What if, when an emergency occurred, you could send in a text message to your regional fire department with the conditions in your neighborhood? And what if that text message was then displayed on a map at the fire department so they could see the unfolding conditions in each neighborhood and respond accordingly? Those are two of the technologies we tested in a San Francisco Bay Area community last November during a public health emergency simulation called Golden Shadow.
Golden Shadow was InSTEDD’s first field test of technologies and procedures selected to overcome some of the shortcomings of our current public health and disaster response systems. We also wanted to develop a local test bed for tools we would be using internationally, including in our Mekong Collaboration Program.
For our first technology tests, we chose our own backyard, home to the world-class California Urban Search and Rescue Task Force 3. This team of firefighters has deployed to Katrina, 9/11, and many other national disasters. USAR 3 is part of the Menlo Park Fire District and housed a few miles from our office.

The challenge: This project arose out of issues Menlo Fire and USAR have repeatedly experienced in their work: the often considerable gap between what is happening in the field and what headquarters knows. Emergencies like Katrina taught us tragic lessons about what happens when community members are left isolated and alone and disconnected from first responders who could help them. In addition to the first responder needs, this project arose out of a new, emerging threat for which we are not well-prepared: large scale public health emergencies.
Figure: Community Volunteers Gathering Public Health Information on their Cell Phones
The questions: InSTEDD’s job was to answer two important questions: How can technology accelerate the flow of information back and forth between community members to first responders? How can field information be visualized at headquarters so that the Inident Commander can use it and doesn’t have to operate ‘blind’?
The options: To address these challenges, InSTEDD modified existing technologies and developed new open source software. With this technology and their own hardware (cell phones, laptops), community volunteers could gather information on the status of their neighborhood and transmit that information in real time in field forms, text messages and blogs, so the first responders had a more complete and useful picture of the unfolding crisis.
This field information was then portrayed in images on Google Earth at the Emergency Communications Center ("ECC"), the headquarters for first responders. For the first time, firefighters and public health officials could see the crisis in real time as it unfolded in the field. 
Figure: Incident Command Team Brainstorming at the Emergency Communications Center
The scenario: The Golden Shadow technology package was tested in November 2007 during a four-hour response to a simulated terrorist attack of pneumonic plague at a rock concert in San Jose. In this simulation, the weapon was biological. Golden Shadow was named for the statewide exercise that gave rise to the scenario, Golden Guardian. But unlike Golden Guardian, we focused on experimentation instead of testing to meet state objectives.
The Menlo Park Fire District, San Mateo Public Health, community volunteers, schools and clinics mobilized to simulate the distribution of antibiotics door to door and to gather field information to be sent back to the Incident Command team directing the response to this public health crisis. The technology tools helped volunteers more quickly document information and share it in real time.
Figure: Golden Shadow Participants
TECHNOLOGY TOOLS
Below is a summary of some of the technology tools we developed or adapted for Golden Shadow.
Biosurveillance forms : These were household survey forms that could be filled out offline (either electronically or paper) and then uploaded to a central repository using satellite internet connections. In this case we are using surveillance forms for the purpose of active surveillance of an epidemiologic investigation. We gathered information on who may have attended the concert or who is showing symptoms of pneumonic plague to determine whether they needed to be hospitalized or receive antibiotics. This information was visualized as an icon using triage colors conveying the worst case in the household on Google Earth.
Figure: Example of Biosurveillance Forms Filled Out by Community Volunteers Who Simulated Door to Door Outreach
Geo-blogs: These were blog entries with in depth field reports from community members that were logged with an address or latitude and longitude.
Figure: Sample of Web View of Blog Page
Blogs were submitted regularly (every 15 – 60 minutes) from team leaders in each neighborhood. Blogs were longer reports from community members about the aggregate conditions in their neighborhoods, such as the status of antibiotic distribution and the number of ill overall they were finding. These blog entries were displayed as an icon and if you hovered over the icon, a pop-up balloon would show you the blog entry. First responders could respond to blog entries directly on Google Earth. The blogs also appeared in chronological order on a separate website similar to a typical blog site (a sample is opposite).
SMS Geochat: These were text messages about field conditions sent by community volunteers and displayed on Google Earth at the sender's longitude and latitude as a 'mail' icon. If you hovered over the icon, you could view the full message.

