Disaster Surveillance: Perspectives from Federal, State, and Local levels
Authors: Bakota Eric , Atrubin David , Coletta Michael , Kite-Powell Aaron 
Published: October 2019

ObjectiveIn this panel, attendees will learn about how disaster surveillance was conducted in response to Hurricanes Irma and Harvey, as well as the role of CDC at the federal level in supporting local response efforts. By hearing and discussing the challenges faced and solutions identified, attendees will be better able to respond in the event of a low-frequency/high-consequence disaster occurring within their jurisdiction.IntroductionIn this panel, the presenters will discuss their perspective in responding to Hurricanes Harvey and Irma. Hurricane Harvey made landfall on August 25th and over the course of 4 days dropped approximately 27 trillion gallons of water on Texas and Louisiana.1 The flooding that ensued was unprecedented and forced over 13,000 people into shelters.2 These individuals needed to have their basic needs -food, shelter, clothing, sanitation- met as well as their physical and mental health needs. The George R Brown Conference Center (GRB) and NRG Stadium Center were set up as mega-shelters to house shelterees. Hurricane Irma made landfall on September 10th in the Florida Keys as a Category 4 Hurricane. The Hurricane caused 72 deaths3 and forced thousands of people into shelters.4 These weather events created novel challenges for local response efforts. Decision makers needed timely and actionable data, including surveillance data.DescriptionAt the federal level, Aaron Kite-Powell will discuss his experiences in supporting local efforts to acquire timely and actionable data collected by on-site federally deployed disaster medical assistance teams (DMAT). DMAT provided clinical services to residents who were staying in a mega-shelter. Data collected from DMAT was electronically sent to CDC through the National Syndromic Surveillance Program (NSSP) where it could be accessed in CDC's instance of ESSENCE. Additionally, in Houston, 3 area hospitals submitted their data to NSSP. The City of Houston Health Department (HHD) was given access to DMAT and hospital syndromic data through ESSENCE. Once access was established, just in time training was conducted for HHD.David Atrubin will discuss how Florida’s syndromic surveillance system was utilized during Hurricane Irma in September 2017. ESSENCE-FL provided critical near real-time surveillance data before, during, and after the storm. Multiple data sources, within the ESSENCE-FL, were utilized including emergency department, poison control, death record, and DMAT data. In addition to the anticipated increases in animal bites, injuries, medication refills, dialysis visits, and carbon monoxide exposures, some unexpected increases were observed as well.Eric Bakota will describe his experience in coordinating the remote shelter surveillance team for the City of Houston Health Department. In the immediate aftermath of the flooding, several organizations opened shelters for people who were forced to leave their homes. Many of these facilities were not officially connected to the City. An ad hoc process was used to identify and connect with these facilities. Once identified as a shelter, a team of 6 epidemiologists conducted daily check-ins to determine the census and status of shelterees. Several tools to coordinate activities and record the data collected were used, including Dropbox, Googlesheets, and MAVEN. Each tool had its own strengths and limitations that will be discussed.How the Moderator Intends to Engage the Audience in Discussions on the TopicThe moderator should engage the panelists by asking questions the following questions:● How did each panelist work with their Federal/State/Local partners● How did each panelist integrate into the larger response framework (e.g., ICS)● How did each panelist use technology to address any novel surveillance barriers during the disasterReferences1. Sanchez R, Yan H, Simon D. Harvey aftermath: Houston 'open for business'; other cities suffering. CNN. 2017 Sep 1.2. Sullivan K, Hernandez A, Fahrenthold D. Harvey leaving record rainfall, at least 22 deaths behind in Houston. Chicago Tribune. 2017 Aug 29.3. Impact of Hurricane Irma. Boston Globe. Accessed 2017 Oct 10. https://www.bostonglobe.com/news/bigpicture/2017/09/11/impact-hurricane-irma/W6WBN9K2lXd4gPmtu26auN/story.html4. Smith A. After Hurricane Irma, Many Ask: How Safe Are Shelters? Tampa Bay Times. 2017 September 21.