Johns Hopkins' chief worrywart

Nobody is more prepared for an emergency than Jonathan Links

Credit: Will Kirk / Johns Hopkins University

A small plunger stands upright on Jonathan Links' office desk. Links has a story for it. He has many stories.

Last year, Links had to bow out of an annual dinner of Bloomberg School of Public Health division directors within his department due to a household plumbing emergency. The meeting was postponed.

The next day, a colleague taped the plunger to his office door as a gag. "He wanted to tease me for being the cause of the postponement," says Links, a professor and deputy chair of Environmental Health Sciences at the Bloomberg School. "I thought it would be funny to keep it."

Funny, and more than a touch ironic. Perhaps nobody is more prepared for an emergency than Links, chair of the university's Committee on Crisis Management and Johns Hopkins' unofficial chief worrywart.

For those who know Links, the postponement should come as no surprise. It's not a brainstorming session or big-think party without Links in attendance.

For a decade now, Links has been Johns Hopkins' go-to man on emergency and crisis planning. Name the event—H1N1 outbreak, gunman at The Johns Hopkins Hospital, earthquake—and Links has played a role directly or indirectly in the response, and the hindsight thinking that followed.

His fingerprints can be found on nearly every crisis-related group, activity, and protocol throughout Johns Hopkins. A visionary thinker, Links has helped the university and health system stay ahead of an ever-evolving curve.

Friends and colleagues describe him as honest, smart, direct, visionary, and an eloquent speaker. Above all, people trust and value his perspective and counsel. For proof, look no further than his business card. He has more titles than the Boston Celtics.

In addition to his academic positions and his role with the Committee on Crisis Management, Links is deputy director of the Johns Hopkins Office of Critical Event Preparedness and Response (known as CEPAR), director of the Johns Hopkins Center for Public Health Preparedness, co-chair of the Student Crisis Committee, and senior adviser to the senior vice president for finance and administration and the provost for university crisis and risk management.

For a man with so much influence, Links remains humble and unassuming. He looks and talks every part the professor, with an uncanny ability to dissect and elucidate complex subjects. He possesses essential tremors in both hands, which seem to move in time with his rapid thoughts.

Links received his doctorate in environmental health sciences from the Bloomberg School in 1983 and joined the faculty as an assistant professor right after graduation. In addition to his roles in Environmental Health Sciences, he has joint appointments in the Bloomberg School's Department of Health Policy and Management, the School of Medicine's departments of Radiology and Emergency Medicine, and the School of Education's Division of Public Safety Leadership.

The San Francisco native and lifelong academic says that he got into the emergency-response business just after 9/11.

Peter Beilenson, a Bloomberg School alum and then Baltimore City health commissioner, called to tap Links to help the city with radiation terrorism preparedness. Links, an expert on medical imaging and radiation physics, says he couldn't say no to a friend.

"I told Peter I'd help, and then immediately after I hung up the phone I Googled dirty bombs," he says with a smirk. "My whole career up until that point was medical imaging. I didn't know what dirty bombs were all about."

Links began to work part time with the Baltimore City Health Department and within weeks was designing protocols and hosting training sessions with first responders on such topics as ionizing radiation and what to do when a suspicious package arrives at City Hall.

"And all the while I'm going, this is really interesting and fulfilling," he says. "I was out there doing really practical stuff. You can't be an ivory tower egghead about these sorts of things. And you're not dealing with doctoral students, so you can't just give a School of Public Health class lecture to firefighters and police officers. I just found it really fulfilling to drill down to the operational essence of stuff."

A year after Links started working with the Health Department, Al Sommer, then dean of the Bloomberg School, asked him to lead an effort to respond to a Centers for Disease Control and Prevention request for proposals for national centers of public health preparedness. The centers would provide national coverage and training for first responders and emergency management.

Johns Hopkins secured a grant, and the Johns Hopkins Center of Public Health Preparedness was created in 2004. Since then, the center, under Links' leadership, has trained more than 60,000 people.

In 2006, Links began his association with CEPAR, an organization created two years earlier to marshal JHU expertise on crisis response and preparedness and cut across the university and health system.

