The Boston Marathon bombing: From emergency care to Twitter insights, what research has found

 
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Although the Boston Marathon bombing took place two years ago, on April 15, 2013, the event’s reverberations continue to be felt by affected families and citizens both in the city and across the globe. It has also become an event much studied by researchers, as it provided unique insight into how a 21st-century city might respond to an urban disaster in real time.

Some factors specific to the event itself clearly helped save lives, and these have been much examined: Because the attack took place at a mass event, emergency personnel were close at hand at the moment of the attack; Boston also has a large number of medical centers, with skilled personnel and well-developed plans and procedures in place. But there are other aspects of the event that are also worth studying, including the performance of law enforcement and government officials; the way that communications technologies operated and either informed, or misinformed, the public; and other facets of the event relating to the hunt for the perpetrators of the bombings.

The following is a selection of research-based papers and reports that, cumulatively, help consolidate the lessons learned from this event:

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“Safety and Solidarity After the Boston Marathon Bombing: A Comparison of Three Diverse Boston Neighborhoods”
Brenner, Philip S.; LeBlanc, Jessica L.; Roman, Anthony M.; Kwate, Naa Oyo A. Sociological Forum, March 2015, Vol. 30, Issue 1. doi: 10.1111/socf.12144.

Abstract: “This article investigates the effect of the Boston Marathon Bombing on city residents — how the tragic incident changed, or did not change, how Bostonians live in and feel about their community and neighborhoods. Unlike prior research that began weeks or months after a terrorist attack and used retrospective reports, this study spans the focal event. An address-based sample of residents from three neighborhoods, distinct in racial and economic makeup was surveyed by mail using a three-contact protocol. About two-thirds of respondents answered a survey of neighborhood sentiments, and health and well-being in the days before the bombing (N = 581) and slightly over a third answered the survey after the bombing (N = 313). Assessments of safety, city and neighborhood satisfaction and solidarity, mental health, and other key measures vary greatly between the three neighborhoods, which are diverse in racial and economic composition, but also vary in proximity to the bomb site. Net of neighborhood differences, the bombing had a strong negative effect on neighborhood cohesion and reduced use of public transit. Strong interactions are also found between timing of survey completion (pre- and post-bombing) and neighborhood for assessments of neighborhood solidarity.”

 

“Media’s Role in Broadcasting Acute Stress Following the Boston Marathon Bombings”
Holman, E. Alison; Garfin, Dana Rose; Cohen Silver, Roxane. Proceedings of the National Academy Science (PNAS), January 2014, Vol. 111, No. 1. doi: 10.1073/pnas.1316265110.

Abstract: “Media coverage of collective traumas may trigger psychological distress in individuals outside the directly affected community. We examined whether repeated media exposure to the Boston Marathon bombings was associated with acute stress and compared the impact of direct exposure (being at/near the bombings) vs. media exposure (bombing-related television, radio, print, online, and social media coverage) on acute stress. We conducted an Internet-based survey 2 to 4 week postbombings with a nationally representative sample and representative subsamples from Boston and New York (4,675 adults). Repeated bombing-related media exposure was associated with higher acute stress than was direct exposure. Media coverage following collective traumas can diffuse acute stress widely. This unique study compares the impact of direct vs. indirect media-based community trauma exposure on acute stress responses.”

 

“Why Was Boston Strong? Lessons from the Boston Marathon Bombing”
Leonard, Herman B. “Dutch”; Cole, Christine M.; Howitt, Arnold M.; Heymann, Philip B. Harvard Kennedy School, Program in Criminal Justice Policy and Management, April 2014.

Findings: “The research points strongly to the fact that the emergency response following the bombing in Boston and the events in Cambridge and Watertown at the end of the week were shaped to a substantial degree by the multidimensional preparedness of the region. Response organizations have undertaken detailed and careful planning for the many fixed events like the Marathon that are staged annually in the Boston area. They have seen to the development of both institutional and personal relationships among response organizations and their senior commanders, ensured the adoption of formal coordination practices, regularly held intra- and cross-organization drills and exercises, and generated experience during actual events. Importantly, the senior commanders of these organizations seem to have internalized the “mindset” of strategic and operational coordination.

The research also suggests that the major contributing factors to much of what went well — and to some of what went less well — were command and coordination structures, relationships, and processes through which responding organizations were deployed and managed. The response organizations — particularly at senior levels — demonstrated effective utilization of the spirit and core principles of the National Incident Management System (NIMS), mandated by Congress in 2002 but still a work in progress in many areas of the country. But the many highly positive dimensions of inter-organizational collaboration in the Boston response are juxtaposed with some notable difficulties in what might be termed “micro-command,” i.e., the leadership and coordination at the street level when individuals and small teams from different organizations suddenly come together and need to operate in concert. The integration of NIMS into the practices and cultures of emergency response agencies is a work in progress — very promising but still incomplete, particularly at the tactical level of operations.”

