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Tuesday, February 11, 2025

2025 Homeland Security Threat Forecast: Vulnerable Healthcare System is a National Security Threat 

Our prediction for 2025 furthers Homeland Security Today assessment areas of “Public Safety” and “Infrastructure Security;” however, instead of focusing on the impact of foreign adversaries, which is still needed, we look at the exploitable regions of weakness within the United States, specifically, healthcare infrastructure. A healthcare system (i.e., a network of organizations, institutions, resources, and individuals that provide healthcare services to meet the health needs of a population) is a critical component of a nation’s overall resilience to crises, allowing us the capacity to not only treat the injured but also detect other threats, such as pandemics and the use of biological agents. In 2025, we believe that healthcare systems’ capability planning should be a priority of homeland security professionals. The recent New Orleans terrorist attack and the devastating California fires have demonstrated potential weaknesses in the state of healthcare and healthcare systems in the U.S., indicating that prompt attention is needed.   

The New Orleans attack, which involved a lone assailant driving a pickup truck into a New Year’s crowd on Bourbon Street, resulted in 15 fatalities and numerous injuries. The city’s healthcare system was overwhelmed by the sudden influx of casualties and critically injured, highlighting the critical need for robust emergency response capabilities, as the University Medical Center New Orleans stated that the sudden influx of critical patients presented a unique challenge (Moses & Ferris, 2025).   

Similarly, the 2025 California fires have immensely strained the state’s healthcare infrastructure. The fires, which started around January 7th, have caused at least 25 deaths (a number that will continue to rise), widespread destruction, and the forced evacuation of thousands of residents (Lin II, et al, 2025). Not only have hospitals closed due to proximity to the fire, but open hospitals and medical centers near the affected areas have struggled to cope with the surge in patients suffering from burns, respiratory issues, and other fire-related issues (News Centre Maine, 2025). The fires’ repercussions won’t just impact the care of present patients, but they also will cause long-term complications. A study by Bedi et al. following the 2023 California fires highlighted that the widespread wildfire risk posed a significant threat to inpatient healthcare facilities, endangering a large portion of California’s inpatient bed capacity. The end also may not be in sight for California, as another study found that smoke from wildfires has a more significant negative effect on respiratory health compared to fine particles originating from other sources, like ambient pollution (Aguilera, et al., 2021).   

The impact of these events on homeland security is profound. Weakened healthcare infrastructure will make it difficult to respond effectively to large-scale emergencies, leaving communities vulnerable to further harm. The New Orleans attack and the California fires have underscored the importance of investing in healthcare infrastructure and capacity building to ensure a resilient and responsive system. Without such investments, the ability to protect and secure the nation against future threats will be severely compromised. This becomes increasingly concerning during this period of polycrisis (where multiple crises overlap and intensify each other), as we face ongoing unrest, rising foreign threats, and the cascading impacts of climate change, leading to more frequent storms, prolonged droughts, and severe heatwaves (Richardson, 2024). In 2025, for the improvement of public health and public safety, we believe a revitalized interest in strengthening our healthcare systems is needed. Homeland security and emergency management professionals must be inclusive of the healthcare system in their planning.  

References:   

Aguilera, R., Corringham, T., Gershunov, A., & Benmarhnia, T. (2021). Wildfire smoke impacts respiratory health more than fine particles from other sources: observational evidence from Southern California. Nature Communications, 12, 1493. https://doi.org/10.1038/s41467-021-21708-0   

Bedi, N. S., Dresser, C., Yadav, A., Schroeder, A., & Balsari, S. (2023). Wildfire Threat to Inpatient Health Care Facilities in California, 2022. American journal of public health, 113(5), 555–558. https://doi.org/10.2105/AJPH.2023.307236   

Lin II, R.-G., Haggerty, N., Sheets, C., Vives, R., Wick, J., Fry, H., Toohey, G., Goldberg, N., Ellis, R., Lin, S., & Castleman, T. (2025, January 7). Pacific Palisades Fire updates: Los Angeles. Los Angeles Times. Retrieved from https://www.latimes.com/california/live/pacific-palisades-fire-updates-los-angeles   

Moses, N., & Farris, M. (2025, January 1). More than 30 hospitalized after Bourbon Street attack. WWLTV. Retrieved from https://www.wwltv.com/article/news/crime/bourbon-street-attack/morethan-30-hospitalized-lcmc-health-bourbon-street-attack/289-26c75586-869e-4b67-8d77-a0e0a9d1e986   

News Center Maine. (2025, January 8). Hospital in Farmington activates ‘surge capacity plan’ [Video]. YouTube. https://www.youtube.com/watch?v=kX95_hn7M-8  

Richard Serino and Michelle Pratt
Richard Serino and Michelle Pratt
The Honorable Richard Serino is currently a “Distinguished Visiting Fellow” at Harvard University, National Preparedness Leadership Initiative. Mr. Serino was appointed by President Obama and confirmed by the Senate as the Federal Emergency Management Agency’s 8th Deputy Administrator in October 2009 and served until 2014. Prior to his appointment as Deputy Administrator, he served as Chief of Boston EMS and Assistant Director of the Boston Public Health Commission. As Chief of Boston EMS, Mr. Serino served as Incident Commander for over 35 mass casualty incidents and for all of Boston’s major planned events. During his time at FEMA, he oversaw 60 disasters from flooding in the Midwest, tornado devastation in Missouri, tsunami destruction, and numerous hurricanes. Mr. Serino was on scene at the Boston Marathon bombings in 2013 as the highest-ranking official of DHS. Under Mr. Serino’s leadership, FEMA has started the following initiatives such as FEMA Corps, FEMA Stat, the FEMA Think Tank, a detailed budgetary process, and a Disaster Workforce and Workplace Transformation. || Michelle Pratt is a professional Human Ecologist and current intern to Rich Serino, Distinguished Senior Fellow Distinguished Visiting Fellow at Harvard School of Public Health, National Preparedness Leadership Initiative. She is currently a student of the Northern Alberta Institute of Technology for Disaster and Emergency Management, and works for the provincial health provider in her home province. Besides being a student, she is also a community volunteer for education projects related to sexual consent and personal safety.

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