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

                         Weekly March 31, 2006 /

55(12);332-335                     

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??