Letter from the Editor

Today, I find myself contemplating the March 26th collapse of the Key Bridge in Baltimore and the sequence of events that led to such a catastrophic incident. For this event to have occurred, several conditions must have been met. First, the bridge’s design must have been susceptible enough for a strike of significant magnitude to compromise the integrity of the supporting piers, leading to a massive failure. Second, the vessel involved must have been sufficiently large and heavy to cause an impact capable of affecting the structural supports. Third, the strike needed to occur at the right place and at the right angle to avoid any in-river buffering system in place. Last, the vessel must have lost power at the wrong moment. Reflecting on these tragedies always brings to my mind the Swiss cheese models of failure that we discuss in medicine, where all the holes must align for such an event to occur, and unfortunately, in this case, they did.

In addition to the tragic loss of life resulting from this incident, the Baltimore area will experience traffic disruptions, along with the prospect of a prolonged and costly bridge construction. Further, there are concerns regarding potential environmental and health hazards stemming from the 1.8 million gallons of fuel aboard the vessel, which has the potential to leak. Moreover, there may be hazards posed by materials in the on-board shipping containers.

After my initial shock and sadness about the event, and as I continued to learn about the ongoing response efforts, I began to consider the multitude of organizations already involved in the initial response, as well as those that will become involved as the recovery efforts progress. Thus far, may different groups are already involved in the response effort. Those groups include the Coast Guard, the Department of Homeland Security (including Cybersecurity and Infrastructure Security Agency - CISA), foreign government officials from Mexico and Guatemala (where some of the now presumed dead, special workers were originally from), The National Transportation Safety Board, and the Department of Transportation alongside the significant local fire and rescue efforts. Despite the adage that “all disasters are local,” what struck me were the national and even international implications of this ostensibly “local” event. These implications include the national response necessary for the rebuilding process, the ramifications for the international supply chain, and investigations into why this international vessel completely lost power.

My primary takeaways from this event are: First, despite the improbability of such occurrences, they continue to happen. Second, it is important to acknowledge that even for a fairly contained event such as this bridge collapse the disaster and event response is a team effort that involves a huge number of organizations and individuals (not just fire, EMS and medicine!). And thirdly, there is the profound impact felt across local, national, and even international communities that are involved in response and rebuilding for these types of events.

Have thoughts about this newsletter? Want to contribute? Email Larissa Unruh, MD, MPH