Emergency Public Health Response to Hurricane Katrina and Hurricane Rita in Louisiana

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Emergency Public Health Response to Hurricane
Katrina and Hurricane Rita
in Louisiana
Fall 2005
Ted Misselbeck Public Health Advisor Nashville TN
May 2006
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Hurricane Katrina 8/29/05 The Day the Music Died
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Hurricane Katrina The largest natural disaster
in United States history
The magnitude of this disaster is not easy to
appreciate
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This was a monster storm
New Orleans
Florida
Texas
450 miles wide
Hurricane Katrina
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Bay St. Louis MS
New Orleans
Florida
Texas
The recorded storm surge of 30 feet high in Bay
St. Louis, MS was the highest ever recorded in
U.S. history
Hurricane Katrina
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Rayne
Temporary State TB Control Office
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Emergency Public Health Concerns
Heres the deal . . .
1.
New Orleans Health Department flooded and closed
Heres how we are managing things right now . . .
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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
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Emergency Public Health Concerns
2.
State Lab closed No alternative in-state lab
available to process sputum specimens
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Emergency Public Health Concerns
2.
State Lab closed Dr. Charles Wallace TB Control
Officer and Texas to the rescue!
Texas Provided self-pay mailers (he sent cases )
for specimen processing
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Emergency Public Health Concerns
3.
State of Louisiana pharmacy and supply room
flooded and closed
This was the supply for all the TB patients
throughout the State of Louisiana
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Emergency Public Health Concerns
Joe Ware and Versapharm to the rescue-
tell us what you need and we will send it- dont
worry about the bills now
R. Joe WarePresident
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Emergency Public Health Concerns
3.
pharmacy

• Procedure Order meds from Versa Pharm
• Versa Pharm sends all meds for State to
  Lafayette, LA. Health Dept.
• 2. Meds separated by 9 La. Regions

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Emergency Public Health Concerns
3.
pharmacy
3. All meds delivered by car 4. Sputum cans also
given
to be delivered to each Region at the same
time.
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Emergency Public Health Concerns
4.
All 132 TB patients from New Orleans area are
missing . . .
and we need to find them!!!
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Our new Lafayette La. office became
TB Control Officers new State office

• New State TB Billing Office invoice (buying
  and payer) Statewide TB supplies

(the check is in the mail!)
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Our Lafayette La. office became
National Hotline Center (receiving phone
calls about found TB patients from health
departments around the United States)
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Our Lafayette La. office became
The new State Pharmacy distribution Center for
all of Louisiana
The new State Sputum Can Distribution Center
Our new Center comprised of two rooms 15 x 20
feet!
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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
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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
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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
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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
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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
Hundreds
We found 100 or more TB patients through this
method
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Finding New Orleans area TB patients
The big question
Where? did all the TB patients go???
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                          Weekly March 31, 2006 / 55(12)332-335                     
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Emergency Public Health Concerns
The Changing geography . . .
Baton Rouge, Louisiana becomes the largest city
in Louisiana overnight From 400,000 to over
500,000
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Out of New Orleans' pre-Katrina population
of city officials now estimate
have returned.
462,269
189,000
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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

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                          Weekly March 31, 2006 / 55(12)332-335                     
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Just when you think you are out of the woods . . .
Here come Hurricane Rita!!!
You gotta be kidding me!!!
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Little Rock
Dallas
?
Houston
Hurricane Ritas track
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This time the Western part of Louisiana was
hit Lake Charles Louisiana
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Return Route
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Lake Charles
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Lessons learned
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)
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Lessons learned from Hurricane Katrina
October 2005
Instructions to TB patients days before
hurricane hit 30 days worth of meds given to all
patients
March 2006
Result All TB patients tracked and accounted for
okay
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Comparison Hurricane
Katrina vs. Hurricane Rita
Time Wind speed Size (width) Radius of
winds Movement Coastal Surge U.S. Deaths
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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
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Hospitals
5,200 hospital beds pre-Katrina 1,200 beds now
(mostly full)
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
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New Orleans school open as of
1/25/06
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New Orleans Health Services
open as of 1/25/06
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Are we prepared for an earthquake?. . .
Where?
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New Madrid, MO fault line (1811-1812) Mississippi
River ran backwards forming new lakes
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Can this happen again??
Tennessee responding to Hurricane Katrina in
making disaster plans to this and other disaster
scenarios
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It was once said
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,
and those who are in the shadows of life, the
sick, the needy and the handicapped.
Hubert H. Humphrey
Former Vice President of U.S.
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For us to ponder . . .
How did we measure up as a nation to this
disaster? How do you think we will measure up
the next time?
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Questions??