DMAT San Diego CA-4 * JULY 2004 Newsletter
****  Volume 13,  Number 7   ****
A deployable  Disaster Medical Assistance Team. Affiliated with the National Disaster Medical System. Founded 1991
DMAT San Diego CA-4 is a public benefit, non-profit  501(c)3 corporation., registered  in the State of California and with the IRS.

Co-Sponsored by: UCSD Medical Center & International Relief Teams
Mailing Address: 200 West Arbor Drive, San Diego, CA 92103-8676
DMAT CA-4 Information Line: 619-543-6216
eMail address of Newsletter Editor, Jake Jacoby:
DMAT CA-4 WEB site:

Calendar Of Events..........................................Page 1
Commander's Log.......................................... .Page 1
June Team Meeting notes .................................Page 2
Other relevant disaster stuff..............................Page 4

DMAT CA-4 Team Meeting
Wed. , July 28, 2004 - 18:00 hours

Wednesday,. August 25, 2004 @ 1800 hrs.

Wednesday, September  22, 2004 @ 1800 hrs.

Wednesday, October 27, 2004 @ 1800 hrs.

Wednesday, November 17, 2004 @ 1800 hrs (3rd instead of 4th Wednesday, due to Thanksgiving holiday)

Wednesday, December 15, 2004: Holiday Party

Unless announced, All team meetings will be held at the
DMAT CA-4 Ops Center

8830-G Rehco Road,  San Diego, CA 92121. 
Saturday, September 11, 2004: RELEASE OF SOULS CONCERT and MEMORIAL .
DMAT CA-4 and  San Diego Urban Search &   Rescue Task Force to participate in Flag ceremony. SIGN UPS NEEDED.

Thursday, October 7, 2003: The 7th Annual California Statewide Medical & Health Disaster Management Conference, Temecula, CA 0700 to 1700 hrs.

Thursday thru Sunday, January 27, 28, 29 and 30, 2005: "Rough 'n' Ready 2005" Statewide DMAT exercise, Los Alamitos Air Station.

{May 2005, Date TBA} : BATREX 2005 Exercise- Joint Training Exercise with SD US&R TF.  PLANNING TO BEGIN SOON.

Commander's Log
Hoping for a quiet summer. With the ongoing war on terrorism still going on, and NDMS being melded in to  FEMA the way sugar melds into hot water ( it disappears), concern and frustration abound throughout the DMATs. Broken FEMA promises lie on the sides of the road, like improvised explosive devices, with insincere "I   apologize" coming from everyone I speak to in authority.
However, our team continues to make its way forward.  Our progress has been marked by:

bulletA successful training exercise, BATREX 2004, a CA-4 three day, two night exercise, held at the San Diego Regional Public Safety Training Institute, courtesy of the San Diego Fire Department, at the former NTC. Aimed primarily at new members, to get them deployable, we had 9 members participate in  the training, along with 25 veteran members. The result was a meld of the old and the new.  A mixture of lectures, problems and exercises, with hands-on litter-bearer training, MRE's and gourmet carne asada BBQ made the weekend bearable, over and above the din of take offs and landings at Lindbergh Field every 90 seconds or so, from 6:30 AM till 11:30 PM, and even after the nightly shut down. Much effort went into the planning and execution of the event. Many thanks are extended to: Dave Holland, who knows his way around the Propane burner; Bob Downey, who put lots of effort into preparing the paperwork, handouts and evaluations  for this exercise; our instructors: Therese Rymer, Michael Sohmer, Bob Downey, Dave Holland, Kevin Spuhler, Scott Barker, and Martin Hill; And to our Chaplain, Mark Reeves, who found scriptural parallels to try to give our activities and missions  some meaning. Thanks to all who participated.
bullet Tent cleaning was completed with the use of a water pressure cleaner, on all DMAT tents, making them white again. Thanks to Ed Snyder, Dave Holland, and everyone else who showed up at the work detail 2 weekends after the exercise.
bullet Significant progress  has been made on our Contract with the County to prepare and deliver a hospital training program on Bed Surge Capacity in Disasters, with the presentation of our powerpoint deliverable to the County, and the scheduling of the first of several presentations.
bullet Newest activities coming up include (1) the Release of Souls Concert and Memorial, for which we will be looking for  team members to participate in the ceremony on 9/11 as flag bearers. We are especially looking for those members who deployed to Ground Zero to participate, since it is they who are being honored.  (2) sign ups for the State Disaster meeting in Temecula, Oct 9th.  (3) Start of planning for Ruff and Ready 2005.
bullet Transitioning to the FEMA way of doing things which includes the suppression of the NDMS logo from most things NDMS, has led to a new FEMA/ndms ID card. ALL team members must return their old ID card and sign a form documenting receipt of the new ID card. If this is not done immediately, then members will be made inactive ( even though FEMA doesn't have an inactive file)...So PLEEZE, everyone, bring in your  current ID card to exchange for the newest one.  Date we were told it had to be done was July 1st, but that was quite unrealistic... I suspect it was extended, but I can't be sure. So do your best to come to the meeting on Wednesday if you haven't traded up... And if you cant make the meeting, please contact our Admin Officer, Zona,, to set up a meeting at Ops to get this done.
 More details about each of these items at the next meeting.
bullet With the year half over already, it is time to start thinking about your nomination for team member of the year.


