2019 Hurricane Season - Transcript

Moderator: Kellee Waters and Jonathan Lynch

  • Vivi Siegel, M.P.H.
  • Bill Rich, PHA, CEM, EMT-P

Date/Time: July 17, 2019, 1 p.m. to 2 p.m. Eastern Time

>> Kellee: Good afternoon, everyone. I am a health communications specialist in C.D.C.’s Center for Preparedness and Response, Division of Emergency Operations. Thank you for joining us for today’s EPIC webinar on 2019 hurricane season. We will hear from Bill Rich and Vivi Siegel. If you do not want you to be recorded, end it at this time. Instructions on how to earn continuing education can be found on our website, emergency.CDC.GOV/EPIC. The course access code is EPIC, capital E-P-I-C0717 with all letters capitalized. To repeat, the course access code to receive continuing education units is in all caps E-P-I-C0717. Today’s webinar is interactive. To make a comment click the chat button on your screen and enter your thought. To ask a question, please use the Q&A button. The Q&A session will begin after all presenters have finished. Closed captions are available for this webinar.

We’re fortunate to have Vivi Siegel and Bill Rich as our speakers today. Vivi Siegel is a Senior Health Communications Specialist for CDC’s Division of Environmental Health Science and Practice. Vivi has a background in public health and journalism, and a professional focus on emergency risk communication and environmental health. She has been a health communications specialist at CDC since 2005. She helps lead communication activities for natural, chemical, and radiological disasters, including the hurricane responses for 2017 and 2018.

Bill Rich serves as an emergency management specialist and disaster planner.  He helped found the National Disaster Medical System, becoming a founding member of Disaster Medical Assistance Team GA-3. While at CDC, Bill has taught First Responder, Mass Casualty Management, Basic and Advanced Cardiac Life Support, disaster planning and all-hazards preparedness in 12 countries and numerous domestic areas.  He has completed an extensive list of mission deployments as a medical officer and a logistics responder.

Thank you for joining us today. Bill, please begin.

>> Bill: Good afternoon. I’m happy to be here today. I hope you find some value in the presentations. Let’s jump right in since your time is far more valuable than mine. Next slide.

First the forecast, everybody loves this part and we’re already in the season as hurricane Barry has proven recently. Activity for this year is predicted to be slightly less in intensity compared to last year. We’re looking at totally 13 named storms, five hurricanes and two major hurricanes that is what we expect. Don’t get weighed do that number. The weather does not get the memo and on its own schedule. If you prepare for the worst, you will only have good surprises. Pessimists are the way to go in this business.

Next slide, don’t rely on the 120 hour warning model. Some of the storms that we faced in the last couple of years and some we will face this year. We may only have 24 hours or less of warning because of the pop-up storms in the hot water around the gulf, particularly. If you prepare yourself and your family, it will enable you to do your job, because you won’t be spending all of your time making sure they are safe and reassuring them and it is your job of having a family.

A direct storm impact is not required for there to be personal or professional impacts from a hurricane. Some of the greatest impacts are indirect, such as a water drains from a river basin from an impact farther upstream. Mississippi is a classic example of that and we will watch as it evolves as we go through the next several weeks just from Barry’s impact. Some of the worst historical impacts, historical events occurred because of slow moving or stalled tropical storms, not even hurricanes. If a tropical storm stalls out like the classic one did over South Georgia a few years back, the rain impact can be horrifying. It can flood out major areas, impact lots and lots of people totally change their lives, so it doesn’t have to be a CAT5 hurricane to have catastrophic impacts.

Stuff that gets compromised, when you have an impact from the storm, one of the things that planners starting to watch is dialysis clinic us because of power loss, clean water loss and transportation impacts, dialysis is very vulnerable as a result of the impact and we saw this in the preparations for Barry to come ahead of shore. Patients were ahead of schedule to carry non-access to their normal schedules. Lots are on concentrated oxygen at homes or places of work and if they don’t have reliable power their access has a stopwatch ticking. Home I.V. therapy, the same thing. Home I.V. therapy pumps work great as they are plugged into the wall. As soon as you have taken away standard electricity and they are on battery, you have that stop washing working against you and if local medical support cannot access these patients because of transportation impact, your problems are multiplying.

