From the CDC Director’s Emergency Operations Center - P.M. Update, September 28, 2005

Message from the Director:

CDC's response to Hurricanes Katrina and Rita is amazing. We have helped save many lives, provided treatment and other health services for thousands of survivors, and decreased complications from infections, injuries, and environmental health threats among workers and evacuees.

As always, people across CDC have stepped in to help wherever it is needed. More than 600 people have worked long hours in the DEOC, contributed to the many teams conducting scientific and programmatic activities in support of the operation, and accepted deployments to the Gulf Coast region. In addition, people in every center have worked extra hard in their normal jobs to fill in for those who are engaged in the emergency.

Protecting the health and resilience of the CDC workforce is always a priority and even more so when we are responding to emergencies. Some are running marathons, running them more often, and will no doubt continue to run them as emergency preparedness and response requirements become a larger core component of our agency. This requires us to develop and train our workforce, learn to pace ourselves, and take breaks to rest and enjoy our family and friends.

I'm glad to see our teams rotating members, changing leaders, and taking some days off to refresh. I also appreciate how people are pulling together and helping each other cope with long hours, personal discomforts, and missed family time. As we take care of others, I'm hoping we will always remember to take care of ourselves and each other.

I thank all who have contributed to Operation Katrina and Operation Rita, and appreciate those who will be called upon to step in now to sustain our response and recovery efforts.

Take Care!
Julie Louise Gerberding, M.D., M.P.H.

Top Line—Public Health:

The Hurricane Rita response is dynamic as CDC’s teams move forward into storm-damaged areas.

Influenza-like illnesses are being reported in evacuation centers. CDC’s outbreak control teams are responding.

Hurricane Situation Update

• To date, CDC has deployed 445 professionals to support Hurricane Katrina recovery operations and 74 to support Hurricane Rita recovery operations.
  Hurricane Rita

• U.S. Coast Guard units have rescued more than 124 people following Hurricane Rita while search and rescue patrols and damage surveys continue.

• There are more than 700 Urban Search and Rescue personnel on the ground in Louisiana performing search and rescue missions.

• Texas, Louisiana, Florida, Mississippi and Alabama have more than 34,000 National Guard soldiers and airmen positioned to assist and respond.

• There are 246 shelters housing over 73,000 Hurricane Rita evacuees nationwide.

• Texas reports five counties without water service and 582,000 customers without electrical power. Especially hard hit was the Beaumont, Texas, area and people are expected to be displaced for longer than initially thought.

Hurricane Katrina

• As of Sept. 27, 2005, reports of 1,159 Hurricane Katrina-associated deaths were received which includes reports from states directly affected by the storm and from states housing persons displaced by the hurricane.

• More than 1,440,000 registrations have been received for Financial Assistance Activity.

• More than $2.2 billion in assistance has been delivered to over 680,000 households to help meet immediate needs.

• There are 853 shelters housing over 80,000 Hurricane Katrina evacuees nationwide.

CDC Public Health Workforce Deployed in Affected Communities:

Total: 116 for Hurricane Katrina (99: 9/26) and 68 for Hurricane Rita (42: 9/26): including the following specialties: veterinarians, public health nursing, occupational, laboratory, medical, epidemiology, sanitation, environmental health, disease surveillance, public information and health risk communication

Preparing to Deploy: 22 Katrina; 5 Rita

Supporting Hurricane Katrina Director’s EOC Response: @ 600 (as of 9/28)

CDC Public Health Analysis:

Influenza:
Surveillance for influenza in hurricane affected states has been ongoing since the beginning of August. To date only one test, a rapid test from Texas done during the week of September 3, was positive for influenza A and it has a high probability of being a false positive. CDC’s outbreak control teams are investigating reports of possible influenza-like illnesses in evacuation centers.

Drug and Blood Supplies:
CDC and the Food and Drug Administration’s Center for Biologic Evaluation and Research are working to monitor and track any shortages associated with globulin products and vaccines. They are also monitoring the blood supply in areas impacted by the hurricanes. No urgent needs have been identified and regional blood supply establishments are meeting blood supply needs.

New Orleans Safe Return:
The city of New Orleans has reinitiated their reentry plan. The Greater New Orleans Public Health Support Team’s (GNOPHST) mission includes providing acute public health services during rescue and reconstruction and rebuilding the public health system for the return of residents. Critical issues involve worker safety, environmental health, health surveillance, mental health, and injury prevention.