Community volunteers used text messages to report short and urgent field conditions, such as the outbreak of a riot (simulated), the discovery of a dead body in the levee or an antibiotic shortage. Anyone with access to the central repository on Google Earth could reply to the messages by clicking on the icon and then replying inside the pop-up balloon. The text messages ‘aged’ over time and would fade in color so first responders could identify which text messages were priority. Text messages from the same phone would show a line between each location of the message so field personnel could be tracked. More detail on this tool is on our
technology page.
Figure: Samples of Text Messages Appearing on Google Earth

Visualization of data on Google Earth: All of the geo-coded data gathered by community members in the field were uploaded to a central repository and plotted on Google Earth. This data included icons representing the field biosurveillance forms, text messages and blogs.
Figure: Text messages (envelopes), field surveillance forms (colored circles) and blogs (thumb tacks) displayed on GIS application. The line between envelopes signifies a number of messages from the same user.
Figure: Epidemiologist Setting up a BGAN on the Roof
Inmarsat BGAN: We assumed we were in an austere environment and thus required that all field computer-based information be transfered using satellite-based internet connections. Inmarsat donated small units and the bandwidth for the demonstration. BGANs worked well for basic information, but they are not equipped to handle a rich graphical environment like Google Earth.
Golden Shadow was phenomenally successful in the amount of information it generated, but fell far short in terms of providing actionable information.When we started, we did not know if community volunteers would transmit any information. In the end, the information flowed so quickly it overwhelmed the ECC’s ability to manage and interpret it.
The Incident Commander expressed the primary complaint of the morning: “It’s great to get the data, but what does it all mean?” The field surveillance data helped the ECC assess the extent of the severity and the amount of prophylaxis needed, but the numerous messages and blogs with requests were, for the most part, ignored because of their large volume, range of relevance and the absence of a methodology for triaging computer-based data. Clearly one of the greatest weaknesses in this test was the interface of the field information and how to marry it with the Incident Command System structure.
Figure: Community Volunteers Reporting Field Conditions Using PDAs and Cell Phones
Another challenge was that the information flowed only one way - from the field to the ECC. As in Katrina, community volunteers felt isolated when they failed to get any feedback on the information they were gathering. Their primary complaint was: “Is anyone out there?” Many community volunteers felt neglected and wondered whether anyone cared about what they were doing. They wanted help, or at least some direction, and received little of either. Little did they realize that the people in the ECC were working frantically to address the crisis. The reality is, as reminded by Fire Division Chief Frank Fraone, the emergency response system is simply not equipped to manage a large scale disaster. The community events in Katrina were echoed in this small experiment, and reminded us how much work is still to be done to bridge the divide between communities and the first responder system.
Figure: Epidemiological Curve Generated in Real Time from Community Volunteer Field Surveillance Form Data
Most of the technology tools worked to communicate information, but fell far short in helping stakeholders respond more effectively to the unfolding crisis. The ECC was simply overwhelmed with a lot more data than they could handle. One community member noted that “even under these calm conditions, [the ECC] was overwhelmed by the information coming in.” These technological innovations needed to do more than work; they needed to be mapped to HOW teams work. Interestingly, the public health department was able to generate epidemiological curves every thirty minutes based on the real time data coming in from the field about the number of people exposed to pneumonic plague or ill.

In terms of field support, the technology tools were intended as a means to relay much more and better data to the ECC than it would normally receive. The tools we used (sms text messaging, surveillance forms and blogs) proved to be superb in the volume of information they could convey and the immediacy of information. These technologies made it possible for community teams to gather a lot of information very quickly, and may have helped the field teams coalesce because every person was needed. Nonetheless, there were times they did not work well and everyone turned to the HAM radio system when other tools either did not work properly or failed to get a response.
Figure: Biosurveillance Forms (colored dots), text message (envelopes) and blogs (thumb tacks) coming from one neighborhood and displayed in real time on Google Earth.