 

“The Boston Marathon Response: Why Did It Work So Well?”
Ron M. Walls; Michael J. Zinner. Journal of the American Medical Association (JAMA). 2013; 309 (23):2441-2442. doi:10.1001/jama.2013.5965.

Findings: “On Monday, April 15, 2013, Boston emergency medical services and other agencies transported scores of casualties to local hospitals within 90 minutes of the two explosions at 2:50 p.m. near the Boylston Street finish line of the 117th Boston Marathon. Brigham and Women’s Hospital received 39 casualties overall, 31 on Monday, and 23 of these in the first hour. Many of these patients had severe injuries, including penetrating head and neck injuries and exsanguinating orthopedic blast injuries. Other trauma centers in the area received similar patients in similar numbers. Overall, only three people were killed by these explosive devices, and all three died before reaching the hospital. Not one patient who arrived at a hospital subsequently died. How did this happen? This astoundingly high survival rate, despite the nature and severity of the injuries, is a tribute to the courageous and rapid response of bystanders and first responders, expert field triage, rapid transportation of injured persons, and the skills and coordination of the receiving hospital trauma teams. It is also, however, the product of a confluence of deliberate actions stretching back to September 11, 2001, augmented by a series of providential but not random events.”

 

“Social Media and Police Leadership: Lessons from Boston”
Davis III, Edward F.; Alves, Alejandro A.; Sklansky, David Alan. Harvard Kennedy School, Program in Criminal Justice Policy and Management, April 2014.

Findings: “What lessons can be drawn from [the Boston Police Department’s] use of social media both before and during the marathon bombing investigation? Perhaps the most important lesson concerns the implications of new communication technologies for the traditional goals and concerns of the police. Law enforcement should not be defined by the tools it uses but rather by the values it embraces and seeks to promote. New tools, such as social media, should be applied in ways that further the longstanding mission of the police and that incorporate the lessons learned in the late 20th century about the importance of partnering with the community. In other words, while the use of social media creates new capabilities and possibilities for the police, law enforcement agencies should make sure they are shaping the tools rather than the other way around. Effective use means respecting the characteristics of social media but using them in ways that are adapted to the traditions and goals of community policing. At the same time, incorporating social media into the police mission is not simply about extending current thinking with a new tool. In some ways, social media are indeed platforms for communication, to be used in ways that best suit policing. However, social media have their own logic, norms and culture, and the police need to understand and respect the nature of social media if they are to use them effectively.”

 

“Twitter as a Sentinel in Emergency Situations: Lessons from the Boston Marathon Explosions”
Cassa, Christopher A.; Chunara, Rumi; Mandl, Kenneth; Brownstein, John S. PloS Currents, July 2013, 5. doi: 10.1371/currents.dis.ad70cd1c8bc585e9470046cde334ee4b.

Abstract: “Immediately following the Boston Marathon attacks, individuals near the scene posted a deluge of data to social media sites. Previous work has shown that these data can be leveraged to provide rapid insight during natural disasters, disease outbreaks and ongoing conflicts that can assist in the public health and medical response. Here, we examine and discuss the social media messages posted immediately after and around the Boston Marathon bombings, and find that specific keywords appear frequently prior to official public safety and news media reports. Individuals immediately adjacent to the explosions posted messages within minutes via Twitter which identify the location and specifics of events, demonstrating a role for social media in the early recognition and characterization of emergency events.”

 

“Communication in the Aftermath of the Boston Bombing”
Lazer, David; Kennedy, Ryan; Margolin, Drew. Northeastern University, Computer and Information Science Faculty Publications, paper 18, 2013.

Summary: “Researchers at Northeastern University conducted a survey from June 27 to July 5, 2013, to see how people found out about the Boston Marathon bombing, how they attempted to get information about those they feared were physically affected by the bombing, and where they heard incorrect information about the situation. Notable findings include: [1] Television is still the dominant means of finding out about the emergency, with about 47% of respondents finding out about the bombings through this medium. Cell phones and electronic media, however, are rapidly increasing in popularity. During the 9/11 attacks only about 5% of respondents reported receiving information from cell phones, computers or tablets. Nearly 30% reported using these media after the Boston Marathon bombing. Learning of the event via cell phone went from about 2% after 9/11 to almost 10% after the Marathon bombing. [2] Respondents closer to the emergency event were more likely to find out from their cell phones. Younger people were also much more likely to find out information from their cell phones. Of those who learned of the situation by cell phone, 52% were under age 40 and 94% were under 60. Interestingly, African Americans are less affected by this trend than other groups. They were almost 12% more likely to learn about the events through TV than other groups, and were 14% less likely than other groups to learn from a cell phone, computer, or tablet. [3] Cell phones are the dominant means for gathering information about people about whom respondents were concerned might have been physically affected. Those further from the incident were more likely to use e-mail or Facebook, while people within Boston tended to prefer texting over calling.”

