Multidisciplinary Response to Receiving Hurricane Matthew Evacuees and the role of the local Epidemiologist Presentation to: Presented by: Date: CSTE Disaster Epidemiology Jonathan Adriano, MPH, GA-CEM East Central Public Health District May 16, 2017
Hurricane Matthew Hurricane Matthew Forecast Track 10/3/16 http://www.nhc.noaa.gov/
http://www.weather.gov/images/mhx/highwater.jpg
Hurricane Matthew Evacuees From 10/4/16 10/10/16 Augusta, GA sheltered approximately 24k Coastal Evacuees Approximately 2800 from Savannah-Chatham County in RCBOE Schools 8 Red Cross Shelters Near 500 in Self Evacuee Shelters (3 Red Cross Shelters) residents from Carolinas I-20 corridor 7,000 Hotel rooms in Augusta (x3 per room) 21,000+
ESF-6 Mass Care, Housing and Human Services Primary Agencies American Red Cross Department of Family and Children Services Support Agencies Richmond County Health Department Augusta-Richmond County EMA Richmond County Board of Education Augusta-Richmond County Recreation Department Salvation Army United Way of the CSRA Augusta Animal Services Augusta Transportation Gold Cross EMS Augusta University Medical Center Medical Reserve Corp
Focus on the PH Response Coordination of Medical Care in Shelters Provide EH personnel to survey and inspect the shelters Conduct Shelter Surveillance for infectious disease Coordination of Shelter staffing Medical and Non-Medical Procurement of DME Durable Medical Equipment Provision of Medical Supplies for Shelters
Coordination of Medical Care in Shelters Worked with Augusta University (Former Medical College of Georgia) to develop Medical Teams to visit each shelter daily sick call visits Staffed Disaster Health Services stations at each of the shelters primarily nurses (PH, MRC, Volunteer) Established a dedicated phone line for shelter staff to call for Medical case consultation Coordinated 12 Dialysis appointments
Volunteer Coordination Coordinate nurses and medical personnel for shifts at each shelter All Volunteers for Disaster Health Services, - 205 Total Public Health Nurses _73_ East Central Health District Nurses _32_ Public Health Nurses from around the State 44 Coordination 132 medical and non-medical volunteers for the duration of the event Local Medical Reserve Corp sent in 52 (mixed)volunteers. AU provided 31 medical Emory University sent in 23 medical Bridgestone Tire 10 non-medical 2086 Total Man Hours - $82,859
Environmental Health Shelter Inspections and Surveys Richmond County Environmental Health took part in pre-event site surveys with EMA, Red Cross and the Board of Education Upon activation of the shelters, EH visited and inspected each shelter site daily Also used the visiting EH specialists to pick up shelter surveillance forms for infectious disease outbreaks from District Epidemiology
How do we measure what is going on at the shelters? Disaster Health Services PH Nurse or Volunteer Nurse stationed at each shelter site for each shift (Surveillance Forms) EMS transports as necessary (Trip Reports) Roving Medical Teams from Augusta University doing sick call to each of the shelters daily
EMS and Hospitals 53 calls from Shelters to 911 36 requiring transport to local hospitals EMS Transports to Hospitals from Local Shelters Hurricane Matthew 2016 8% 11% 3% 25% 53% AU UH Doctors Trinity VA
What types of medical conditions did we see? Chronic Diseases Hypertension and Diabetes Many forgot their meds Asthma/Chronic Bronchitis Identified need for Oxygen at shelters Mental Health Anxiety Dementia Substance abuse (Detox)
What types of medical conditions did we see? Functional needs Assistance with Activities of Daily Living Blindness 1 Baby delivered Chest Pain Colostomy issues with Medical Supplies
Shelter Surveillance and the Role of the local Epidemiologist
Epi Capacity 1 Epidemiologist to serve the East Central Health District (approximately 450,000 residents, 13 counties, near 5,198 square miles)
Shelter Surveillance Historic Shelter Operations Stays of short duration 24 hour 48 hours Local populations Hx. Tornadoes (2009), Ice Storms (2014) Catch and Release Unless expecting a large event, shelter surveillance not activated until shelters open for at least 48 hours Hurricane Evacuation? day stay before evacuees could return to the coast Non local populations Longer stays concern for communicable disease, shelter related illnesses etc. Activated Shelter surveillance within 24 hours
Shelter Surveillance forms Red Cross based Surveillance forms Locally Green Forms - Handout Disaster Health Service Forms filled out at each shift Picked up by County Environmentalists upon daily inspections Given for to District Epidemiologist for Analysis and entry in to SENDSS
SENDSS Shelter Surveillance
Flow of Surveillance Forms County Environmental Health Specialists Local Epidemiologist State Epidemiology Office
Additional Roles of Local Epidemiology Site visits to shelters to explain the role of surveillance to shelter managers, staff and nurses Identify locations in shelters to put ill people (ex. GI illness or Flu-like) Monitoring the situation and receiving calls at the District Operations Center Infection control consult for all of the shelters
Admin/Finance Nursing Health Director Epidemiology Me Emergency Preparedness
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