Power loss at medical service companies, direct impact like the home I.V. therapy. If they cannot get out of their house or access their patients there is a gap it will have to be dealt with in your planning. Hospitals always have generators, but how much fuel do they have in terms of run time?  Where are the generators physically located if they are in the basement, this is a problem if the hospital floods this was driven home in a number of places, especially during the floods in Dallas years ago.

Radio communications backup, radio is a critical part to E. M. S. field response that is how you get medical control over your medics out in the field there is a limitation to how much radio equipment and training and operators there are at a typical hospital. Hospitals are chronically understaffed for a number of reasons. Keep that limitation in mind and try to have a Plan B. and a Plan C. for communicating if it directly hits the hospital or taking out a tower. Loss of medical refrigeration, when certain medications exceed a range of temperature they are no longer a drug and that clock starts ticking as soon as the power is out, so have a Plan B. and Plan C. and access to those who need the access, pharmacies, hospitals, clinics, field clinics, EMS.

Loss of security systems and lighting will cause a number of places to close until recently a policy in major hotels if the power drops they had to get everybody out of the hotel. If the power dropped because of a CAT3 storm was outside in their parking lot this was problematic and this came up in several hurricanes. We had to have short discussions with the hotels to keep them from dumping people into the storm. If you plan for it now, it won’t surprise you during the real ones.

Next slide. There will be a couple of points of discussion during this press patience. We are not going to stop now, but I want you to consider how have passed hurricanes affected access to medical services for your clients, your constituents, your people. You have already been instructed on how to use the Q&A button and so forth on to comment to the moderators and if they can’t answer something, they will reach out to me as quickly as we can we’ll get an answer back.

Next slide. Direct citizen impacts these almost always happen, at least to some extent, higher extent, lower extent that will be the variation. Loss of home lighting and refrigeration, when the lights go out and the refrigerator stops humming tension rises in most homes. I’m a professional planner and I have a plan A., B., C., and D., but if it goes to E. there is problems. Loss of news sources. People want to know what is going on and they will go to increase lengths to find out what is going on and if they can’t get clear information, someone will make up things to tell them.

Outages will impact land lines. Land lines have to have electricity and sooner or later if the outage is severe enough, the phone lines will go down. This also takes down computer lines, this takes down a lot of things that you may or may not have planned for. Cell phones, besides the obvious impacts to the cell towers, which most jurisdictions have planned around, just having your cell phone run the battery down. How are you going to charge it up?  What is your Plan B. and C. for charging a cell phone?  Do you have a car charger you can run your vehicle and do you want to use up your fuel for the vehicle just to charge a cell phone?  There are other options and we can assist with that line of thinking if you need us to help you.

Loss of thermo stability there is a narrow range where humans are comfortable and safe and if humans involved are otherwise compromised, very old, very young, compromised immune systems, their thermo stability is a narrower range. If they are not kept warm enough or cool enough they become less and less stable and this can have a health impact. We all right addressed the hotel company’s issue that I spoke in the last slide.

Next slide. Electric shock this gets people every time so I know we have not yet communicated enough on this. Fallen power lines, if the power lines that are usually overhead are now under foot, don’t step on them. Call the electric company if you have the ability to report them. Watch out for the power lines that are still overhead but not as high as they were. If they are drooping down low enough for you to touch or your vehicle to touch there is a danger.

Flooded homes, if you can stand in a dry place, turn off the main breaker, if you can’t, have an electrician to do this. During the storm is not the time you should think about who should I call?  That is something you can plan. Never turn the power on or off or use a tool or appliance while standing in water. Really, folks, empirical evidence tells me that I had to say that.

Water damaged power tools, once you have gotten a power tool, a drill, a vacuum cleaner wet, you have to assume it is still wet until you are positive it is dried out or you can have somebody examine it. If it is plugged in and you are standing in a dry place you can unplug it and wait for an electrician to check this thing. If you’re in doubt, OK, don’t take a chance on it. It is not worth your life.

