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How could New Haven hope to vaccinate 123,000 people in the course of ten days? Rubano and his staff developed a contingency plan to hold multiple vaccination clinics, each open for sixteen hours a day. They recruited and trained volunteers to administer the vaccines. Unlike most injections, smallpox vaccines require bifurcated (two-pronged) needles. Other volunteers learned to show informational fi lms to patients at the clinics, to keep vaccination logs, to distribute consent forms, and to direct traffi c. Health offi cials were coached on how to cope with the infl ux of patients that would inevitably fl ood clinics and hospital emergency rooms. Security offi cials developed strategies to keep the peace during such a crisis. The effort’s scale was unprecedented, but Rubano believed that the plan would work.

As the Iraq War accelerated, the Connecticut Offi ce of Emergency Management (OEM) and the Department of Emergency Management and Homeland Security attempted to coordinate local bioterrorism initiatives into a state-wide approach. They divided Connecticut into ten regions and distributed guidelines to each planning committee. The City of New Haven became part of Preparedness Planning Region 8, which also included North Haven, West Haven, Guilford, Branford, Meridan, and Orange. These committees were expected to meet on a regular basis to establish bioterrorism protocols and to conduct trial runs. The state guidelines outlined general topics of concern – including security, immunizations, quarantines, and mortalities – but were vague on the details. As Rubano explained to P.H., “They told you what you had to do but not how you were going to do it or who was going to do it.” New Haven’s old smallpox-readiness plan seemed a logical place to start. Continued
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