As a field assignee (FA) from CDC’s Division of State and Local Readiness, I am attached to the Massachusetts Department of Public Health’s Emergency Preparedness Bureau. I support the Bureau’s development of medical countermeasure preparedness and response capabilities as outlined in the PHEP (Public Health Emergency Preparedness) agreement between the State and CDC. Field assignees are the “on the ground” eyes and ears of CDC.
Public health was at the forefront of concern in this historical storm. Without power, homes, businesses, and healthcare facilities all lost heat. At my house it was 16 degrees below zero at 8:00 a.m. this past Sunday!
Unfortunately, there were casualties from carbon monoxide poisoning. Without heat, people turned to generators, stoves, and grills to heat their homes. People were also warming themselves up in their cars, but the exhaust pipes were clogged with snow and the CO gas backfilled into the car interior. Prevention and education are core pieces of what public health does and even though the State and the media got the word out, we tragically still had victims of CO poisoning.
In Massachusetts, public health plays a prominent role in emergency sheltering activities. When a town or city sets up an overnight or warming shelter they typically reach out to Medical Reserve Corps volunteers that are coordinated through the state health department. With an accumulation of 2-3 feet of snow, roads became impassable and all efforts to transport goods and people stopped. For safety reasons, the Governor of Massachusetts declared a statewide ban on driving. The restricted roads hindered the Medical Reserve Corps volunteers that we heavily depend upon to staff our shelters.
Hospitals were severely affected by the transportation issues caused by the snow. A major challenge that hospitals faced was the discharging of well patients to make room for those in need of care. In most cases, the statewide driving ban meant that discharged patients had no way to get home. Ambulances were re-purposed to allow them to transport discharged patients to emergency shelters.
With road closures, pharmacies shut down, too. Officials made the decision to have functioning hospital pharmacies dispense to arriving and discharged patients, and also to be the pharmacy of last resort for the general public.
An interesting development from the power outage was the people without heat that came to the hospital for warmth. In addition to patient management and medical surge challenges, these health facilities needed public health guidance as to how to care for the cold and worried.
After having experienced a number of disasters in my role as an FA, a great lesson from an emergency situation is to make sure all systems, methods, and procedures are flexible and can adjust to the rapidly changing situation. While we can do our best to prepare for events, it is imperative that we be able to adjust effectively to protect the public’s health.