CDC Immersed in Massive Hurricane Relief Efforts
September 8, 2005
NOTE: This article is reprinted from CDC Connects, a CDC internal publication. It first appeared on September 8, 2005, while CDC was engaged in the initial response to Hurricane Katrina. The agency’s efforts to protect public health in the affected areas continue, through our work with our partners including state and local health departments in the affected areas.
Liz O'Mara surveys a shelter in Jackson, Mississippi. A PHA with COTPER, she
spent her second week wedding anniversary on a cot in a conference room with
ten men "who snored!" But she says, "It is an honorable experience to play a
small part of a State and local response effort. We [the Strategic National Stockpile] are not here as
individuals, but as a team. We rely on each other's commitment to their
specific responsibilities and expertise as a synchronized unit, or we simply
would not be very successful assisting with State and local needs."
Photo by Kathy Nellis
Roaring winds. Deadly waters. Desperate people. CDC began its response efforts even before Hurricane Katrina hit landfall. As early as Friday, August 26, 2005, the Director's Emergency Operations Center (DEOC) was fully staffed to monitor and track the storm progress and began daily communications with the Secretary's Operation Center at the Department of Health and Human Services.
On Monday, August 29, after Hurricane Katrina hit the gulf coast, CDC went into full activation for response, with the newly appointed Director of the Coordinating Office for Terrorism Preparedness and Emergency Response (COTPER), Rich Besser, MD, as the lead for incident management of the CDC response and relief activities.
"I'm so proud of the tremendous outpouring of support from my colleagues all across our agency, representing the much-needed subject matter expertise to respond to an emergency of this magnitude," said Besser. "It is really incredible to be part of this team."
Co-lead for public health and science for this incident in the DEOC, Tom Sinks, PhD, echoed that sentiment saying, "This is the most complex humanitarian effort that CDC has responded to in the U.S. The interest among staff from across CDC to contribute in any way necessary to this response effort has been overwhelming."
CDC's Various Roles
CDC has been responding to the multitude of requests from states for clinicians, public health assessments, environmental health screenings, epidemiologic surveillance, occupational health screenings, and vector control. As of today (Sept. 8) 202 CDC staff had been deployed to provide this support in seven states.
Phil Navin (left), has been "an absolute hero in managing the operation side
of things in DEOC," said CDC Director Julie Gerberding this week. He is shown
here with Tom Reynolds, Emergency Response Coordinator and NCEH/ATSDR's
Acting Deputy Director, Tom Sinks. Photo by Kathy Nellis
CDC's Strategic National Stockpile's (SNS) first Technical Advisory Response Unit (TARU) team of four people left Atlanta on Sunday, Aug. 28 and were on the ground in Baton Rouge, Louisiana, that night ready to receive its first supply truck with 30 pallets of materials for Federal Medical Contingency Stations (FMCS). The FMCS are 250-bed mobile units intended to provide basic non-acute care in emergency situations. The SNS has just this past year begun to establish and supply these necessary units and geared up to respond to the need of the evacuees. Each mobile FMCS has a variety of medicines, and can treat 250 patients for three days. TARU received its first shipment of material that Monday morning, about 40 minutes after the hurricane made landfall!
By Friday, Sept. 2, the SNS established FMCS units in LA and MS. Two US Marshals accompany each TARU team to provide the needed security. Steve Bice, Director of the SNS says, "Many people at CDC are working very hard to mitigate the suffering and pain we all see on the nightly news. Stockpile teams were on the ground quickly but unlike some of the disasters and terrorist incidents we've responded to over the years, Hurricane Katrina literally devastated the infrastructure that we are trained to work with. We are working with brave people in state and local areas who have very little to fall back on except their courage and inner strength. We'll get through, but the tough road lies ahead and the only way to walk it is to walk it together."
In addition to the CDC staff deployed to the affected region, CDC has sent hundreds of thousands of doses of antibiotics, maintenance medications for chronic diseases such as diabetes, heart disease, high blood pressure, pain, anxiety, and diarrhea and other conditions to the affected areas. Also included were IV supplies, adult diapers, insulin syringes and other related items. Many of the basic pharmaceuticals were in place within hours of the hurricane's passage.
How You Can Help
Ed Thompson, MD, MPH, Chief of Public Health Practice, visits a shelter at the
Coliseum in Jackson, Mississippi. Photo by Kathy Nellis
CDC's Operations Center has been fully activated in response mode at least 22 times since 9/11/01, explains CDC Director Julie Gerberding, MD, MPH. "With each operation, our ability to support the urgent mission and still retain our other work has improved, but challenges remain. We will be staffing and managing Operation Katrina as a 'marathon' and not a 'sprint'.
"CDC's call for employee volunteers for Operation Katrina has overwhelmed us with offers to assist and offers of donations of money and goods to help the hurricane survivors and their communities," she continues. "Such a generous response from the CDC family is heartening - and typical! - and very much appreciated.”
