By Suzet M. McKinney, DrPH, MPH
Author of the Forthcoming text: Public Health Emergency Preparedness: Practical Solutions for the Real World
It’s hard to believe that it has been over 10 years since Hurricane Katrina tore through the Gulf Coast region, leaving damage and devastation that would take years to repair. I think it’s safe to say that Katrina was the most devastating storm ever seen here in the U.S.; a category 5 hurricane of epic proportions. The all too vivid images of entire neighborhoods underwater, desperate pleas for rescue scribbled across rooftops, and deceased bodies floating down the streets turned urban rivers, seemed more like a scene from a third world country, than a beloved, modern day American city. At the time, not many of us thought we’d ever see anything like it again in our lifetimes. And now comes, Harvey.
Making landfall on the coast of Texas on August 25, 2017 Hurricane Harvey, though only a category 4, brought winds, rain, and destruction that rivaled Katrina at its strongest. Almost immediately, Hurricane Harvey began to intensify at record speeds, which began a race against time for government officials and first responders to brace for what would turn out to be a monumental response effort, while residents hurried to heed the evacuation warnings. The prediction of devastating flood levels had everyone concerned, especially responders who undoubtedly hoped to avoid a Katrina-like situation in the aftermath of the storm.
By the time Harvey began to slow and move out into the Gulf, the hurricane had brought extreme flooding to much of Texas, with Houston being one of the hardest hit areas. The images are eerily reminiscent of Katrina’s impact to New Orleans. Stories of NOLA residents who relocated to Houston after Katrina began to emerge, as many of them were reliving that long-gone tragedy. Much of Houston was underwater, just as had occurred in New Orleans. But as quickly as these stories were emerging, so too were stories of resilience and resolve, images of Texans coming together to help one another, hundreds of people lining up to join the volunteer effort; and an outpouring of support from across the country. While many residents remain in shelters, recovery efforts in some areas have already begun. What still remains to be seen are the many lessons that we will all learn from Hurricane Harvey and the question of what we will do with that information looms large for those of us in preparedness, who continue to watch the Harvey situation unfold.
Speaking of preparedness, I’ve heard many people ask the question, “was Houston prepared?”, “Shouldn’t officials have expected this?” As a public health practitioner, one who has worked in emergency preparedness for nearly fifteen years, I’d urge us all to understand the gravity of what this response has been like for the residents of Texas and the Gulf region and emergency responders so far, as well as what remains to come. While we know that natural disasters can be predicted, planning for their full impact can be elusive. Natural disasters are unpreventable and the magnitude of severe hurricanes like Harvey and now, Irma, cannot be predicted. They also cannot be confined to a geographical area, so planning for response to these types of disasters can be significant. The response to, and recovery from these types of events will take the “whole of community”. That means it is important for us all: government officials, emergency responders, business owners, community leaders, families and individuals to maintain knowledge of natural threats and their impacts. Doing so will help entire communities plan mitigation, response and recovery efforts for these types of events.
More importantly, the response to and recovery from these types of events will take time. In Houston and across the Gulf region the rain has passed, but the public health implications of Hurricane Harvey are just beginning. Residents, responders, volunteers and everyone in the impacted area have to now consider the unseen dangers that are left behind by these types of events, even as they work to address the obvious, physical dangers and begin the rebuilding process. Waters are still high, and even rising still in some places. Those back in the area need to take care to avoid the hazards that are presented by enduring flood waters. These compounding factors include drinking water systems contaminated with sewage, gasoline, or chemicals; human infection from bacteria growing in floodwaters that can enter the body through the smallest cut or abrasion; standing water which serves as a breeding ground for disease-carrying mosquitos, i.e. Zika and West Nile Virus. Mental health episodes are likely to increase, as the damage and destruction continues to sink in. And let’s not forget about the silent, invisible threat that often looms undercover after these types of events: fast-growing, persistent mold. All of these things represent additional consequences from the hurricane that must also be remediated. If not managed properly, these additional threats can escalate to levels that will also test the emergency response system, especially the health and medical infrastructure.
So, what are the lessons that we can learn from Hurricane Harvey? The answer to that question is not difficult to determine. Cities, towns and jurisdictions across the U.S. need to be more diligent in planning for natural disasters. That is not to say that much work hasn’t already been done; it has. But, preparedness is a journey not a destination. As much planning as has been done, more still is needed. Everywhere! Our emergency response plans for these types of disasters need to be tested and evaluated, time and again. Public infrastructure systems need to be evaluated to determine repair and replacement needs. Greater partnerships need to be developed, across private businesses, community groups and non-profit organizations. More robust planning for at-risk populations, including the medically fragile, physically disabled, and institutionalized persons such as nursing home residents, hospital patients, and jail inmates. Diligence in preparing is just as important as the preparedness, if not equally so. And the time is now, not when the National Weather Service begins tracking the next mega storm. We learned many lessons after Katrina, but we also got complacent after the immediate threat was gone. We will learn many lessons from Harvey and Irma. The real question is: will we really learn them this time? For the sake of those of us living in the city where the next mega storm decides to hit, I certainly hope so.
Suzet M. McKinney, DrPH, MPH, is the author of the forthcoming, Public Health Emergency Preparedness: Practical Solutions for the Real World (Available Spring 2018).
Dr. McKinney currently serves as CEO/Executive Director of the Illinois Medical District (IMD), one of the largest urban medical districts in the United States. Dr. McKinney is the former Deputy Commissioner of the Bureau of Public Health Preparedness and Emergency Response at the Chicago Department of Public Health (CDPH), where she oversaw the emergency preparedness efforts for the Department and coordinated those efforts within the larger spectrum of the City of Chicago’s Public Safety activities, in addition to overseeing the Department’s Division of Women and Children’s Health. During her time at CDPH, Dr. McKinney also spearheaded Chicago’s efforts as the field test site for the U.S. Department of Homeland Security’s (DHS) Generation-3 autonomous biological detection system technology.
In academia, Dr. McKinney serves as an Instructor in the Division of Translational Policy and Leadership Development at Harvard University’s T.H. Chan School of Public Health and as Adjunct Assistant Professor of Environmental and Occupational Health Sciences at the University of Illinois at Chicago School of Public Health. She also serves as a mentor for the Biomedical Sciences Careers Project, also at Harvard University.