Emergency Public Health Response to
Hurricane Katrina and Hurricane Rita in Louisiana
Fall 2005 Ted Misselbeck Public Health Advisor Nashville TN May 2006
Hurricane Katrina: 8/29/05The Day the Music Died
Hurricane Katrina The largest natural disaster in
United States history
The magnitude of this disaster is not easy to appreciate
Hurricane Katrina
New Orleans
Texas
Florida
This was a monster storm
450 miles w
ide
Hurricane Katrina
New Orleans
Texas
Florida
Bay St. Louis MS
The recorded storm surge of 30 feet high in Bay St. Louis, MS was the highest ever recorded in U.S. history
Rayne
Temporary State TB Control Office
Emergency Public Health Concerns
New Orleans Health Department flooded and closed
Here’s the deal . . .
1.
Here’s how we are managing things right now . . .
Emergency Public Health Concerns
New Orleans TB staff:
TB Manager # 1 in Shreveport, La.
TB Manager # 2 in Houston, Texas
Nurse Practitioner in Monroe, La.
State secretary house submerged to the roof- living with relatives
Emergency Public Health Concerns
State Lab closed
No alternative in-state lab available to process sputum specimens
2.
Emergency Public Health Concerns
State Lab closed
Dr. Charles Wallace TB Control Officer and Texas to the rescue!
2.
Texas Provided self-pay mailers (he sent cases ) for specimen
processing
Emergency Public Health Concerns
This was the supply for all the TB patients throughout the State of Louisiana
State of Louisiana pharmacy and supply room flooded and closed
3.
Emergency Public Health Concerns
Joe Ware and Versapharm to the rescue-
R. Joe Ware
President
tell us what you need and we will send it- don’t worry about the bills now
Emergency Public Health Concerns
pharmacy3.Procedure: Order meds from Versa Pharm
1.Versa Pharm sends all meds for State to Lafayette, LA. Health Dept.
2. Meds separated by 9 La. Regions
Emergency Public Health Concerns
pharmacy3.
3. All meds delivered by car
4. Sputum cans also given to be delivered to each Region at the same time.
Emergency Public Health Concerns
All 132 TB patients from New Orleans area are missing . . .
4.
and we need to find them!!!
TB Control Officer’s new State office
Our new Lafayette La. office became:
(the check is in the mail!)
•New State TB Billing Office invoice (buying and payer) Statewide TB supplies
National Hotline Center (receiving phone calls about found TB patients from health departments around the United States)
Our Lafayette La. office became:
The new State Pharmacy distribution Center for all of Louisiana
Our Lafayette La. office became:
Our new Center comprised of two rooms 15 x 20 feet!
The new State Sputum Can Distribution Center
Finding New Orleans area TB patients
The detective process
Lafayette Office phone number distributed nationally for reporting found New Orleans patients
Provide CDC with daily update list
Updated daily list sent to TB controllers to continue national search
Finding New Orleans area TB patients
The detective process
After about a month we were able to get lists of registered shelter clients from FEMA (in Texas)
This helped in identifying new locations of about 15 TB patients in Louisiana and Texas
Finding New Orleans area TB patients
The detective process
Walgreens list (new local address and old New Orleans address)
We found about 3 TB patients through these lists
Finding New Orleans area TB patients
The detective process
Every possible .com lists
Katrina.COM
Hurricane Katrina.COM
Missing Katrina relatives.COM
We found 4 TB patients through this effort
Finding New Orleans area TB patients
The detective process
The main daily process:
of phone calls to patients homes, cell phones, emergency contacts and following up leads in other states
We found 100 or more TB patients through this method
Hundreds
Finding New Orleans area TB patients
Where?
did all the TB patients go???
The big question:
Weekly March 31, 2006 / 55(12);332-335
Emergency Public Health Concerns
The Changing geography . . .
Baton Rouge, Louisiana becomes the largest city in Louisiana overnight
From 400,000 to over 500,000
Out of New Orleans' pre-Katrina
population of
city officials now estimate have returned.
462,269
189,000
The New Orleans TB detective team
•Try and get to homes to determine if TB patients are still living there-
-or as time went on- did they return?
•Make inquiries in neighborhoods if anyone knows their whereabouts
Here come Hurricane Rita!!!
You gotta be kidding me!!!
Just when you think you are out of the woods . . .
?Houston
Dallas
Little Rock
Hurricane Rita’s track
This time the Western part of Louisiana was hit
Lake Charles Louisiana
Return Route
Lake Charles
TB Control plan for Lake Charles and Western Louisiana Parishes post-Hurricane Rita
Set-up contingent reporting network format similar to Hurricane Katrina (if needed)
Lessons learned from Hurricane Katrina
Instructions to TB patients days before hurricane hit
30 days worth of meds given to all patients
Result: All TB patients tracked and accounted for okay
October 2005
March 2006
Comparison: Hurricane Katrina vs. Hurricane Rita
Time
Wind speed
Size (width)
Radius of winds
Movement
Coastal Surge
U.S. Deaths
6 months later some numbers
FEMA has filled only 48,158 of the 90,000 trailer requests
215,000 homes destroyed
189,000 of 500,000 pre-Katrina residents have returned
Only 20 of 128 public schools are open
Med-1 unit (12 beds minor surgery) has set up in parking lot between Charity and LSU Medical Center
Charity Hospital may never open again
5,200 hospital beds pre-Katrina 1,200 beds now (mostly full)
Hospitals
New Orleans school open as of 1/25/06
New Orleans Health Services open as of 1/25/06
Are we prepared for an earthquake?. . .
Where?
New Madrid, MO fault line(1811-1812) Mississippi River ran backwards forming new lakes
Can this happen again??
Tennessee responding to Hurricane Katrina in making disaster plans to this and other disaster scenarios
and those who are in the shadows of life, the sick, the needy and the handicapped.
It was once said:
Hubert H. Humphrey Former Vice President of U.S.
The moral test of Government is how that Government treats those who are in the dawn of life, the children,
those who are in the twilight of life, the elderly,
How did we measure up as a nation to this disaster?
How do you think we will measure up the next time?
For us to ponder . . .
Questions??