Florida's 2005 hurricane season: lessons continuing to be learned.

Editor's note: This article was originally published in the spring 2006 Florida Journal of Environmental Health (No. 192), with contributions from Bob Washam of the Martin County Health Department, Melissa Brock of the Brevard County Health Department, and Um-resh Asrani of the Palm Beach County Health Department. It has been adapted, with permission, for this issue of JEH.

After two busy years of hurricanes in Florida, we should feel pretty confident in how we respond to these storms. For those who are new to environmental health or who have been fortunate enough to have avoided the excitement of responding to the aftermath of these disasters, this article describes some lessons learned by the affected counties that can make it easier next time for any county. Many of these lessons are not found in books or in planning manuals:

* Make sure staff are safe and ready to come back to work. Allow them time to handle personal issues before adding work-related problems. If their minds are preoccupied with how their family is doing or about the condition of their home, they will not be able to focus on their jobs. This lack of complete attention to work issues adds stress and safety issues to the response effort.

* Require that all staff work reasonable hours. During disasters, some staff will want to work long hours, as there are almost an unlimited number of things to do. Be aware, however, that allowing them to do so leads to burnout, short tempers, and accidents.

* Allow staff to stagger their hours. If everyone comes in at the same time, it is difficult to quickly organize everyone. It helps to have some staff start early to do the preparation work and then have others work late to distribute reports and carry out other end-of-day activities.

* Do not expect to be able to do everything after the storm. Experienced health departments have found that efficiency goes way down, communication is strained, and confusion increases. Develop priorities. Work first on the issues that will help the most people in the shortest period of time. Having an incident action plan for each day also helps to focus resources.

* Employees with a general environmental health background will become the most valuable after a storm. Specialized employees who know one program will be more limited in what they can do. Most disasters result in the need for employees who know how to measure safe temperatures, how to employ disinfectant methods appropriate to power outages and water shortages, and how to apply various sampling procedures and general sanitation concepts at all types of facilities.

* Always plan for communication devices to be of limited use or out of operation, especially for staff working in the field. In South Florida, 800-MHz radios have proven to be the most dependable method of keeping in contact with field staff. It is best to have a plan to get these radios and have them on hand before an approaching storm hits the area.

* Special-needs shelters in a hurricane-affected area will get a lot of attention. Nevertheless, do not lose sight of the needs of the general public in the community. Addressing their concerns should also be considered very important.

* Good maps are always needed, especially those with locations of facilities like group care, migrant housing, mobile-home parks, and lift stations. Having these maps ready for use in advance can assist you in making good use of resources and help you avoid wasting time.

* Remember, with every hurricane a county goes through, the job of the county health department in responding to the aftermath becomes clearer. It is never easy, but going through one makes the next one much easier. The ability to remember past lessons learned and the effective application of that knowledge will help you do a better job each time such an event occurs. Pre-event drills are nice, but it is impossible to ever know how things will really work out until a real emergency situation occurs.

* Plan to spend a lot of time with working on People First time sheet records. The requirements seem to change after every storm and it will seem especially frustrating after all the good work that has been done.

One new lesson learned in Brevard County was the benefits of using the Tracker System. Initially, there were demands for San-Pacs at several comfort stations that were opened for displaced residents. One Tracker request was submitted for all San-Pacs. The addresses of the comfort locations were listed with the Tracker request. But then some comfort stations were moved to new locations. The Tracker request was affected, and it was soon realized that it would have been more efficient to submit an individual Tracker request for each San-Pac for each location. Then, if the location of a comfort station changed, only the individual request would have to be updated.

The day immediately following Hurricane Wilma, an initial assessment was performed in Brevard County focusing on the areas most prone to flooding. During the assessment, a subdivision was discovered to have been devastated by hurricane-related flooding. When environmental health staff from the county health department arrived, they noticed helicopters flying above, and news media and local law enforcement on air boats. It quickly became obvious that the county health department had been the last to know about the extent of the flooding and its impact on the homes. Copies of several flyers addressing flooding, the dangers of flood waters, and mold-related questions were brought along, then handed out to the local law enforcement officials to distribute to residents as they returned to their homes. When the environmental health staff returned to the office, they called the local Emergency Operations Center and asked to be notified as soon as the center became aware of any other affected locations.

One thing done in Brevard County that wasn't necessarily in the county's preparedness plans but was found to be important and worked well was a public service announcement (PSA) that addressed the water-sampling needs of affected residents. The department waived all water-sampling fees for residents affected by the hurricanes.

During Hurricane Wilma, Brevard County Environmental Health Services followed the Hurricane Preparedness and Response Check-list more closely than it had the previous year, which helped the county to prepare and cope with Wilma better.

Meanwhile, at the Palm Beach County Health Department, as in prior years, Environmental Health provided support at the Emergency Operations Center/Emergency Support Function 8 (EOC/ESF-8) (Health & Medical) and conducted assessments of regulated facilities. In both 2004 and 2005, the Palm Beach County Health Department established a mini-EOC to coordinate the assessment activities and respond to calls from the public; epidemiology and environmental health employees worked together from the same location.

Since the West Palm Beach County Health Department office was closed for approximately two weeks as a result of damage, activities were conducted during that time from a special-needs room in the West Palm Beach clinic.

In an assessment of nursing homes and assisted-living facilities conducted in 2005, the Palm Beach County Health Department staff had assessed emergency needs, including food, water, ice, diapers, fuel for the generator, and medical supplies, and had coordinated the provision of these needs through the main EOC.

Another new activity performed by the Environmental Health division in Palm Beach County was the assessment of certain condominiums predominantly occupied by elderly residents to be sure that the unique needs of those residents were addressed and considered appropriately.