The CDC Foundation
Nikki Economou, a public health analyst with the Strategic National Stockpile,
grabbed a couple of hours of sleep on a cot in a conference room before
heading back to work. Team works in shifts, putting in long hours in demanding
circumstances. Photo by Kathy Nellis
Last week, the CDC Foundation began seeking funds for their Emergency Preparedness & Response Fund which they will make available to CDC and its partners at the state and local level to immediately obtain equipment, supplies and services that may not be readily available or that are difficult for governments to purchase quickly. On Sept. 2, Kaiser Permanente generously contributed $2 million to support public health response to Katrina.
For those employees who aren't volunteering time, but would like to donate cash to help, the American Red Cross at www.redcross.org is one information resource. The American Red Cross may also post options for those who wish to donate goods. Also, the CDC Foundation has activated their Emergency Preparedness and Response Fund to support this public health response (www.cdcfoundation.org).
Joe W. Ellis, U.S. Department of Health and Human Services (HHS) Assistant Secretary for Administration and Management, "We understand that employees have inquired about how they can make contributions to assist relief efforts. The Office of Personnel Management (OPM) has established a mechanism for giving to Hurricane Katrina relief efforts through the Combined Federal Campaign (CFC). These funds may be directed to one or more of the organizations identified as providing relief services."
Emergency response specialist Gary Goolsby unloads supplies in Mississippi. Photo by Kathy Nellis
The Hurricane Katrina response and recovery efforts are well underway, he asserts. "The Federal Government, including HHS, and State and Local governments, are providing the services needed by the people so terribly affected by this disaster. HHS employees are already in the disaster and relief areas - the Commissioned Corps has been deployed, non-Corps clinicians have been deployed, and other HHS employees are in the field providing medical care and social services. More HHS employees will be called on to fulfill the mission of the Department in the weeks and months ahead. The mission of this Department has never been more clear. We are making a positive difference in the lives of countless people."
CDC Response
Medical Officer Dori Reissman, MD, MPH, provides an update on resiliency. CDC
staff are heading to an environment where decisions are fast and furious and
the situation is constantly changing. Traumatic stress concerns are being
reported from all states, all shelters and many responders. Photo by Kathy Nellis
CDC's involvement includes the following specialties: medical, epidemiologist, sanitation, environmental health, assessment, disease surveillance, public information and health risk communication.
CDC has sent 3,500 beds and critical medications including for conditions such as diabetes, heart disease, high blood pressure, pain, anxiety, and diarrhea to the affected areas. Many of the basic pharmaceuticals were in place within hours of the hurricane's passage.
CDC deployed from its Strategic National Stockpile a 12-hour Push Package to Mississippi. A 12-hour Push Package is designed for rapid deployment and delivery, and contains a broad spectrum of medical supplies: Each 12-hour Push Package includes: oral and intravenous drugs to provide post-exposure prophylaxis and therapeutic treatment. The package also includes: catheters, IV administration sets, antiseptics, and other supplies needed to provide IV therapy and emergency medications.
CDC delivered the following vaccines to Louisiana:
- 90,000 vials of tetanus/diphtheria - treats 90,000 people
- 10,000 vials of hepatitis A vaccine - treats 22,000 people
- 10,000 vials of hepatitis B vaccine - treats 36,000 people
CDC delivered 10,000 vials of insulin to Mississippi and 20,000 vials of insulin to Louisiana.
CDC's Division of Media Relations is being bombarded by media requests. Glenn
Nowak, Acting Director, said, "A growing number of reporters, including those
who routinely cover the CDC, are arriving or heading to the New Orleans area.
We already have two press officers there, Dave Daigle and Curtis Allen, who
will be able to assist CDC teams and staff. We are establishing daily contact
with them, and other CDC public affairs people who are deployed, with the goal
being two-fold: to provide them access to the latest information and resources
from headquarters; and to learn what the media/communication needs are in the
field." Photo by Kathy Nellis
CDC launched a special flight on September 1, 2005, for rapid delivery of prescription pain medications to Louisiana. A shipment of 28 ventilator kits was also delivered to the airport in New Orleans, to aid in evacuation of patients with critical health concerns.
Disaster Area Tour
Over the weekend, Gerberding and top health officials, including HHS Secretary Mike Leavitt, Surgeon General Richard Carmona, MD, and others, took a tour of the major evacuation centers and shelters in New Orleans, Baton Rouge, Houston, Dallas, San Antonio and parts of Mississippi.
Leavitt, praised the massive health efforts underway, "led in large measure by local communities. They have responded in a remarkable way, but the extent of the crisis is draining resources." Hundreds of hospital organizations and thousands of health care professionals are standing by to help relieve those who have been working so hard for so long. CDC staff are expected to be deployed on a rotating basis, to provide assistance. "We're working on a six-month plan," said Besser.
A joint task force, including CDC, EPA, the Defense Department, the Department of Energy, the State of Louisiana and New Orleans public health officials are working together to monitor public health in the area, he explained, not only to assess public health issues but to determine when it will be safe for people to re-inhabit the area.