CEPAR at the time was working on an institutionwide avian flu (H5N1) plan. Links, who had helped craft a pandemic flu plan for the Bloomberg School, was to become the school's CEPAR representative.

Links says he immediately hit it off with CEPAR Director Gabor Kelen, who just months later would ask him to be CEPAR deputy director.

In his new role, Links set out to bring the university and health system more into balance on crisis response. He would regularly attend the universitywide Committee on Crisis Management meetings as the CEPAR representative.

Once again, Links made a good impression.

Kristina Johnson, who was provost at the time, asked Links to take over the Committee on Crisis Management, where he instantly became a transformational figure.

The committee, which was founded in 1998 and had met quarterly to share best practices, began to meet monthly and work on new response procedures. Specifically, Links wanted the university to become compliant with FEMA's National Incident Management System, a standardized structure and protocol system that came as a direct result of 9/11 and the subsequent commission that looked into the response to the attacks.

"Before NIMS, fire and police could not talk to each other. It's kind of mind-boggling," he says. "What NIMS does is institute the same command structure and position titles across enterprises. A commander of police and a commander of a fire department, for example, have different roles. You don't know if you're talking to lower management, mid-management, or the person in charge. If we're not talking the same language, there is the danger of a giant disconnect in coordination to a response. My platform as the new chair was the need to become NIMS compliant."

One of Links' first steps as chair was to abolish the university's Crisis Response Team, a handpicked group of representatives from across Johns Hopkins divisions who were involved with responding to critical events.

"The Crisis Response Team was logical in the beginning, but the group was a collection of people without formalized individualized roles and a structure," he says. "What happens if one person is away on vacation or leaves the university? Who steps in?"

Links championed the implementation of an Incident Command System and unified command at Johns Hopkins. Today, every school, campus, and component of the health system has an ICS, with an identical organization chart within a unified multitiered structure.

The system played a direct and effective role, he says, in the immediate and coordinated response to the incident at The Johns Hopkins Hospital on Sept. 16, 2010, when a gunman, upset over news about his mother's medical condition, opened fire, wounding a doctor before fatally shooting his mother and then turning the gun on himself.

In the wake of the shootings, faculty, staff, and students were reminded to subscribe to the university's Emergency Alert text message system for receiving vital information in the event of a life-threatening emergency, a system that Links helped expand to every school and campus.

He also played an important role in expanding the Student Crisis Committee, which began as an informal Homewood "What If?" committee, headed by Susan Boswell, dean of student life. Today, the committee, which Links co-chairs, involves representatives from all the academic divisions and meets regularly to discuss issues that could impact students.

A lover of stories, Links jumps into a favorite: one about the university's response to the H1N1 outbreak in 2009.

Links, who regularly shuttles between campuses to attend meetings on any given day, found himself at Homewood on the spring day when news broke of the first H1N1 cases. Links walked to the office of Scott Zeger, then interim provost, to offer his support and advice.

"I asked someone at the front desk if I could have two minutes with Scott. But Scott hears my voice and runs out, 'Jon, get in here.' I started to tell him how I was here to help you, and he goes, 'Are you kidding me? You're going to sit here in my vice provost's office for however long it takes to get through H1N1.' I was like, what? My head was spinning."

Links bunkered down in the empty office that day and got to work, organizing meetings and sketching a plan. While in the office, the phone rang.

"I was like, nobody knows I'm here," he says. "But I thought picking it up was the polite thing to do. Turns out, the phone was for me. Ron Daniels, who just became president a week prior mind you, wanted to see me immediately. I'm a fairly confident guy, but I remember going up to his office door, which was closed, and tapping lightly with this wimpy knock."

Links sat down across from the president and served as sounding board and ideas man.

"We had a lot to consider. We had to think about the public health implications of this. I mean, the news just broke. What do you do? Do you cancel classes? What is the chain of command, and how do we coordinate a response? We had to talk through some really tricky issues." Links says that the university's response was immediate.

"Sure, we made some missteps along the way, but it was unbelievable how we had this down pat in just one week. On the fly, we worked out a whole procedure of communications and policies to mitigate the impact on all our campuses. The H1N1 response lasted for nearly six months, and controlled Links' life 24/7.