 

“The Road to Boston: Counterterrorism Challenges and Lessons from the Boston Marathon Bombings”
U.S. House of Representatives, House Homeland Security Committee Report, March 2014.

Findings: “The Committee’s Report identifies four areas for continued improvement in counterterrorism efforts with corresponding recommendations: [1] Cooperation between federal and local law enforcement can be improved. The Fusion Centers owned and operated by state and local law enforcement agencies should be supplied with greater independent access to the Guardian System (the FBI’s terror database). The Memoranda of Understandings (MOU) between the Joint Terrorism Task Forces (JTTF) and state and local entities should be amended to allow for sharing information with state and local law enforcement without seeking supervisor approval. Equally important, leadership of all law agencies on the JTTFs should constantly encourage collaboration and sharing between members. [2] Policy surrounding the use of travel records and the screening of international travelers can be refined. The records of each traveler of concern should be properly screened. The sharing of alerts and notifications should be documented electronically among members of the JTTFs and within member agencies. [3] There is room for information sharing with regard to various terror/travel watch lists at the federal level. The Committee recommends agencies provide all the information available to them in their nominations to terror watch lists and other databases. [4] Over the long-term, more sophisticated efforts are required to mitigate terrorist threats. Efforts to educate the public on the terrorist threat (such as the See Something, Say Something campaign) need to be refined and evaluated. Intelligence and law enforcement agencies at the federal and state and local levels need to be constantly evaluating and improving their efforts to investigate and mitigate terrorist threats.”

 

“Media’s Role in Broadcasting Acute Stress Following the Boston Marathon Bombings”
Holman, E. Alison; Garfin, Dana Rose; Silver, Roxane Cohen. Proceedings of the National Academy of Sciences, December 2013. doi: 10.1073/pnas.1316265110.

Abstract: “We compared the impact of media vs. direct exposure on acute stress response to collective trauma. We conducted an Internet-based survey following the Boston Marathon bombings between April 29 and May 13, 2013, with representative samples of residents from Boston (n = 846), New York City (n = 941), and the remainder of the United States (n = 2,888). Acute stress symptom scores were comparable in Boston and New York [regression coefficient (b) = 0.43; SE = 1.42; 95% confidence interval (CI), −2.36, 3.23], but lower nationwide when compared with Boston (b = −2.21; SE = 1.07; 95% CI, −4.31, −0.12). Adjusting for prebombing mental health (collected prospectively), demographics, and prior collective stress exposure, six or more daily hours of bombing-related media exposure in the week after the bombings was associated with higher acute stress than direct exposure to the bombings (continuous acute stress symptom total: media exposure b = 15.61 vs. direct exposure b = 5.69). Controlling for prospectively collected prebombing television-watching habits did not change the findings. In adjusted models, direct exposure to the 9/11 terrorist attacks and the Sandy Hook School shootings were both significantly associated with bombing-related acute stress; Superstorm Sandy exposure wasn’t. Prior exposure to similar and/or violent events may render some individuals vulnerable to the negative effects of collective traumas. Repeatedly engaging with trauma-related media content for several hours daily shortly after collective trauma may prolong acute stress experiences and promote substantial stress-related symptomatology. Mass media may become a conduit that spreads negative consequences of community trauma beyond directly affected communities.”

 

“Be Prepared: The Boston Marathon and Mass-Casualty Events”
Biddinger, Paul D; Baggish, Aaron; Harrington, Lori; d’Hemecourt, Pierre; Hooley, James; Jones, Jerrilyn; Kue, Ricky; Troyanos, Chris; Dyer, K. Sophia. New England Journal of Medicine, May 2013, 368; 21.

Findings: “It’s important to recognize that the response in Boston generally followed a very carefully crafted and much-practiced set of plans and that those plans owe much to the lessons of others in the unfortunate fraternity of cities that have experienced mass casualties from intentional attacks. We believe that the speed and coordination of the response is partially attributable to reviewing other cities’ experiences, adjusting our plans, and repeatedly training staff in implementing those plans. In this context, it seems especially unfortunate that U.S. health departments, hospitals, and EMS are facing severe budget constraints, owing to cuts in federal funding that will undermine planning, training, and practice activities that have been so important in building health emergency preparedness capabilities. Nonetheless, as we review our successes and failures in detail, we will endeavor, in turn, to share our findings with others.”

