Query: hurricane maria shelter damage

title: Disaster Related Surveillance Among US Virgin Islands (USVI) Shelters During the Hurricanes Irma and Maria Response
abstract: Two Category 5 storms, Hurricane Irma and Hurricane Maria, hit the U.S. Virgin Islands (USVI) within 13 days of each other in September 2017. These storms caused catastrophic damage across the territory, including widespread loss of power, destruction of homes, and devastation of critical infrastructure. During large scale disasters such as Hurricanes Irma and Maria, public health surveillance is an important tool to track emerging illnesses and injuries, identify at risk populations, and assess the effectiveness of response efforts. The USVI Department of Health (DoH) partnered with shelter staff volunteers to monitor the health of the sheltered population and help guide response efforts.  Shelter volunteers collect data on the American Red Cross Aggregate Morbidity Report form that tallies the number of client visits at a shelter's health services every 24 hours. Morbidity data were collected at all 5 shelters on St. Thomas and St. Croix between September and October 2017. This article describes the health surveillance data collected in response to Hurricanes Irma and Maria.  Following Hurricanes Irma and Maria, 1130 health related client visits were reported, accounting for 1655 reasons for the visits (each client may have more than 1 reason for a single visit) Only 1 shelter reported data daily. Over half of visits (51.2% were for health care management; 17.7% for acute illnesses, which include respiratory conditions, gastrointestinal symptoms, and pain; 14.6% for exacerbation of chronic disease; 9.8% for mental health; and 6.7% for injury. Shelter volunteers treated many clients within the shelters; however, reporting of the disposition (eg, referred to physician, pharmacist) was often missed (78.1% Conclusion Shelter surveillance is an efficient means of quickly identifying and characterizing health issues and concerns in sheltered populations following disasters, allowing for the development of evidence based strategies to address identified needs. When incorporated into broader surveillance strategies using multiple data sources, shelter data can enable disaster epidemiologists to paint a more comprehensive picture of community health, thereby planning and responding to health issues both within and outside of shelters. The findings from this report illustrated that managing chronic conditions presented a more notable resource demand than acute injuries and illnesses. Although there remains room for improvement because reporting was inconsistent throughout the response, the capacity of shelter staff to address the health needs of shelter residents and the ability to monitor the health needs in the sheltered population were critical resources for the USVI DoH overwhelmed by the disaster.

title: Health and Social Services in Puerto Rico Before and After Hurricane Maria: Predisaster Conditions, Hurricane Damage, and Themes for Recovery.
abstract: "In September 2017, Puerto Rico was struck by two major hurricanes Irma and Maria that intensified existing challenges in Puerto Rico's health and social services infrastructure. In the aftermath, the government of Puerto Rico created a long term recovery plan built on an evidence based assessment of the damage from the hurricanes and the ongoing needs across Puerto Rico. Development of the recovery plan was supported by the Federal Emergency Management Agency, other federal agencies, local stakeholders, and analysis from the Homeland Security Operational Analysis Center (HSOAC) operated by RAND Corporation under contract with the U.S. Department of Homeland Security. HSOAC research provided the foundation for the 31 courses of action in the recovery plan addressing the health and social services sector. These actions are a mix of social, governmental, fiscal, and economic policies and reforms. This collection of actions presents an opportunity to build a more resilient health and social services infrastructure and regional health care networks to ensure reliable access to services, promote health and well being, and more efficiently and effectively respond to public health crises and future disasters. The actions span the areas of health care, public health and emergency preparedness, environmental health, mental and behavioral health, and social services. The damage and needs assessment and courses of actions cover four major themes: building system capacity to respond both during disasters and routine times; strengthening the health and social services workforce; strengthening support services for at need populations; and creating health promoting communities.

title: Public Buildings in Puerto Rico After Hurricane Maria: Prestorm Challenges, Hurricane Damage, and Suggested Courses of Action for Recovery
abstract: The government of Puerto Rico submitted a recovery plan to Congress in 2018 describing a strategic approach to recover from the 2017 hurricane destruction. HSOAC input provides a summary of damage to public buildings and the basis for 12 courses of action to repair hurricane damage and modernize the public building infrastructure to increase resilience to natural hazards, improve energy efficiency, and improve functionality and user experience.