June Team Meeting Notes 6/23/2004


The meeting was called to order  by Team CDR Jake Jacoby  at 1805 hours .

1.)    Visitors and new members were greeted and introduced.

2.)    Logistics (Dave Holland)

a.       Dave Holland reported that he  & Scott Norton  "went through" and removed  expired MREs. Hydrogen-generating heaters were removed so the meals could be disposed of in general trash, will be retained for training and for meals missing them.  He also reported that,on the logistics conference call, they were told that, as far as FEMA was concerned, we no longer had a team budget, and that whatever funds VWI was using to reimburse us with for our team expenses was now taken over by FEMA and they were going to use the funds to extend the budget year to end of September, from August 19th, and so they could not honor any team expenses, even if they were mentioned in the work agreements.

b.      Commo (Jay Thompson):  -  Satellite  phone was  tested, worked fine. Radio batteries charged.

3.)    Planning (Jake Jacoby and Therese Rymer)

a.       Hospital Bed Surge Capacity Hospital Training Project - "About 99% of Power Point deliverable is complete."   This part of the deliverables will result in $10,000. to the team.

b.      Training (Sara Ontiveros)- a) 177  members on CA-4 team, only 23 (or 12%) have completed the online training core curriculum, 5 members (3%) have completed advanced curriculum.  The current requirement is that 30% of the team needs to complete the "core" curriculum otherwise CA-4's federal funding may disappear if fewer than 30% participate.     Members were reminded that  non-medical personnel can receive college credit if the request is submitted before the end of the year. UMBC (University of Maryland, Baltimore County) will no longer be handling the course after  December, as it is being taken over by FEMA's Emergency Training Institute in Emmitsburgh, MD.

c.       Final planning for the BATREX 2004 Overnight Training Exercise, directions, and training agenda were reviewed and distributed. Participants will be eating MREs for Dinner on Friday and Lunch on Saturday;  Satruday Night Dinner will be a carne asada and grilled mahi BBQ extravanganza, to be orchestrated by the famous saucy barbarian Mexican Chef Dave Hollandaise.

d.      No reports from recruitment and web site committee members.

4.)    Training Presentation: "Anti-Terrorism in Israel: The San Diego County Sheriff's Dept. Training Trip to Israel - Lessons Learned"  Rabbi Arthur Zuckerman, Chaplain, and Lt. Dan Papp of the S.D. County Sheriff's Dept. provided the evening's training presentation.  According to Rabbi Zuckerman, "An estimated 10% (or approximately 30 million) Islamic fundamentalists believe that the world should revert back to the period between 600 - 1200 A.D."...i.e., before Western Civilization "took over".  These Islamists (as described by the Rabbi) are looking for a revival of the "good old days" via "Jihad" or "Holy War".  Rabbi Zuckerman also showed   from the Steve Emerson video "Jihad in America," describing the phenomenon of extremist Islamic thought.  Lt. Papp stated that "Before 9/11, we didn't know who our enemies were."  One of the goals of their joint presentation, Lt. Papp stated, was to educate first responders (such as DMAT CA-4) about "who the enemy is".  "In Israel," continued Lt. Papp, "They  know the enemy."    Our thanks to Rabbi Zuckerman and Lt. Papp for their interesting and informative presentation. Lt. Papp has a  separate slide presentation and this will be scheduled at a future meeting.