Next slide. Electric shock is a big risk for responders. I want to think about the advice you would give your volunteers, employers that are showing up to help you on thousand avoid electrocution during the response work. What are you going to warn them about?  How are you going to get the message to them and absorbed?

Next slide. Food, in the survival hierarchy you worry about breathing and shelter and then water and then food, but the very first thing people start to worry about is what am I going to eat. You can last up to three weeks without eating at all, but it is not comfortable in the slightest, again, if you have any other limiting factors it can be a positive danger. Spoiled food, contaminated food and water can make you sick if you’re one of the people who is already compromised, getting sick can kill you. This is not good. This can be planned around. If the food has been sitting in a non-running refrigerator to the point where sit now room temperature, warmer than refrigerated, it is dangerous. You have to make a judgment call and most cases, judge no. Don’t eat it that means you need a Plan B. that does not require refrigerated food. If you get sick, how are you going to get to a compromised hospital or clinic over compromised transportation systems?  You see things piling up in your way, right?  Stockpile canned food ahead of time and we’re not talking about two and a half tons of wheat or something, but have several days of nonperishable food that does haven’t to be refrigerated and stuff you doing have to heat to eat. Get that before the storm gets there because as you have seen over and over again, three to four days before the storm hits, milk and bread and so forth will evaporate from your local stores. It is gone. Keep food fresh. There are rotation schedules for canned goods, if food spoils, throw it away. Don’t take a risk on it. Canned food, if it is in a non-compromised can, you can scrub the can off and open it if you store canned goods inside, gallon-size zipper bags this will save you time because you won’t have to wash those cans off. You will have to clean off the outside of the bag before you open it up. Much simpler.

Use bottled water post event until you know your water is safe. Boil water if you have to use non-bottled water and if you’re not sure about it, boil it. There are other methods on our website and freely available in the media on how to treat water to purify it or sanitize it. If you have to have safe water to do whatever you’re doing and especially medical procedures, infant feeding things like, that use treated water, water that you know has not been compromised. If you don’t know, assume it has been compromised and treat it.

Next slide. Carbon monoxide poisoning, every single event this claims lives so we’re not done being missionaries on this subject. It is an odorless, colorless gas. It is not carbon dioxide, it is carbon monoxide. It can cause sudden illness and death. You can’t smell it. You can’t taste it. You won’t know it is there until it is too late. People might use generators and other things if electricity is out and they need to absolutely know not to use them in an enclosed area. Certainly not inside the house, but also not inside the garage. You open the garage door and you think it is plenty ventilated and you fire up the generator and they end up dead. Think about it, warn everybody you are responsible for about it and maybe we can get this killer out of the picture finally.

Next slide. Don’t use gasoline, kerosene, coal-burning equipment any of that inside your home, basement, and garage, especially the home and basement because the gases will pool in these areas and you won’t know it is there until it is too late. Outside and at least 20 feet from a door or window or air intake. Know where the air intakes are in your building. You can’t avoid the problem if you don’t know where the access points are. Use a battery backup CO detector any time you use a generator orb anything that burns fuel. If you’re using a stove, you need a CO detector because you can’t smell it or taste it. Don’t run a car or truck inside of a garage even with the garage open. This can pool the gases and it has proven to occur. Don’t heat your house with a gas oven. You should have another option for keeping warm. If you have carbon monoxide detector go off, get out. Get out of the structure right then, call 911, access some help.

Next slide. Driving through flood waters, how many times do we have to teach this?  If you can’t see the road through the water, don’t drive there. It takes far less water to sweep your car off the road than most people believe. It takes less to sweep your feet out from under you and most water that you drive through is not clean, pure water. It is muddy water. You don’t know what is in it there’s, my God, there could be logs, broken glass or alligators or dead dogs floating through this stuff, nothing you want to contact. Animals and pests, after the event, the animals will be displaced, their territory markers will be displaced but until they re-establish all of that, they will not be acting normally. Dogs turn into wolves after an event until they get their conditions back again.

