpkin, Senior Vice President and Director, Health Care Group, the Robert Wood Johnson Foundation and former Director of the Illinois Department of Public Health

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