5.)    OPERATIONS:  Activity reports:

a.       G-8 Summit [George Durgin] - "Many logistics problems reported... e.g., computer viruses, cache problems, etc."  George also contributed some other anecdotal observations. George  worked  in the Joint Operations Center for the G-8  Summit.

b.      Rough & Ready 2004 - Ukraine:  14 CA-4 team members participated in a training scenario which included a "huge" earthquake of magnitude 8 on the Richter scale;  Therese Rymer reported that the exercise was very "visual"; i.e., real fire, smoke, real train cars derailed, etc.   CA-4's Ukrainian counterparts reportedly had very sophisticated medical equipment.  Seven of the CA-4 team members who participated in the Ukraine trip commented briefly on their experiences.  All agreed that it was an excellent, interesting and educational experience.

c.       Tactical Strike Team Operations - Jake stated that Sal Ruiz had updated policies and procedures for the planned Tactical Strike Team.

6.)    Finance & Administration

a.       AO Zona Wahrenbrock reported that only 27 CA-4 team members have up-to-date licensure information.  "Every active member needs to be certified and their information forward to FEMA," cautioned Zona. All RNs, Resp therapists, MDs, EMTs, pharmacists and paramedics must update their licenses every  time they are renewed. The same people keep bringing in their licenses, even though we have them on file, while the same "other people" never bring them in.  If licenses are not brought in, members will not be able to deploy when the time comes. Allmembers hould bring their licenses in if they have not already done so in last few months, at next meeting if not before.

b.      Financial: Jake Jacoby reported that the team had received zero dollars in reimbursements from FEMA since April of this year, balance we are due is for April warehouse rent ($3821.) and the radio battery rechargers (approx $1700.) that had to be bought because the ones we had are not compatible with the radios we have, all originally sent by NDMS commo, as they badly overheat; and some of the expenses for member immunizations and our biomedical equipment semi-annual engineering inspection. Forms have been submitted several times.

c.       With respect to State of CA  (EMSA) funding, Jake informed the team that a new budget had been filed -  about $25,000 - which included an increase in insurance expense(s) to $12,000 - an increase of about $5,000 (previous amount was $7,000)...nearly double.; and will cover utilities on the warehouse, since FEMA has not yet demonstrated they can pay bills on time, and not paying the utility bills could (a) ruin our team credit, and (b) threaten us with cut off of services.

7.)    New business - No new item s were introduced.

The meeting was adjourned by Dr. Jacoby at 2020 hours.

 This report was submitted by Ken Rogers, Pharm. D.


Relevant Stuff found on the Web:

Scientists Model Disease Outbreaks in Realistic Urban Social Networks
Scientists report that mass vaccination may not be needed to prevent the spread of smallpox from a bioterrorist attack.  Most mathematical models for the spread of disease use differential equations based on uniform mixing assumptions or ad hoc models for the contact process.  Currently, researchers at Los Alamos National Laboratory are exploring the use of a simulation tool that combines population models with information on the transmission of disease to develop a realistic model of an urban setting undergoing a biological attack with smallpox.  Within this large-scale simulation framework, the relative merits of several proposed mitigation strategies for smallpox spread were analyzed.  Results suggest that a strategy of targeted vaccination of front-line healthcare workers and affected individuals, combined with early detection, could be enough to contain the disease without resorting to mass vaccination of a population. The most important factor is the time to detection of the disease and making sure that all affected people are found quickly. 

Eubank S, Guclu H, Kumar VS, Marathe MV, Srinivasan A, Toroczkai Z, Wang N. "Modeling disease outbreaks in realistic urban social networks.Nature. 2004 May 13; 429(6988):180-4.


SARS Vaccine Trials and Development

China's State Food and Drug Administration has authorized the first phase of human testing of a new severe acute respiratory
syndrome (SARS) vaccine made by Sinovac Biotech.  The human trials will be conducted over the next three months and began with inoculation of four out of 30 selected volunteers at a Beijing hospital. Sinovac's vaccine has proven effective in tests on rhesus monkeys, and this first phase of human trials will help to determine the vaccine's safety and efficacy for humans.

An international coalition of researchers led by Professor Robert Anderson from Dalhousie University Medical School in Nova Scotia, Canada, is working to create a vaccine against SARS. The project, funded by the Canadian Institute for Health Research, combines Anderson's expertise in respiratory syncytial virus, which is similar to SARS, with the efforts of virus and immunology experts at Thailand's Thammasat University and Taiwan's Kaohsiung Medical University. The vaccine will be designed at Dalhousie, but all live virus testing will be conducted in Taiwan. The teams are hoping to use man-made portions of the SARS virus protein to create immunity-causing molecules for the vaccine. The researchers will test the potential molecules on mice and will also try to determine whether the vaccine should be administered as an injection or a nasal spray.  It will probably be at least another three years before the vaccine is ready, and then it could take up to five additional years for it to be approved by Health Canada.