title: Description Analysis of Primary Care Issues in Puerto Rico after Hurricane Maria: Results from Federal Medical Shelter Manati
abstract: In September 2017, Hurricane Maria devastated Puerto Rico's health care infrastructure. To meet the demands of ongoing primary care and medical emergencies, Federal Medical Shelters (FMS) were set up to serve local communities for the weeks after the hurricane. A team of health professionals from New York assisted federal authorities in the provision of healthcare in the FMS.  To describe the population of patients requesting medical care in the aftermath of Hurricane Maria at FMS Manati and to categorize the range of problems faced by patients after the hurricane, and examine how this changed longitudinally over the course of the operation.  Researchers collected basic data of patients at presentation to the FMS. Descriptive analyses were performed of the patient population and nature of presenting illnesses. Chi squared analysis was performed to compare the change over time of presenting complaints. Ethics approval was granted by Columbia University.  Data was collected for a two week period approximately three weeks after the hurricane made landfall. The FMS saw 2,154 patients over a 14 day period. The population of patients (median age 43 years [IQR 39 years] assessed was bimodal in distribution, with one peak in children at 1 year. A second peak occurred at age 53 years. 60.2% of presenting complaints were infection or chronic disease related. Musculoskeletal complaints were the third most common. Chi squared tests revealed no statistically significant change in the frequency of specific types of complaints between the start and end of data collection.  In the weeks after Hurricane Maria, infants and elderly were seen to predominantly seek medical care. Likely related to the collapse of the healthcare infrastructure, there was a high prevalence of infection related and chronic medical conditions. The data support the need to focus resources to treat vulnerable populations, infectious issues, and chronic medical conditions.

title: After Hurricane Maria: Predisaster Conditions, Hurricane Damage, and Recovery Needs in Puerto Rico
abstract: To support development of Puerto Rico's short and long term recovery and resilience plan, experts conducted a comprehensive assessment of the commonwealth's challenges and the damage caused by the 2017 hurricanes. They identified short and longer term needs for Puerto Rico to recover and to build resilience to future storms; economic, social, and environmental trends; and ongoing governance challenges. This report summarizes their work.

title: The Education Sector in Puerto Rico After Hurricane Maria: Predisaster Conditions, Hurricane Damage, and Themes for Recovery
abstract: Presenting a strategic approach to aid Puerto Rico's recovery from Hurricanes Irma and Maria, the report details prestorm conditions, assesses damage and recovery needs, and describes courses of action for the Education sector. Analyses and discussions with local education stakeholders and subject matter experts informed the development of 13 courses of action to support Puerto Rico's recovery plan and efforts to transform the education system.

title: Municipalities on the Front Lines of Puerto Rico's Recovery: Assessing Damage, Needs, and Opportunities for Recovery After Hurricane Maria
abstract: Homeland Security Operational Analysis Center experts assessed Hurricanes Irma and Maria's effect on Puerto Rico's municipalities' ability to govern, deliver services, and recover from the damage they incurred. They created a framework for assessing municipalities' recovery and developed courses of action to address damage and improve municipal capacity.

title: Community Planning and Capacity Building in Puerto Rico After Hurricane Maria: Predisaster Conditions, Hurricane Damage, and Courses of Action
abstract: The authors describe Puerto Rico's communities in terms of population characteristics, community and individual preparedness, and economic pressures leading up to Hurricanes Irma and Maria. They detail the storms' impact in terms of damage, community stress, and migration. The researchers developed courses of action to improve capacity for emergency preparedness, coordination, communication, recovery planning, and research and training.

title: Dose Response of the Pro Inflammatory Potential Induced by Indoor Settled Dust from Homes with Different Levels of Water Damage during Hurricane Maria in San Juan, Puerto Rico

title: Associations between Upper Respiratory Symptom Scores of Puerto Rican Residents, Pro Inflammatory Potential of Indoor Settled Dust, and Level of Water Damage to Homes during Hurricane Maria