Mosquitoes tend to build up, although this varies depending on the area and the season and snakes and so forth try to go to high ground trying not to drown. If your house is the only high ground, guess where they are going. Psychological harm after an event and there is a lot of data and it is very, very real. You don’t have to be in a war to have post-traumatic stress. All you have to be is after a trauma.

Cleanup from injuries, I’ve been to over 35 named disasters and I treated an awful lot of workers and homeowners and so forth from burns and nontraditional cooking methods to touching parts of the generator that they were not familiar with, lots of problems like that. Every time, the first hour after the event, people will have injuries from stepping on nails, staple guns that get them, from screw guns from taking the plywood down, common things and most of them, if they just slowed down and relaxed for a minute they would not have hurt themselves.

Mold, this is a big information problem after hurricanes, tropical storms, any weather, cyclonic weather event, mold follows this and not enough people know about it. We have lots of information on our website and there are other sources of information. Get some, all right?  Get some information on it and you won’t fear it as much, but you will be able to deal with it. It is an honest problem, especially for asthmatics or compromised respiratory is a life threat. Learn about how to avoid it, how to fix it after it happens.

Hyper and hypothermia and I said humans exist in a narrow temperature range. If you get them too warm or too cold they don’t function as well. They make dumb decisions and it’s avoidable. You know these storms are coming. You know they are going to come this year and next year and every year for the rest of our lives. Plan for this. Plan a way to get as cool as necessary, plan a way to keep as warm as necessary and as your life changes, as need your homes or your business age, change your plan. Your plan has to evolve.

Next slide. These are some links to resources. Note most of them are government there is Red Cross on there. The one I want to point out is the bottom one, spaghettimodels.com. A guy named Mike runs the site and it is a huge page with track predictions, the size of the storm, the radar, all of that is on one place. You can go to one spot and look and at least get a snapshot of how things are going with your event there are links to all of the once above that. There are links to the government agencies, there are links to Red Cross and links for tracking earthquakes and so forth. If you are a disaster professional it is one place you should know about and I get nothing from any of these people listed here, so I’m trying to give you access to information and that’s what I got. Vivi?

>> Vivi: Hi, everyone. Thank you very much, Bill that was very informative and I appreciate your years of experience and knowledge on this. Thank you, Kellee for setting up the webinar and thank you for being here today.

I’m going to build on what Bill has been talking about and go to the next step, so we know hurricanes and storms can cause all of these health problems. What can we do about it and what communication resources does C.D.C. have that your organization may be able to use this hurricane season during 2019?

Next slide, please. So we’ll talk a little bit of our work for the last two years. C.D.C. has been working on public health aspects of hurricanes for many years and a lot of the way we do things now has been informed by hurricane Katrina in 2005 and we work within the national response system with HHS and FEMA and cover what are the public health impacts of the disaster. In 2017 was a very intense season as you probably all remember. We had seven of the 13 named storms develop into hurricanes and we were very close to top 15 years, so we had — we saw hurricane Harvey, Maria, Irma hitting the southeast, our territories in the Caribbean and there was the hurricane in New England.

2018 was hurricane Florence and hurricane Michael and that affected my own parents in Tallahassee and I know they are still dealing with the after effects from those storms. We will talk about those on how to help people with the long term effects they are still having.

All of the things that Bill spoke about during his presentation we saw happening in 2017 and 2018. People drowned, there were carbon monoxide poisoning, people displaced, long term losses of power, contaminated drinking water, damaged and destroyed infrastructure and affected medical facilities and people were dealing with mold in their homes and other damages to their homes.

Next slide, please. So I would like to ask a question and this is something we were faced with, you know and will be faced with again and again after a storm eliminates power. We are losing our major way that we are communicating with people now, so how do we get messages out when there is no power and no Internet?  I would like to hear in the chat box how your organization does this and what plans you have for redundant communications that you lose power, Internet, and you may lose cell access as well. Here is a few after a month after hurricane Irma and Maria and the power lines were still down.

