Hurricane Katrina Response:

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• Hurricane Katrina Response
• Public Health Infrastructure in Action

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Harris County, Texas

• Harris County is the third largest county in
  United States
• Population of over 3.5 million people
• 1.9 million within City of Houston
• 1.2 million in unincorporated areas of Harris
  County
• 450,000 in 30 other municipalities within Harris
  County
• Large geographic area (1729 square miles)
• Diverse (geopolitically, racially, ethically,
  economically)

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Public Health is what we as a society do
collectively to assure the conditions in which
people can be healthy
The Future of the Publics Health in the 21st
Century, IOM 2003
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All-Hazards Approach to Public Health

• To prepare for the many types of threats that
  may affect the health of the people, including
  chemical, biological, radiological/nuclear and
  mass trauma.

CDC. A national public health strategy for
terrorism preparedness and response, 2003-2008.
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All-of-Public Health response to a single hazard

• Hurricane Katrina and the development of a
  full public health infrastructure at Reliant City

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Katrina Response Timeline

• August 31, 2005
• 0508 hours the call
• 0600 hours reaching out
• 0700 hours multi-agency conference call
• 0900 hours multi-agency planning meeting

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Unified Area Command
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Unified Area Command
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Katrina Response Timeline

• August 31, 2005 (continued)
• 08/31, 1300 hours Team does site visit at
  Reliant Astrodome
• 08/31, 1600 hours Reliant Astrodome opens
  shelter operations

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Reliant /Astrodome Complex

• still August 31, 2005
• 2300 hours First Buses from New Orleans arrive
  at Reliant

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Reliant Medical Branch

• and buses keep coming . . .

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Initial processing triage Over 65,000 evacuees
Reliant Center 8,000 residents
Reliant Astrodome 17,000 residents
Reliant City Town Center
Reliant Arena 2,000 residents
38,000 evacuees to other locations
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Reliant Medical Branch

• 09/01/05, 2000 hours 8,000 evacuees
• 09/02/05, 0800 hours 17,000 evacuees

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Reliant Medical Branch
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Incident Command Center
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Reliant Medical Branch
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Reliant Medical Branch
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• Staffing estimates
• 5 physicians
• 3 nurses
• 5 technicians
• 5 clerks
• 1 lab tech
• Equipment
• 16 exam rooms
• 4 isolation rooms

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Reliant Medical Branch

• now Day 2 . . .
• Reliant Arena Medical Clinic averaging 100-150
  patients/hour
• Clinic beds increase from 20 beds to 40 beds
  (plus, 40 fast-track chairs)
• EMS transport variable averaging 15-46
  patients/hour

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Reliant Medical Branch
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Reliant Medical Branch

• Sources of Epidemiological Data
• Reliant Clinic Triage Intake Surveys
• Cot-to-Cot Surveys

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GI Outbreak
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Reliant Medical Branch

• Epidemiological Data
• Design and Implementation of Prevention
  Interventions

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Reliant Medical Branch
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Reliant Medical Branch Immunization Statistics

•  
•                         
                   

Includes  Hepatitis A, Hepatitis B, Polio,
Measles, Mumps, Rubella, Prevnar, Varicella,
Haemophilus influenza and Pediarix (DTaP/HBV/IPV).
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Reliant Medical Branch
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Reliant Medical Branch
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Unified Area Command
Public Information Officer
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• and Rumor Control

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Reliant Medical Branch
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Reliant Medical Branch HCPHES - Support Resource

• HCPHES utilized over 500 staff persons
• Incident Command Structure set up at
• HCPHES Main Office
• Everyday life in the community still goes on

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Reliant Medical Branch By The Numbers

• Over 27,000 shelter residents
• Over 60,000 volunteers
• Over 50,000 hand sanitizers
• Over 5,000 mental health crisis counseling
  sessions
• Over 13,000 immunizations given
• Over 10,000 patient visits to Reliant Clinic
• Over 15,000 Rx prescribed at Reliant Clinic
• Over 1,300 patient EMS transfers
• Three (3) confirmed deaths

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Infrastructure in Action

• Assessment
• food quality
• air quality
• safety hazards
• Policy Development
• hand-washing campaign
• clothes-washing policies
• isolation procedures
• emergency public information and risk
  communications
• Assurance
• food safety inspection and enforcement
• animal management
• immunizations
• indoor and outdoor air quality enforcement
• sanitation

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• In public health, a strong infrastructure
  provides the capacity to prepare for and respond
  to both acute and chronic threats to the Nations
  health....

Healthy People 2010
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Lessons Learned

• Build relationships NOW
• Importance of National Incident Management System
  (NIMS) and Incident Command System (ICS)
  trainings - extend to anticipated partners
• Value the resourcefulness and creativity of
  employees
• Value participation of private sector
• Be prepared to be self-sustaining at local level
  for several days
• Prepare in advance for care of special needs
  populations
• Chase down and stamp out rumors
• Importance of effective volunteer management
  program
• Be flexible!!!!!!!!

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Just a few thanks

• Umair Shah, MD, MPH Medical Branch Director
  (nights)
• Ken Mattox, MD Deputy Medical Branch Director
• Tom Gavagan, MD Ambulatory Clinical Group
  Leader
• Arena Clinic Task Force Team Lead
• Kiran Smart, MD Astrodome First Aid Task Force
  Team Lead
• Doug Hamilton, MD Center First Aid Task force
  Team Lead
• Jim Stanley, MBA Public Health Surveillance
  Response Group Leader HCPHES Support
  Task Force Team Lead
• Cindy Kilborn, MPH Epidemiology Task Force Team
  Lead
• Lois Austin, RN, MSN Immunization Task Force
  Team Lead
• Janet Lane Environmental Task Force Team Lead
• Carrie Robertson, RN, MSN TB Task Force Team
  Lead
• Dawn Blackmar, DVM Veterinary Public Health
  Task Force Team Lead
• Allen Johnson Emergency Medical Group Leader
• Lt. Gary Scheibe Texas In-Processing Team Lead
• Thelma Logan EMS Task Force Team Lead
• Rita Obey Public Information Officer
• David Persse, MD Disaster Medical Unified
  Command
• GRB Medical Branch
  Director
• Kristie Lillibridge, DVM Collaborator UTSPH

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Herminia Palacio, MD, MPH Executive
Director Office 713.439.6016 Fax
713.439.6080 Email hpalacio_at_hcphes.org Website
www.hcphes.org