Although Algiers’ water system is still operable after Hurricane Rita and the areas of East Jefferson, West Jefferson, Westwego, and Gretna are still on the cleared list for water, all other areas in greater New Orleans are still under a boil water order.

In the New Orleans area, about one third of hospital and clinic medical visits are related to unintentional injuries. Insect stings, falls, cuts, and blunt trauma top the list as do auto crashes. CDC is concerned about residents and workers being injured in activities related to the return and recovery process. CDC has created simple safety posters on preventing falls, chainsaw injuries, electrical hazards, and safe driving in places where traffic lights may not be functioning.

Approximately 536 food establishments in the greater New Orleans area have been inspected and approved to reopen.

The 21 new cases of West Nile that were reported from the Shreveport/Bossier City area were actually contracted and the people had symptoms before Hurricane Katrina. No new cases were reported form Orleans, Jefferson, St. Bernard, or Plaquemines parishes.

Texas:
CDC teams are moving forward to do environmental health assessments in Hurricane Rita affected areas despite spotty availability of fuel and electricity east of Houston. A federal staging area has been located at Ford Park, two miles west of Beaumont on I-10. The facility is a large convention center and food and water are being provided.

CDC is working with the Texas Department of State Health Services to conduct rapid needs assessments in areas hard hit by Hurricane Rita. Texas and CDC public health professionals are using surveys and checklists to assess health needs within shelters and in damaged communities. CDC’s experts include environmental health specialists, epidemiologists, and infection control specialists who are supported by communications, IT and logistics professionals.

Laboratories:
Select-agent laboratories in Texas and Louisiana in the path of Hurricane Rita all reported that they are secure and items are accounted for.

Public Health Recommendations: Pass it On

Pay Close Attention to the Well-being of Responders:
People who respond to crises are typically extremely committed individuals who think of others before themselves. While it is precisely their generous outlook that calls them to this work, it is imperative that they—and those who care for them—be encouraged to pay close attention to their physical and emotional well-being. The strength of responders is the engine behind rescue and recovery.

Those who respond to a crisis have the potential to become “secondary victims,” as they work long, intensive hours often under poor conditions. In some cases, physical dangers exist for responders. For those deployed away from home, personal support systems are left behind. Supervisory styles vary from person to person; and administrative organization and regulations often must change with little warning, adding additional stressors.

Most people who willingly respond to a crisis are dedicated individuals who also tend to be perfectionists. As such, they are at risk of pushing themselves too hard and of not being satisfied with what they have accomplished. With so much yet to do, they often fail to take credit for the amount of work completed and their contribution to the operation.

Frustration is common, and one’s usual sense of humor is often stretched beyond its limits. Workers become exhausted, and anger easily surfaces. The anger of others—workers, victims, media—becomes difficult to deal with, and may be experienced as a personal attack on the worker rather than as a normal response to exhaustion. Survivor guilt may emerge as workers see what others have lost.

Remember that your response efforts are a gift of yourself—your time and your caring—that you couldn’t give if you, too, were a victim.

Few of us have experience with mass death or destruction. Workers need to understand and appreciate the intensity of their emotions, and others, and talk about their feelings.

Although workers may function in superhuman ways during a disaster operation, the stress associated with this work takes its toll. Workers get tired, confused, hurt, and scared. It is critical for both the workers and those they are trying to help them understand the effects of stress and make an effort to deal with it.

Stress-relieving activities are not as difficult or time-consuming as we may think. A 15-minute walk, talking to someone, taking a “brain break” by going out to dinner or a movie, or just using deep breathing exercises, can significantly reduce stress.

During the operation, it’s important to eat nutritional foods, avoid drinking large amounts of caffeine and alcohol, get some exercise whenever possible, and get as much sleep as possible.

www.bt.cdc.gov/mentalhealth/responders.asp

Where to Find Out More About:

Free Health Education Information:
The CDC has produced free information in many languages on topics such as hand washing, returning to your home, protecting yourself from carbon monoxide poisoning and from mold. A comprehensive index of available resources can be found at: www.bt.cdc.gov/disasters/hurricanes/printindex.asp.

A number of free Public Service Announcements produced by both CDC and HHS are available at: www.bt.cdc.gov/disasters/hurricanes/psa.asp.

CDC Foundation Emergency Preparedness and Response Fund: The CDC Foundation has activated its Emergency Preparedness and Response Fund and is seeking donations. Contributions can be made online at www.cdcfoundation.org or by calling 1-888-880-4CDC.

The next CDC DEOC Hurricane Katrina update will be Friday , Sept. 30, 2005

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