Next slide, please. So the way we approach this is we did it in a number of ways. We were reliant on radio and we also knew we would have to go back to old fashioned printed information, whether that was signs and posters at places where people were going, shelters, at FEMA, recovery centers where people are applying for assistance, grocery stores and hardware stores and we were able to work with the U.S. postal services and with the territory to put together a one-page flyer to get into 50,000 mailboxes within the territory. If you only have one page to tell people everything they need to do to stay safe after a hurricane, what messages do you include and this was a conversation that C.D.C. has closely with the department of health and Virgin islands and other partners trying to determine what was the specific health effects that were particularly affecting the audience and what information could we give them that was actionable?  We wanted to make sure the things we were telling them was achievable, things they could do to protect themselves, and so we choice to discuss safety of food and water, protecting from mosquitoes, being safe while cleaning up and avoiding carbon monoxide poisoning and avoiding drowning, preventing infectious disease and talking about mental health, which we knew you would be long term issue.

Next slide, please. Here is an example. I want to give credit to the U.S. Virgin islands department of health for building strong preexisting relationships with radio stations and because of those preexisting relationships where you met weekly with the local radio stations in non-disaster time, we were able to leverage that relationship to get information out over the radio and a lot of people didn’t have power in their homes. They listened to radio in their cars and were able to get fuel for their cars so that was a major way people received information in the weeks after the hurricane.

Next slide, please. We went to health fairs and shared printed information in collaboration with the department of health. Next slide, please. This is the display we had at the hardware store. When you want to remove mold, you won to remove barriers, so we worked with the hardware stores to ask them to pull together everything a person would need to clean mold out of their house and have a sample kit and checklist and a shopping list that people could use so they could get the brushes, gloves, and the cleaners that they were going to use all at once.

Next slide, please. We also knew that outside of the affected areas were a great number of people who wanted to help and worried about their families, but they didn’t know the best way to reach out to their families, they did not know the right information to send to them. We created a one-stop shop for family members and friends in affected areas. This has been adopted so it can be used during any hurricane or storm as a way for people to share information with their friends and social media, text messages that you can copy and paste to share to their loved ones, there are phone calls, it gives them ideas of what you can mention to your loved ones if you may be in an affected area.

I want to share more of the specific materials that we have that are available on C.D.C.’s website and all of these are public access. They are free. You can download, you can print. You can share over social media. You can put them on your own website and we’re hoping in the future to provide more information to make it easier to put C.D.C. information on your own websites, so keep an eye out for that it is in the works.

Here are some public service announcements that we created about mold that were taken from mold info graphics and we put them in social media form so you can share them over Twitter and social media. Next slide. We know sending information from C.D.C., something that has video will get more shares and more attention than just a text message, so we’re trying to include video and pictures in every message we send out. We had a focus on mental health, particularly to help children affected by the disaster and we’re still seeing children and teenagers who are displaced based on the storm, many people from Puerto Rico may have moved in the aftermath or temporarily or permanently, those challenges stay with people, whether they are children or adults. It is something that can affect health for years to come and we know making sure it is something we address head on and this is helpful.

We also translate almost all of our materials is translated in English and Spanish and we are able to translate into other languages as needed depending on the audience in a particular disaster. That is something we don’t keep the materials in every language fully updated, but we know we’re making changes too often to make that realistically updated in every language, but for a certain disaster, if health departments or partners are noticing a need for a specific language we don’t have that is something we always take requests for and we’re willing to work with you and help those materials get translated into the languages they are needed in.

Next slide, please. Carbon mon objection idea is a major concern. We have done surveillance on health impacts and deaths following a storm. We also see carbon monoxide deaths. We always see driving in flood water deaths and those are two that we have been able to count. Another major way that people are affected, a category of health effects, is people who have a chronic disease whose care is affected by the storm because they are dialysis are affected by power outages or they are not able to get their medicine on time, their insulin. We are getting better at being able to count these as disaster related illnesses and injuries and deaths, so I don’t know we fully understand the scope, but it is many, many people and it is an area that we need to focus on, helping people with chronic disease get through the aftermath of the storm.

Next slide, please. National weather service does a great job with their slogan, turn around don’t drown. Our partners promote this. When there is water on the road, people will get into car accidents and it is one of the, if not the number one way people die during and after a storm.

