Public health branch incident management and support as part of the Federal Government response during the emergency phase of Hurricanes Irma and Maria in Puerto Rico and the US Virgin Islands
Keywords:public health, emergency management, natural disasters, environmental health, disaster assessments
On September 6 and 20, 2017, Hurricanes Irma and Maria made landfall as major hurricanes in the US Caribbean Territories of the Virgin Islands and Puerto Rico with devastating effects. As part of the initial response, a public health team (PHT) was initially deployed as part of the US Department of Health and Human Services Incident Response Coordination Team. As a result of increased demands for additional expertise and resources, a public health branch (PHB) was established for coordinating a broad spectrum of public health response activities in support of the affected territories. This paper describes the conceptual framework for organizing these activities; summarizes some key public health activities and roles; outlines partner support and coordination with key agencies; and defines best practices and areas for improvement in disaster future operations.
Noji E: The public health consequences of Disasters. Prehosp Disaster Med. 2000; 15: 147-157.
Bathi JR, Das HS: Vulnerability of coastal communities from storm surge and flood disasters. Int J Environ Res Public Health. 2016; 13: 239.
PAHO Website: Environmental health management after natural disasters. 1982. Available at http://www.disaster-info.net/watermitigation/i/publications/Envhealth/index_en.html. Accessed October 25, 2020.
DHS Website: National Response Framework. 2016. Available at https://www.fema.gov/media-library-data/1466014682982-9bcf8245ba4c60c120aa915abe74e15d/National_Response_Framework3rd.pdf. Accessed October 20, 2020.
Malilay J, Heumann M, Perrotta D, et al.: The role of applied epidemiology methods in the disaster management cycle. Am J Public Health. 2014; 04: 2092-2102.
CDC: Epidemiologic notes and reports surveillance of shelters after hurricane Hugo—Puerto Rico. MMWR. 1990; 39: 41-47.
CDC: Infectious disease and dermatologic conditions in evacuees and rescue workers after hurricane Katrina—Multiple states, August—September 2015. MMWR. 2005; 54: 961-964.
Friedrich MJ: Determining the health effects of hazardous materials released during hurricane Harvey. JAMA. 2017; 19: 2218-2285.
Sengul H, Santella N, Steinberg LJ, et al.: Analysis of hazardous materials due to natural hazards in the United States. Disasters. 2012; 36: 723-743.
Cruz MA, Garcia S, Chowdhury MA, et al.: Assessing the congregate disaster shelter: Using shelter facility assessment data for evaluating potential hazards to occupants during disasters. J Public Health Manag Pract. 2017; 23: 54-58.
Schnall A, Nakata N, Talbert T, et al.: Community assessment for public health emergency response (CASPER): An innovative emergency management tool in the United States. Am J Public Health. 2017; 107: S186-S192.
Cruz MA, Rubens M, Garcia SJ, et al.: Knowledge of and preparedness for use of environmental assessments in shelters during disasters: Results of the 2013 state and territorial use of shelter assessments survey. Disaster Med Public Health Prep. 2017; 11: 11-14.
Kirsch TD, Mitrani-Reiser J, Bissell R, et al.: Impact on hospital functions following the 2010 Chilean earthquake. Disaster Med Public Health Prep. 2010; 4: 122-128.
Nour M, Alhajri M, Farag EABA, et al.: How do the first days count? A case study of Qatar experience in emergency risk communication during the MERS-CoV outbreak. Int J Environ Res Public Health. 2017; 14: 1597. DOI: 10.3390/ijerph14121597.
National Hurricane Center: Tropical cyclone climatology. NOAA Website. Available at https://www.nhc.noaa.gov/climo/#bac. Accessed October 23, 2020.
NY Post Website: Hurricane Irma makes landfall in the Caribbean as a category 5 storm. Available at http://www.weather.gov/sju/maria2017. Accessed October 25, 2020.
NY Post Website: Hurricane Maria September 20. 2017. Available at https://nypost.com/2017/09/06/hurricane-irma-makes-landfall-incaribbean-as-a-category-5-storm/. Accessed October 25, 2020.
FEMA Website: Virgin Islands Hurricane Maria (DR-4340). Available at https://www.fema.gov/disaster/4340. Accessed October 25, 2020.