Golden Shadow proved to be as much a social experiment as a technological experiment. This demonstration was the first time field-based community volunteers were integrated with the Incident Command System in a scenario. This demonstration was also the first time in Menlo Park that the public health department worked with the fire department on a public health emergency. These teams were just figuring out how to work together and understand each other’s language, much less use new technologies. These social innovations (and cross-jurisdictional innovations) made evaluation of the technology more difficult to isolate from the social context.
Figure: Community Volunteers Monitoring the Levee in East Palo Alto During Golden Shadow
Indeed, many of the discoveries during Golden Shadow only peripherally related to the technology. A health clinic, for instance, learned they needed to improve their facility with radio protocols. Neighborhood volunteers realized how different a real life scenario could be from what they imagined it would be. That difference prompted a realization that they need to practice regularly to improve their performance. First responders realized how much better they need to be at coordinating their plans with those of other organizations - and how few of their protocols were familiar to other responders.
Nonetheless, everyone involved had a fantastic experience, and learned a tremendous amount about their own preparedness in an emergency. Peter Carpenter, a Menlo Park Fire District board member and an InSTEDD board member, believes that Golden Shadow’s lessons "will become the basis for a generic protocol for the dramatic enrichment of the Common Operating Picture with GIS tagged data from the grassroots level.’’
While the pneumonic plague scenario is certainly frightening, experience with earlier epidemics (pneumonic plague among them), knowledge of the issues, and expertise to deal with them show that in a crisis people from all disciplines pull together.
TERMINOLOGY
BGAN: Broadband Global Area Network. This is a device from satellite internet provider Inmarsat that provides mobile internet service when all terrestrial internet is down. We used BGANs at six sites during Golden Shadow. Inmarsat donated the units and bandwidth for the demonstration.
CERT: Community Emergency Response Team. These are community volunteers who are specially trained to assist in emergency response. In Golden Shadow, we relied both on CERT volunteers and other community volunteers. Menlo Park had one of the first CERT programs in the United States.
ECC: Emergency Communications Center. This is an emergency response center based at Menlo Park Fire District where many response agencies could gather in the event of an emergency. The primary emergency response center for San Mateo County is called the Emergency Operations Center (EOC) and that is in the city of San Mateo. During Golden Shadow, the emergency response was coordinated from the ECC.
FRS: Family service radios, also known as walkie-talkies. In Golden Shadow these radios were used to communicate within teams in the field. They have a range of 1-2 miles and do not require a license to operate.
GPS: Global positioning system. This system allows a GPS receiver to record its location, speed, direction and time. In Golden Shadow, we used GPS receivers (both handheld and laptop-based) in the field to record latitude and longitude.
ICS: Incident Command System. The ICS is a standardized, “first on scene” all hazards emergency management concept. ICS brings multiple agencies together under a standard process and operation procedure. The lead on scene is called the Incident Commander (IC).
HAM: Also known as amateur radio, this radio is used for as a hobby and as a service during emergencies. This radio has a stronger signal than FRS radios and requires a license to operate. The ECC uses ham radio to communicate with community volunteers, and it was used during Golden Shadow as a backup communication method.
SMS: Short messaging service. This is a form of text messaging on cell phones. In Golden Shadow, we added site location to the text messaging feature so that the message could be displayed on a visualized map. We called this geo micro blogging.
USAR: Urban Search and Rescue force is part of the
Federal Emergency Management Agency (FEMA). When deployed by FEMA, these national teams help state and local emergency responders locate victims and manage recovery operations in major disasters. These teams are comprised of emergency personnel, and in this region, is co-located and shares staff with the Menlo Park Fire District. USAR Task Force 3 was not involved in the Golden Shadow response but they did test out some of the tools, including the Ricoh camera, for possible use among the USAR teams.
Figure: Community Volunteer Smiling After a Long Day
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