Emergency preparedness should include plans for infectious diseases

Emergency preparedness is on the minds of many as the 2022 Atlantic hurricane season—predicted by NOAA to have an above-average number of storms—enters its traditional highpoint during the months of August and September. Yet emergency preparedness and public health professionals will face new challenges to keeping evacuees safe with the increasing prevalence of infectious diseases such as the new COVID-19 variants and monkeypox, according to Texas A&M University Assistant Professor Angela Clendenin, PhD, MA.

In an interview with Southerly Magazine, Clendenin recommends that state, regional and local emergency officials and public health professionals take several additional steps to mitigate a potential outbreak of an infectious disease during hurricane evacuations. She also offers advice to individuals making plans for their families.

Change the paradigm

The constant evolution of COVID-19 requires a significant paradigm shift in hurricane preparedness because of the increasing potential of an infectious disease outbreak. To change the paradigm, Clendenin believes public health officials should take more of a leadership role in how we plan evacuation shelters and rethink how these facilities are laid out and staffed.

This recommended paradigm shift is based on the rapidly changing nature of infectious diseases, some of which are just emerging. As an example, Clendenin—who researches emergency management and risk communication at the Texas A&M School of Public Health—points to the latest COVID-19 variant. “This is a new variant of the pandemic virus. As a new variant, we have a lot to learn about it concerning severity and transmissibility,” she said.

Pre-emergency planning

Public health officials need to have a larger role in emergency shelter operations, Clendenin said. This is especially important as mask mandates end and vaccination rates decline, especially in U.S. Southern states that are historically more vulnerable to hurricanes. Although these changes have heightened the need for personal responsibility, evacuees may suddenly find themselves in emergency shelters surrounded by strangers who may have an infectious disease, such as one of the COVID-19 variants, the flu, salmonella, E. coli, cholera or monkeypox.

Therefore, Clendenin stressed that it’s important that public health expertise guide emergency shelter planning so that appropriate logistical support—such as requisitioning masks and COVID-19 tests and setting up testing and vaccination stations within the shelters—is in place.

Making appropriate space

Public health officials can recommend appropriate measures that will slow or stop the spread of contagious diseases in a confined area such as an evacuation center. Although many would think these recommendations only involve wearing a mask and getting the COVID-19 vaccination, other health issues such as gastrointestinal diseases can quickly become virulent. Clendenin pointed out that salmonella or E coli infections may spring up at an emergency shelter because of contaminated water, food that wasn’t properly refrigerated due to electrical outages, or inadequate restroom facilities.

Public health professionals also can identify signs of a potential outbreak. “We can watch for people who may be showing signs of respiratory illness and find space nearby where those people can then be isolated and make sure that they get the care that they need,” Clendenin said.

Because emergency operations now extend past hurricane season, officials need to continually take infectious diseases into account in their emergency management planning. Clendenin pointed to Winter Storm Uri in 2021, when the Texas power grid failed and emergency warming stations were opened across the state.

“There were issues because we had people with flu, and we had people with COVID that we needed to have a place where they could get warm,” Clendenin said. “So how do we try to set up a space where people can come in and get warm, that we can keep them far enough apart from others, so that if somebody comes in and maybe they’re asymptomatic with COVID, they’re not spreading it?”

Consider rural areas

Many American states are in rural, underserved areas that lack a true local health authority. In these cases, the state health department needs to step in and assist with community-level planning beyond just hospital preparedness.

“I think we really need to talk through evacuation plans with public health and come up with a shelter response plan for what happens when someone with a contagious disease comes in and make that part of the training from this point forward,” Clendenin told the magazine.

Individual responsibility

As the 2022 hurricane season’s primetime ramps up, officials will be calling for individuals to begin to make their hurricane preparedness plans. Because of the COVID-19 variants that continue to emerge, Clendenin encourages individuals to expand their planning even further in case they are forced to evacuate to a shelter.

She recommends that individuals receive the COVID-19 vaccination and have a box of masks and rapid tests with them. They need to be mindful of their surroundings as well as their own personal health. If they test positive, individuals should notify shelter staff of the diagnosis so they can be pointed to appropriate accommodations where they can take care of their health without putting anyone else at risk.

Through taking a public health approach to emergency preparedness planning for hurricane season, Clendenin believes the health and well-being of all individuals can be taken into account.

“Maybe COVID is this wakeup call where we start to say that we have a plan in place for people who cannot afford to evacuate somewhere else,” she said. “But we can put measures in place to protect the main part of the population in a shelter while also caring for the people who come down with an infectious condition.”

“Everyone should have a personal preparedness plan for their families and their pets. This includes evacuation plans,” Clendenin continued. “And now, even more than ever, we need to know how to protect our families from potentially getting sick if having to evacuate to a shelter.”