Next slide, please. We partner very closely with SAMHSA on mental health messaging after a storm. They provide a disaster distress hotline that gets a lot of use after a natural disaster and so one thing that we as partners can do is promote this and help people know. They have a way you can text to it instead of talk if you don’t want to talk on the phone because many people are more comfortable with texting or they have text access when they don’t have talk access after a storm.

Next slide, please. So now we will talk a little bit about how do we make sure we’re on the same page with all of our partners and this affects the C.D.C. itself. C.D.C. is made up of a number of different centers and they each have a different focus, you have a chronic disease center, infectious disease center and Bill and I work at environmental health. How do we make sure we are coordinating internally and externally so everybody is on the same page?  I mentioned that a lot of the way we approach hurricanes now has been informed by hurricane Katrina and after that storm, C.D.C. realized that there are certain — you can divide hurricane response and recovery into different phases and plan out messaging based on the phase, so that you can anticipate the questions people will have, the health issues they will have depending on how many days it has been since the storm.

If everyone knows approximately what the phases are and they can anticipate the issues that we’ll face, it helps make sure we’re talking about the same thing at the same time and that coordination of messages increases the impact of the messages that we’re having. If people are hearing a different message from every federal agency and every partner they are not sure where to turn. They don’t know which one is the most important and they don’t know where to look, so we found that the more we can emphasize and help share our partners’ messages and be on the same page, the more impactful our messages will be.

Next slide, please. This is a basic outline, by no means does it have every topic for each phase, but I want to show you in general what it looks like in the first days before landfall and immediately after landfall you’re thinking about first, evacuation guidance, how to find a shelter, how to leave your home safely, do you have what is in your disaster kit prepared, hopefully you did that in advance power outage risk. It is days later that we get mold, it takes a few days for the mold to grow. If we’re talking about mold as the storm is hitting, people might be listening to that instead of what they should be hearing, which is staying off roads if there is water on the roads. Longer term, coping with trauma, re-entering your home safely and dealing with injuries.

Next slide, please. So the most important thing I can say is we’ve got to keep our lines of communication open with our partners. We are very appreciative that the EPIC team at C.D.C. allows us to reach all of you and let you know during a storm and we can share key messages and make sure everyone knows this is what C.D.C. is saying and we have our state partners make sure we agree on the main messages and we’re in coordination with each other to get help messages out. We know C.D.C. does not lead on every message, maybe E. P. A. or F.D.A. and we help amplify their message, so talking to each other can help that we’re in sync and agree who is in lead and when we have disagreements, we’re able to discuss them and come to a quick resolution.

Next slide, please. Here is a big, huge slide. I can tell you if you go to the top link, you find all of these other links, but I did want to pull out some that I thought were particularly important and particularly helpful. I just want to highlight a couple of items here. If you go to the hurricanes and tropical storms link, you can see there is a before guidance and after guidance. You can go to food and water safety pages that have all of the detailed information and info graphics about how long food stays safe in the refrigerator after the power goes out, how to disinfect water, like Bill said, you know we encourage use of bottled water and then boiling or disinfecting if needed and always listen to local authorities to find out what is the best approach. Boiling water can get rid of biological contaminants but not chemical contaminants. Cleanup safety material, mold, I want to highlight within the mold information, it is not only how to clean your house safely and make sure people who have — who are children or people who have immune systems issues are not there while you’re cleaning mold, but it also has information for clinicians on how to recognize diseases that may be related to mold infections and, it also has information on how to access other resources on more professional help.

Coping with a disaster, information for professionals and response workers, we work closely with the organization that focuses on workers safety. How to help loved ones where people can check on friends and loved ones in affected areas. We have a whole data site of printable educational materials and these are mostly the ones that are C.D.C. materials, but we know that partners have great materials, too. For example, the national public health coalition has a site where they have a repository for a flood communication material that includes a lot of great materials from state health departments.

Finally we have public service announcements that are audio, some are video, and some are texts that can be used for texting and sharing over the radio, so this is all that I have. Bill and I are going to take questions for a little while now. Thank you for your attention. If there is something I didn’t address that you would like to see addressed or something I don’t have the answers today, we can find the answers and get back to you.