Commissioned Corps
Richard Besser, MD, is the new Director of the Coordinating Office for
Terrorism and Preparedness and Emergency Response (COTPER). Here he goes over
notes just before a special briefing of the Executive Leadership Board,
Management Council and Division Directors. Besser took over just days before
Hurricane Katrina struck. Photo by Kathy Nellis
Dawn Tuckey, Division of Tuberculosis Elimination, receives a tetanus shot
from Regan Hall, RN, before being deployed into the field to help with
hurricane relief efforts. Photo by Kathy Nellis
Laura Jackson-Usher packs supply kits for CDC staff being deployed. Photo by Kathy Nellis
Uniformed public health officers from the Commissioned Corps have been embedded in all major evacuation centers, announced Leavitt. "Their purpose is to be sure the medical needs of the evacuees are ascertained."
"We have probably never been involved in anything that has made the Corps so visible to the public," said Gerberding, at a special meeting of CDC's Executive Leadership Board, Management Council and Division Directors Tuesday.
DEOC Organization
To handle the massive mission facing CDC, DEOC is sharing leadership. Rich Besser, MD, is overall lead for incident management of the CDC response, Phil Navin is in charge of the Operational side, while the Public Health Science side is co-led by Tom Sinks, PhD. from NCEH, and Lisa Rotz, MD, MPH, (CAPT USPHS) from NCID during the day and Tim Mastro, MD, (CAPT USPHS) from NCHSTP and Scott Deitchman, MD, MPH (CAPT USPHS) from NCEH during the evening. The DEOC is now organized by desks related to functions.
Some of those people will be working from CDC's new headquarters building. In fact, scores have already moved in, the first residents of a building not expected to be occupied this early.
Humanitarian Assistance Team
Residents of the gulf coast states face desperate hardship in the wake of Hurricane Katrina. "People in the region, including 22 CDC employees have suffered significant personal losses. All CDC staff have been accounted for. CDC is making every effort to assist them during this trying time," said Chief Operating Officer Bill Gimson. "To address the immediate needs of our fellow employees, CDC activated the Humanitarian Assistance Team (HAT), including a hotline."
The HAT group was originally created to handle internal emergency and casualties, but its scope has been expanded. The HAT is working in coordination with the ongoing resiliency efforts underway in the DEOC. This team was established two years ago to address the needs of CDC employees who have been deployed or are working long hours on emergency situations.
"We will be letting you know in the near future how you can help these employees by donating your leave," Gimson added. "Please continue to keep our fellow employees and all the victims of this disaster in your thoughts and prayers."
Health Issues
San Antonio Evacuation Center at Kelly USAFB. CDC Director Julie Gerberding,
MD, MPH, paid a visit over the weekend, on a tour of the storm-ravaged area.
She met with the San Antonio Response Team from CDC.
A Federal Management Contingency Station (FMCS) at Pete Maravich Assembly
Center on the campus of Louisiana State University at Baton Rouge begins
receiving patients in the aftermath of Hurricane Katrina.
CDC is tasked with the lead responsibility for public health, said Gerberding. "We are preparing for the possibility of infectious diseases that could spread due to the overcrowding in the shelters, diseases such as the common cold, influenza as the season approaches, and also diarrheal diseases. The shelters are doing an amazing job of supplying hand hygiene products. We are also checking to make sure that children's immunizations are up to date. We're concentrating on tetanus immunizations for adults who may have been injured and could be at risk of infection. The biggest challenge is going to be maintaining chronic care for the people who had chronic problems before the hurricane hit. Services and support will require major investments."
CDC's public health response is urgently focused on infection control in evacuation centers, mosquito and other vector control in communities, and medical resupply to affected states from the Strategic National Stockpile.
"I'm worried about measles. I'm worried about pertussis (whooping cough)," said Marty Cetron, the quarantine chief who accompanied Gerberding on her weekend tour. "Imagine the effect in one of those shelters of one patient with multi-drug resistant TB."
HHS has committed to medical care, both urgent and ongoing, mental health services, public health, and human services. There is growing emphasis on mental health and coping strategies for individuals, community resilience, and injuries as people return to damaged communities.
While the situation is improving, the tragedy is heart-wrenching, said Gerberding. "One woman in a shelter told me it's as if all the evil people could hold was suddenly let loose at one moment."
"Our work is cut out for us," she continued. "It's unprecedented in the history of CDC. We're providing public health assessments and environmental health assessments and determining what personnel and materials are needed to get the job done. What are the threats and what can we do to mitigate and prevent disease outbreak? Our overall philosophy is that speed is crucial. Local and state governments have performed miracles, but there's more work to be done. I'm tremendously proud of CDC and how much good has been accomplished.
"And as we work to help out during this national disaster, our regular public health work can't fall by the wayside," she added. "It will take the commitment of everyone at CDC."
This Inside Story by CDC Connects reporter Kathy Nellis, with contributions from Sharon Katz and Barbara Reynolds.
Page last modified August 28, 2006