What can we learn from the blackouts in Spain and Portugal?
The imperative of preparedness in overlapping crises
The events of April 28th, 2025, when a major power outage plunged significant portions of France, Spain and Portugal into darkness, serve as a stark reminder of the vulnerabilities of modern infrastructure and the potential for cascading crises. Even though this kind of event has become the norm in Ukraine, where Russian ballistic missiles and drones have targeted on multiple occasions critical infrastructure like hospitals and power grids, such events are not a common occurrence in Western Europe.
While the cause of this particular blackout is still under investigation, the widespread disruption it caused offers invaluable lessons for emergency services across Europe, particularly in the context of disaster and counter-terrorism medicine in preparing for mass casualty incidents amidst other potential disruptions.
The immediate aftermath of the blackout highlighted the fragility of systems often taken for granted. Reports flooded in of communication networks struggling under the surge of demand, transportation systems facing delays and safety concerns, and, crucially, healthcare facilities operating on backup power with varying degrees of capacity.
This event highlighted a fundamental vulnerability: the dependence of emergency services on a stable power grid for communication, dispatch, and information sharing – all critical elements in responding to large-scale emergencies, such as natural disasters or terrorist attacks.
Furthermore, the blackout illustrated the potential for overlapping crises. It is not difficult to imagine a terror-related mass casualty incident co-occurring with a widespread power outage. Hospitals, already dealing with a surge of casualties, would face the added burden of limited lighting, compromised medical equipment reliant on stable power, and potential failures in digital record-keeping and communication systems. This scenario emphasises the critical need for robust preparedness and resilience within emergency services. The lessons from the Spain and Portugal blackouts directly inform CTM-E's strategic focus on independent communication systems, healthcare infrastructure resilience, analogue backups, and low-tech solutions, as well as cross-sector coordination and regular multi-agency drills. Investing in and maintaining reliable communication networks that are less dependent on the public power grid, such as satellite-based systems or robust radio networks with independent power sources, remains a low-cost and viable option. When it comes to Emergency Resilience and Response Plans, ensuring that all healthcare facilities have adequate and regularly tested backup power systems capable of sustaining full operational capacity for extended periods should be part of routine operational tasks. This includes not just life support but also essential diagnostic and treatment equipment. In the event of multiple points of failure, maintaining and regularly training staff on analogue backup systems for patient records, communication, and triage is a good practice. Low-tech solutions, like manual lighting and wayfinding, should also be readily available. Other means of preparedness include strengthening pre-established protocols for coordination between emergency services, utility companies, and government agencies to ensure a unified response during infrastructure failures, and conducting realistic simulation exercises that incorporate power outages as a complicating factor in mass casualty incident scenarios. This allows responders to practice operating under degraded conditions and identify weaknesses in current protocols.
NATO - Resilience is the first line of defence
NATO emphasises that the resilience of critical infrastructure is a national responsibility, but also a collective commitment among allies. Their advice centres on a comprehensive, cross-government approach. While not directly quoting a specific document on hospital blackouts, NATO highlights a series of principles relevant to the scenario of an attack on critical infrastructure. Allies are encouraged to establish "redundancy or backup measures, including restore and repair capabilities," for critical infrastructure. This would directly apply to hospitals that need robust generator systems and alternative power sources. NATO recognises the complex interdependencies between infrastructure sectors (e.g., energy and healthcare) and stresses the need to understand and mitigate cascading effects. A blackout impacting transportation or communication would directly affect hospital operations. Continuous monitoring, information sharing, and preparedness actions are crucial. This translates to hospitals needing robust emergency plans specifically addressing prolonged power outages. Strengthening cooperation between civilian authorities and military resources can be vital in responding to large-scale infrastructure failures.
RAND Corporation on critical infrastructure resilience (applicable to hospitals during blackouts)
RAND Corporation's work on critical infrastructure emphasises a risk analysis-based approach focused on developing security and resilience. Their research suggests key considerations such as system-level understanding, investing in enhancements, cascading effects, and building community resilience to reduce reliance on major acute centres. A deep understanding of the targeted infrastructure, such as hospitals, and their dependencies, including power, water, and communications, is crucial for effective mitigation. RAND notes that underinvestment in infrastructure enhancements increases the likelihood of disruption. This underscores the need for consistent investment in hospital backup power systems and related infrastructure. Their analysis highlighted that disruptions in one sector, such as energy, can have cascading effects on others, like healthcare, necessitating integrated planning. RAND's research also highlights the importance of community-level resilience, which includes ensuring that hospitals can function as anchors during widespread disruptions.
In essence, both NATO and RAND advise a proactive, multi-layered approach to critical infrastructure resilience. For hospitals facing a central blackout scenario, this translates to robust backup power systems, well-rehearsed emergency protocols, understanding and mitigating interdependencies with other utilities, and being integrated into broader national and community resilience plans. While direct quotes on hospital blackouts might be scarce, their overarching principles provide a strong framework for preparedness.
The blackout of April 28th, 2025, provides a crucial learning opportunity for the entire European emergency response community. It underscores the interconnectedness of critical infrastructure and the potential for seemingly unrelated events to compound the challenges of responding to major incidents, including those of a terror-related nature. At CTM-E, we will leverage these lessons to refine our recommendations further and strengthen the resilience of medical services across Europe, ensuring we are prepared for any crisis, regardless of its complexity.
Author
George Tataru
EPRR Special Interest Group
About CTM-E
CTM-E is a research organisation that looks into the medical challenges posed by mass casualty incidents in Europe. It develops solutions to public policy issues to help make communities safer and more secure.
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