>> Kellee: Thank you, we will transition to our Q&A session. Can you read the first question?

>> Jonathan:  First question is coming in from Daniel. Daniel is bringing up opioid addiction and the issues that brings up during an emergency. He says opioid addiction in a catastrophe is particularly problematic, especially if the DMAT teams have narcotics or thought to be holding them. How are medications, eye glass, hearing aids, wheelchair, et cetera replaced during a catastrophe?

>> Bill: Do you want me to take that one?

>> Jonathan:  Why don’t you go ahead and take that one.

>> Bill: Short answer, they are not in any coherent form. It will rely on local planning, on local capabilities. What works for Miami Beach may or may not work for Mexico City Beach. The opioid addiction problem is multifaceted. It involved chemical addiction and the mental health aspects, which have to be added in your planning, because addressing them post event is terribly problematic and will be competing other aspects of the catastrophe for attention. Please bear in mind, what you just stated, the difference between a disaster and a catastrophe. We handle emergencies every day. We handle disasters pretty well because of our planning and practice. Nobody handles a catastrophe. You get through a catastrophe and then you’re planning and your workers will get you through the after affects eventually. Catastrophes, by their very nature, destroy the system and your not going to plan your way around it. You can plan around some of the effects. Now, wheelchairs, doable goods can be stockpiled and acquired through purchase oriental, but that implies the people who need them have access to money or has access to transportation and has access to people who care in their immediate area that will see they have been evaluated and need to be reequipped that is just one item. We can help you address some of the other stuff, but all we can do is help. It is your house.

>> Jonathan:  The next question is for you Vivi. It comes from Jane. I’m going to expand a little bit, our copies of the direct mail information available for facilities to hand out to staff and families?  I know we have a lot of products as well, so way to see if you can comment on the practicality of that.

>> Vivi: That specific direct mail product was something we developed with the department of health and the Virgin Islands that was specific to that time and place. We are working on creating a more evergreen one that can be used in more situations. Right now, no, but we do have the printable material, the other once that I mentioned available on the educational material page on the resources side. If there is a specific need that you see that we don’t have on the C.D.C. website, we can use a fact sheet on this, our constituents need it and we want to have something, please let us know. You can reach out to Jonathan’s team and they can pass that on to the program so we can know what there is a need to develop. We see that as a two-way process that we want to make sure we’re creating materials that are useful for people.

I wanted to quickly mention in addition to what Bill said, HHS has a emergency prescription assistant program can help people with some and this doesn’t directly address opioid addiction, but it does help with prescription medicines that some people may not be able to access after a disaster, particularly, if they don’t have insurance. More information can be found at PhD.gov.

>> Jonathan:  Thank you. The next question I’m going to take and I’m going to address this question first, it says will there will be a class on managing volunteers post hurricane?  This gives me a great moment to plug next month’s EPIC webinar, which will be on response workers safety so look out for that. Do you know of other managing volunteers post hurricane?

>> Bill: Vivi what is that — is it VOAD?

>> Vivi: The national volunteer organization active and disaster. Yeah, that is a good resource and I think Red Cross may have some information on that topic, too.

>> Bill: That is as a one step you can do a quick search for VOAD and lots of people deal with that question and it is a huge one. At the world trade center, we had to rent six warehouses for the inappropriate donations that couldn’t be burned, couldn’t be thrown away. They were sent in good faith but inappropriate for that type of disaster and it took away precious resources and manpower and time and money to apply to what is actually wrong. Managing volunteers, managing donations  is a huge issue and there is a lot of stuff that can be taught on it and it won’t happen in this lecture, but it is available, so reach out to us.

>> Jonathan:  The next question comes from Gavin who says we have over 100 dialysis patients in our community. The 2017 hurricanes, we had 76 patients and some died, we still do not have a plan for these patients other than evacuation prior to the storm. What are others doing for a post response plan for dialysis patients?  Bill that sounds something that would be in your lane.