FEMA Website: Puerto Rico Hurricane Maria (DR-4339). Available at https://www.fema.gov/disaster/4339. Accessed October 25, 2020.
HHS Website: Secretary price declares public health emergency in Puerto Rico and US Virgin islands due to Hurricane Irma. Available at https://www.hhs.gov/about/news/2017/09/06/hhs-secretary-price-declares-public-health-emergency-puerto-rico-us-vi-duehurricane.html. Accessed October 25, 2020.
HHS Website: Secretary price declares public health emergency in Puerto Rico and US Virgin Islands due to Hurricane Maria. Available at https://www.hhs.gov/about/news/2017/09/19/secretaryprice-declares-public-health-emergency-puerto-rico-and-usvi-duehurricane-maria.html. Accessed October 25, 2020.
Public Health Emergency: HHS concept of operations for ESF-8. HHS website. Available at https://www.phe.gov/Preparedness/planning/mscc/handbook/chapter7/Pages/hhsconcept.aspx. Accessed October 21, 2020.
WHO Website: Communicable diseases following natural disasters. Risk assessment and priority interventions. Available at http://www.who.int/diseasecontrol_emergencies/guidelines/CD_Disasters_26_06.pdf?ua=1. Accessed October 25, 2020.
CDC: Emergency Mosquito Control Associated with Hurricane Andrew—Florida and Louisiana, 1992. MMWR. 1993; 42: 240-242.
Simpson JE: Emergency mosquito aerial spray response to the 2004 Florida hurricanes Charley, Frances, Ivan, and Jeanne: An overview of control results. J Am Mosq Control Assoc. 2006; 22: 457-463.
Tomashek KM, Lorenzi OD, Andújar-Pérez DA, et al.: Clinical and epidemiologic characteristics of dengue and other etiologic agents among patients with acute febrile illness, Puerto Rico, 2012-2015. PLoS Negl Trop Dis. 2017; 11(9): e0005859. DOI: 10.1371/journal.pntd.0005859.
CDC: ESSENCE II and the framework for evaluating syndromic surveillance systems. MMWR Suppl. 2004; 53: 159-165.
Lucero CA, Oda G, Cox K, et al.: Enhanced health event detection and influenza surveillance using a joint Veterans Affairs and Department of Defense bio surveillance application. BMC Med Inform Decision Making. 2011; 11: 56. DOI: 10.1186/1472-6947-11-56.
Sanders EJ, Rigau-Pérez JG, Smits HL, et al.: Increase of leptospirosis in dengue-negative patients after a hurricane in Puerto Rico in 1996 [correction of 1966]. Am J Trop Med Hyg. 1999; 61: 399-404, 861.
USDA Website: Animal Health Emergency Management. Available at https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/emergency-managementl76UfgVFGQHKgIAHq7ZJA!!/. Accessed October 25, 2020.
Everard CO, Everard JD: Mongoose rabies. Rev Infect Dis. 1988; 10(Suppl 4): S610S-614.
Styczynski A, Tran C, Dirlikov E, et al.: Human rabies—Puerto Rico, 2015. MMWR. 2017; 65: 1474-1476.
Safe Hospitals in Emergencies and Disasters: Structural, non-structural and functional indicators. WHO Website. Available at http://www.wpro.who.int/emergencies_disasters/documents/SafeHospitalsinEmergenciesandDisastersweboptimized.pdf. Accessed October 25, 2020.
Kile JC, Skowronski S, Miller MD, et al.: Impact of 2003 power outages on public health and emergency response. Prehosp Disaster Med. 2005; 20: 93-97.
Irvin-Barnwell EA, Cruz M, Maniglier-Poulet C, et al.: Evaluating disaster damages and operational status of health-care facilities during the emergency response phase of hurricane Maria in Puerto Rico. Disaster Med Public Health Prep. 2020; 14: 80-88.
Public Health Emergency: Medical assistance. HHS website. 2019. Available at https://www.phe.gov/preparedness/support/medicalassistance/Pages/default.aspx. Accessed July 20, 2019.
Concepción-Acevedo J, Patel A, Luna-Pinto C, et al.: Initial public health laboratory response after hurricane Maria—Puerto Rico, 2017. MMWR. 2018; 67: 333-336.
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