 

“Lessons from Boston”
Kellermann, Arthur L.; Peleg, Kobi. New England Journal of Medicine, 2013, 368:1956-1957. Doi: 10.1056/NEJMp1305304.

Findings: “What is not clear is whether other U.S. cities, if faced with a challenge of similar magnitude, would have done as well. In contrast to Israel, a country that has ample experience with terrorist bombings, too many U.S. hospitals treat disaster preparedness as an afterthought. We would be wise to emulate Israel’s doctrine, which emphasizes the importance of national coordination, standard operating procedures, constant attention to surge capacity, the avoidance of emergency-department overcrowding, the distribution of casualties according to type and severity, and the frequent conducting of rigorous drills…. Because Boston followed many of these principles, it mounted an effective response. Our goal must be to ensure that every U.S. city can do the same.”

 

“The Boston Bombers”
Volpp, Leti. Fordham Law Review, 2014, Vol. 82.

Abstract: “On April 15, 2013, two bombs were set off during the Boston Marathon. The first suspects were fingered by the public through a new, technologically enabled vigilantism, based upon their appearance as ‘brown,’ or ‘looks Muslim.’ More than a decade after September 11, that those who appear Middle Eastern, Arab or Muslim are identified as terrorists and disidentified as citizens, seems sadly uncontroversial. But what to make of the Tsarnaev brothers? I argue that, while both brothers are generally held to have been responsible for the bombings, Dzhokhar is perceived as the citizen and Tamerlan as the terrorist. While this is formally true — Dzhokhar had successfully naturalized as a citizen and Tamerlan had not — it is also the case that only the younger brother is perceived to be a citizen as a matter of identity. There is tremendous sympathy directed towards the younger brother. This is both linked to the belief that he was brainwashed by his older brother, and produced by a line between the ‘white ethnic’ and ‘Islamic terrorist’ the two brothers differently straddle. For many Americans, Dzhokhar is one of ‘us.’ Dzhokhar thus appears as the white American victim of his nonwhite — Muslim and alien — brother. In the words of his friends, Dzhokhar was ‘just a normal American kid,’ and, as such, he resists being cast as a monster, the monster that we assume to be the terrorist.”

 

“Rumors, False Flags and Digital Vigilantes: Misinformation on Twitter after the 2013 Boston Marathon Bombing”
Starbird, Kate; Maddock, Jim; Orand, Mania; Achterman, Peg; Mason, Robert M. University of Washington, conference paper, 2014.

Abstract: “The Boston Marathon bombing story unfolded on every possible carrier of information available in the spring of 2013, including Twitter. As information spread, it was filled with rumors (unsubstantiated information), and many of these rumors contained misinformation. Earlier studies have suggested that crowdsourced information flows can correct misinformation, and our research investigates this proposition. This exploratory research examines three rumors, later demonstrated to be false, that circulated on Twitter in the aftermath of the bombings. Our findings suggest that corrections to the misinformation emerge but are muted compared with the propagation of the misinformation. The similarities and differences we observe in the patterns of the misinformation and corrections contained within the stream over the days that followed the attacks suggest directions for possible research strategies to automatically detect misinformation.”

 

“A Case Study on Unconstrained Facial Recognition Using the Boston Marathon Bombings Suspects”
Klontz, Joshua C.; Jain, Anil K. Michigan State University technical report, 2013.

Abstract: “The investigation surrounding the Boston Marathon bombings was a missed opportunity for automated facial recognition to assist law enforcement in identifying suspects. We simulate the identification scenario presented by the investigation using three state-of-the-art commercial face recognition systems, and evaluate the maturity of face recognition technology in matching low quality face images of uncooperative subjects. Our experimental results show one instance where a commercial face matcher returns a rank-one hit for suspect Dzhokhar Tsarnaev against a one million mugshot background database. Though issues surrounding pose, occlusion, and resolution continue to confound matchers, there have been significant advances made in face recognition technology to assist law enforcement agencies in their investigations.”

 

“TerrorWars: Boston, Iraq”
Sylvester, Christine. Critical Studies on Terrorism, 2014, Vol. 7, Issue 1.

Abstract: “This article queries the difference between experiencing an urban terror attack and experiencing war in an urban war zone. The case considered is the Boston marathon bombings of April 2013 and the lockdown that followed, a first in the USA. Official responses to the bombings exceeded militarised urban policing strategies in ways that arguably turned Boston into an urban war zone. To consider that proposition, I juxtapose events in Boston with U.S. war operations around Al Tafar Iraq in 2004…. I also consider responses to the lockdown by people in the area of the bombings, people waiting for delayed transportation during the lockdown and experts on anti-terrorism.”

 

Keywords: terrorism, crime, emergency preparedness, racial profiling

Last updated: April 19, 2015

 

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