"It was the greatest and worst experience of my life rolled into one," he says. "It was the greatest of feelings because everyone pulled together and it was an amazing team effort. It was the worst because none of my professor and academic duties went away. I had a pretty full plate."

He still does.

More recently, Links has led the university's efforts to adopt an Institution Risk Management program that pools all the risks that face the university into one "unified bucket," as Links likes to call it. The bucket currently contains a list of 63 potential risks, largely crafted by Steve Dunham, who was then the university's general counsel and a vice president.

"As a starting point, we put down the entire ensemble of risks, such as earthquake, active shooter, downturn in enrollment, misconduct. Every type of risk we could imagine," he says. "We wanted to create one venue where all of the risks get considered, mitigated, and owned by the appropriate parties." The group that manages the Institution Risk Management program reports directly to the university's board of trustees.

In February 2011, Senior Vice President Daniel Ennis appointed Links to the new position of senior adviser on crisis and risk management activities, with a primary focus on organizational frameworks and structures for crisis and risk management, development of the university's Incident Command System, and operational processes for institutional risk assessment and risk management.

The position arose out of a need to harmonize existing crisis and risk management activities under a unified and coordinated organizational structure, and to facilitate the development and maintenance of institutional risk management activities and programs.

"Jon has been an extraordinary partner to me and to the provost," Ennis says. "We are very fortunate that, among his many responsibilities, he has been so committed to serving in this important risk and crisis leadership role for the university. Most recently, his judgment and expertise served the university very well throughout our preparations for and response to Hurricane Sandy. A critical ingredient to Jon's success," he said, "is that he balances a deep and action-oriented knowledge of risk and crisis management with a great appreciation for the fact that the university will often be in the position where it is important to take smart, carefully considered risks in order to best deliver on JHU teaching, research and service missions."

This September, Links also became chair of the Institutional Compliance Oversight Committee, so that Johns Hopkins can better coordinate and unify the university's risk management, compliance, and crisis management programs.

Links says that his professional evolution has become the university's story of progression in formalizing risk and crisis management.

Kelen, chair of the School of Medicine's Department of Emergency Medicine as well as director of both CEPAR and the Center for the Study of Preparedness and Catastrophic Event Response, says that Links has several "amazing" personality traits that have made him the perfect choice for every appointment.

"One, Jon is an awfully nice and engaging guy who connects well with everyone he comes into contact with," Kelen says. "He's also as honest as the day is long. He's deliberate, humble, and a great communicator who can get his point across. And he's not intimidated by the situation or who might be in the room. He has a presence about him, and people trust him and his authority."

Not surprisingly, the much-in-demand Links gets brought into numerous meetings and conference calls. Kelen describes Links' energy in these settings as infectious.

"He's not a wallflower in meetings," he says. "He speaks his mind, but he's very diplomatic. He doesn't mind if you disagree. He can view things from the 40,000-foot level and the one-foot level. Some people are big-vision thinkers, and some people are doers. He is both."

Of all his colleague's accomplishments, Kelen says that perhaps Links' greatest achievement is getting top administration to buy into crisis preparation at a high level, realizing that all involved must have faith in the plan and relinquish some degree of control when a situation occurs. They, like him, have to step back and let the designated responders handle their roles.

For his part, Links says that loving what he does helps.

To keep himself sane, he rarely brings work home during the week. He only recently got a smartphone, and keeps his meeting schedule on paper, in a small agenda book.

Despite the demands on his time related to emergency planning, Links wants to continue teaching and his research on both emergency preparedness and medical imaging. He's currently the principal investigator on three CDC preparedness grants and the co-principal investigator on an NIH imaging grant slated to start soon.

"I have a lot of energy and try to be very efficient with my time during the day," he says. "At night, I like to unwind and watch TV or a movie. I sleep well because I worked my butt off during the day. A person recently asked me how I handle my job and all these unthinkable scenarios I'm asked to address. I told him I think it's an advantage for this role to be a worrywart. I get paid to be one."