The trick of preparing for chaos is routine. As the trauma medical director at Grady Memorial Hospital, Elizabeth Benjamin sees what one might define as a mass casualty incident on a regular basis: Some weekend nights can bring in more than 110 trauma patients through the doors.
“Grady, for better or worse, sees events where we have 10, 20, or more patients coming in at the same time,” Benjamin says. “So we’re used to scaling up.”
Like many of Atlanta’s institutions, Grady has geared up for the FIFA World Cup 2026 this summer. The hospital is the first stop for critical medical care for major events in Atlanta, and as of 2022, it is the region’s only level one trauma center, which has put strain on its patient capacity and staffing. For the hospital accustomed to high-volume, the World Cup has brought a chance to increase resources and specialization for its trauma department: On top of Grady’s normal workload, Benjamin has run disaster drills for the World Cup with the trauma teams for nearly two years.
The scenarios have included, but are not limited to, triaging instances of mass violence, rapidly expanding bed access and blood resources, working with interpreters for international visitors, identifying symptoms of a biohazard, treating mass dehydration, and communicating with other hospitals when Grady hits its limit. Then layer on a concurrent cyber attack and a trauma surgeon stuck in World Cup traffic.
“All of these drills are to be prepared for the unpredictable,” says Keith Delman, Emory chief of surgery at Grady whose team assists in the trauma unit. “Grady is really a quiet participant in any big event we have here, so God forbid something happens, we have to be ready to deal with crisis incredibly well.”
The World Cup arrives in Atlanta 30 years after the 1996 Olympics as well as the bombing at Centennial Olympic Park, which has defined the hospital’s response to emergencies. (Grady treated more than 34 patients then and performed emergency surgery on four.)
Significant investment has gone into the first line of response—Grady EMS—which will have staff on the ground downtown as well as transporting patients to the hospital. The EMS team has similarly participated in drills for mass casualty events, but focused around the stadium and at Centennial Olympic Park with Atlanta Police Department officers and Atlanta Fire & Rescue firefighters.
“We’re used to responding to emergencies inside the stadium, so we’re more worried about outside the stadium,” says Shane Smith, Grady’s EMS senior divisional manager of events. “This is unique in that one of our biggest worries is someone wanting to come in and do something with bad intentions.”
For the World Cup, Grady EMS over the last eight months have increased personnel “by close to 115 people” in its event division to better respond to emergencies on the ground. For matchdays, the hospital will operate 10 additional ambulances on call, with extra units of blood. (Five additional ambulances will also run for nonpeak days.) Smith says that Grady has also hired more 911 operators to handle calls during surge hours.
With increased international visitors, Smith and the event division also trained to immediately communicate via interpreters as well as identify foreign contagious diseases, such as Ebola or hantavirus.
“We get all of that training so that we can definitely say, Hey these are the signs of this illness, so that we can contain it,” Smith says. “We try to get our arms around every scenario to understand as much as we can to respond to it.”
Benjamin and Delman run through the trauma center’s disaster plan frequently. The World Cup brings new challenges but they are confident that Grady can absorb it. “Everyone at Grady, from our CEO to our staff, works with unexpected emergencies every day and has become very good at it,” Delman says. “That’s the best preparation you can have.”
“We want everyone to stay healthy and hydrated and enjoy the World Cup,” Benjamin adds. “Success, for us, is that nobody comes.”