>> Bill: Evacuation is your best move. If they are not there to be harmed, they won’t be harmed, knowing that won’t be a 100% answer.  If they could have been evacuated, they would have. They would not be in harm’s way. There are plans available, planning organizations that can help you lean on that in a short, quick way to access some of it is to reach out to Red Cross or FEMA and access the existing planning already done on that. Bear in mind, the key components of compromised dialysis systems are supplies and access and the more planning you can put towards clean water and available power and transportation the easier it will be to deal with a dialysis crisis. In the Barry response, the predominant method of dealing with it was to dialysis them ahead of time so they had some time and the once that were so critical, so fragile, get them out of the way. There are portable dialysis and other methods to deal with this particular issue.

>> Jonathan:  Thank you. The next question comes from A. Messer who asks if C.D.C. has advice for state UOC’s who are working with situation where is people might have pet emergencies.

>> Bill: Go for that one. You are shaking your heads.

>> Vivi: I’m assuming you are mean people who want to protect their pets, cats and dogs during a disaster.

>> Jonathan:  That is the interpretation, yes.

>> Vivi: We do have a web page on our disaster website that is focused on helping your pets during a disaster, helping people locate pet-friendly shelters and some considerations. We recommend that in a disaster kit that people have for their family that they include food and water for every pet in the household and it is certainly something that we know happens. We never want to see someone who is unable to evacuate or doesn’t want to evacuate because they are worried about their pet, you know, many people believe it is an important part of their family, so they want to make sure people know how to get help for their pets and their other family members.

>> Bill: One preparation you can carry out right now to get ready for the next one is to have accurate, printed history on your pets and printed pictures of you and your pet, so if your pet is separated from you during the event or at a shelter environment, you can show that is mine and I own them and here is a picture of us, OK, that is available from your veterinarian, by the way. They bought into this type of preparation. Keeping good relationships with your veterinarian, they will store records on you and your pet; microchipping is an option, things like that.

>> Jonathan:  This one will go to have I have. I’m going to list some of the things that people mentioned for redundant communication methods, radio, sat phones, satellite phone, hand radio, banner planes, mobile loud speakers and live speaking at churches. Vivi, you have been deployed in this kind of a setting. What is your experience with some of these methods?

>> Vivi: Those are all great and creative ideas. Partnering with faith communities is something we definitely do. It is a good way to get information out to churches and other types of religious gatherings, some applies people are going anyway to rebuild that sense of community and they are getting a lot of leadership and good information from their pastors and Rabbis and other clergy, so we definitely want to work with them so those clergy has access to health information and resources so they can share them. A shout out to hand radio. When I attended the VOAD meeting a few years back and spoke with the hand radio folks and they are active in getting the information out to people.

I know we’re ending soon. I want to get out some of the resources, thank you for posting resources in the chat. I hope everyone had a chance to scroll up and down that everyone is posting for each other. One that I did not call out in my presentation, but I think is important, I mentioned during a disaster, C.D.C. shares its key messages with our partners and this past year turned the 2017 key messages document into an evergreen document that is available on the website. If you scroll up, Jamie Vasquez posted it and it is meant to be a source document on all topics for state health departments, non-government departments can use the messaging in a way that works best for their audiences. Please take a look at that if you have a chance and thank you for bringing that up.

>> Bill: Two resources we used during hurricane Andrew and subsequent storms and they will be resource specific. We used commercial blimps with the marquees to get information out at night floating over the areas that were affected. They didn’t require that the recipients have any power or anything other than the view of the night sky. The reverse call system for cell phones was used in a number of events very successfully, comes to mind, carbon monoxide warnings.

>> Jonathan:  That is great. With that, we are running out of time so I’m going to hand the floor back to Kellee.

>> Kellee: Thank you, everyone. Thanks for everyone joining us today for the webinar. If you have additional questions, if your question didn’t get answered, please do e-mail them to EPIC@CDC.GOV. Today’s presentation has been recorded and you can earn continuing education units for your participation. Please follow the instructions found on emergency.CDC.GOV/EPIC, the course code is EPIC0717 with all letters capitalized. Thank you again to everyone and goodbye.

>> Vivi: Thank you.

Page last reviewed: July 18, 2019