Severe Weather Event Public Health Response:

Kentucky’s Experience

CAPT (USPHS) Doug Thoroughman, PhD, MSCDC Career Epidemiology Field OfficerKentucky Department for Public Health

Ice Storm Impact on Kentucky

• Jan 26, 2009 Ice storm moves across state

• Leaves nearly 800,000 without power• Worst natural disaster in Kentucky’s

history • 36 Storm Related Deaths• 101 counties declared state of emergency

Statewide Impact

Tornado Impact on Kentucky

• March 2, 2012 severe weather event moves across state

• 15 tornados spawned– 1 tracked 86 miles– Even affected “hollers”

• 22 Tornado related deaths• 650 Homes destroyed (1600 more

damaged)

• Two communities destroyed

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Background

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West Liberty, KY

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West Liberty, KY

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Disaster Data Collection• Shelter surveillance

– Environmental– Infectious disease

• CASPER Rapid Needs Assessments

• Carbon Monoxide Poisoning Surveillance

• Tornado Injury Surveillance

• Mortality surveillance

CASPER

• Community Assessment for Public Health Emergency Response

• Epidemiologic technique to provide household-based information about an affected community’s needs after a disaster. — Identify needs— Prioritize responses— Plan for distribution of resources

• Based on WHO-EPI method

When to Conduct a CASPER

• Effect of disaster on population is unknown

• Health status and basic needs are unknown

• Concerns about specific groups or individuals (e.g. older adults, children, pregnant women)

• Response and recovery efforts evaluation

• Information needed for planning

Multi-stage Cluster Sampling

Define sampling frame (population of concern) Political boundaries Geographic boundaries Subpopulation of affected area

30 clusters/region census block probability proportional to

estimated number of housing units 7 households/cluster Data weighted to:

account for incomplete sampling provide population estimates of data collected

30 X 7 Design

CASPER in Kentucky• 2 Emergency Response Uses

– 2009 Ice Storm– 2012 Tornado Response

• 1 Health Impact Assessment• 2 Preparedness/Functional Needs

Assessments– USPHS Response Team Training Missions– National Level Exercise: Western KY– Training Mission in Eastern KY

• Strategic Plan – non-disaster CASPER use to increase PH Preparedness

CO Poisonings By Day

0

5

10

15

20

25

30

35

26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14

Num

ber o

f Cas

es

January 26 – February 14

Deaths

Confirmed Poisonings

Probable Poisonings

Sources of CO Poisoning

Deaths(%)

HBOT’s(%)

KRPC Incidents(% of incidents)

Generator 8 (80%) 16 (57%) 20 (31%)

Kerosene heater 1 (4%) 29 (45%)

Propane heater 1 (10%) 11 (17%)

Propane cooking device 5 (18%)

Indoor charcoal use 1 (10%) 5 (18%)

Vehicle running in garage 1 (4%)

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Tornado Injury Surveillance• Night of March 2nd

adapted CDC Mortality Surveillance Form

• Revised, vetted and distributed before noon March 3rd

• Tasked regional Epi’s with data collection

• Hospital ICP’s, LHD Epi’s submitted reports daily

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Surveillance Findings

Table 1. Submitted injury surveillance forms3/2 3/3 3/4 3/5 3/6 3/7 3/8

TotalF Sa Su M T W Th

Type of FacilityLong-Term Care Facilities 0 30 1 41 24 2 22 120 (59)Hospitals 3 13 3 29 9 12 3 72 (35)Shelters/Other Facilities 0 0 1 7 2 1 0 11 (6)

Total 3 (1) 43 (21) 5 (2) 77 (38) 35 (17) 15 (7) 25 (12) 203

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Surveillance Findings

Table 2. Frequencies of storm-related injuries by severity3/2 3/3 3/4 3/5 3/6 3/7 3/8 TotalF Sa Su M T W Th

Injury SeverityMinor 26 56 12 11 0 0 2 107Serious 2 27 3 2 0 0 0 34Life Threatening 1 10 1 0 0 0 0 12

Total 31 92 18 13 0 2 2 158