Responding to tropical storm Harvey

See transcript

{***Pause/Music***}

{***Noah Leavitt***}

Coming up on Harvard Chan: This Week in Health…responding to the devastation caused by Tropical Storm Harvey.

{***Rich Serino Soundbite***}

(This is not going to be a quick resolution to this. This is gonna take not weeks, not months, but years to recover from this disaster.)

In this week’s episode: We speak with Richard Serino a former deputy administrator at FEMA about the response to the storm so far in Houston and what we can expect as Harvey makes its way to Louisiana and New Orleans.

{***Pause/Music***}

{***Noah Leavitt***}

Hello and welcome to Harvard Chan: This Week in Health, it’s Thursday, August 31, 2017. I’m Noah Leavitt.

{***Amie Montemurro***}

And I’m Amie Montemurro.

{***Noah Leavitt***}

This week we’ll be focusing on the response to tropical storm Harvey which has caused devastating flooding around Houston, Texas since making landfall as a hurricane on August 26.

The storm has dumped nearly 50 inches of rain—and is being blamed for more than two dozen deaths—though that number is likely to rise.

The storm is next heading to Louisiana—where there are also concerns about flooding.

{***Amie Montemurro***}

To get an update on the response to Harvey so far—and the next steps—we spoke with Richard Serino by phone.

He served as deputy administrator of FEMA from 2009 to 2014 and is currently distinguished visiting fellow at the National Preparedness Leadership Initiative at the Harvard Chan School and Harvard Kennedy School.

{***Noah Leavitt***}

I started our conversation with Serino by asking him what’s worked well so far in terms of the emergency response.

Richard Serino: I think one of the things that has been working well has been the coordination– the communication– between the federal, the state, the local level in preparation for Harvey making landfall, and then also in the initial rescue portion of the response, as well.

One of the biggest challenges is that it’s very much still in the life safety mode– looking at how to save lives. There’s still a number of people that are trapped in homes, people that they’re still finding in their homes, and trying to get those people to safety. One of the things that we have seen that’s been very good is, along with the federal, state, and the local resources, we’ve seen a lot of neighbors helping neighbors– watching how people are able to help each other, and bringing out people with their own boats going to rescue people.

In fact, the mayor of Houston asked for people, if they have boats, to come out and help. And I think that’s an important aspect– that this is a whole community response. It’s bringing together the federal, state, and local. It’s bringing together the citizens– but also the nonprofits– the Red Cross, the Salvation Army, Team Rubicon– that are helping others, and also, going to be there for the long term. Looking at how to have people from the Southern Baptists that are going into shelters and feeding 20,000 people a day, but also the faith-based community that comes in to help them feed people, clothe people, and house people. And the businesses could step up and assist, too– the businesses that are impacted, but also, other ones in the area and throughout the country, they’re going to be able to help, as well.

Noah Leavitt: And so you mentioned that they’re very much in this life saving mode at the moment. And I think that one of the things that has stood over the past couple days is, there appears to be this almost backlog of emergency calls, because so many people are stranded. So many people need help. So as an emergency responder– as kind of a leader on the ground– what are some of the things they have to balance in terms of working through that backlog of people who do need help?

Richard Serino: One of the things is to prioritize what people’s needs are. Anybody that’s in a flooded home, that’s trapped, and they have medical conditions– serious medical conditions– those are the ones that are going to be triaged and prioritized first. If people are just in their homes with water and there’s no medical evidence, they’ll move down a little bit further, and then somebody will come to get them next.

So they’re going through a triaging and prioritizing process first. And then from there, they’ll decide where to go after that, and just take in the most severe emergencies right now with the resources that they have.

Noah Leavitt: What do you think has been unique about Harvey that has made it so devastating? I know on some level, it’s the fact that it’s almost all over the city, and just keeps dumping rain. But are there other factors at play that have made this such a devastating storm?

Richard Serino: Well, I think it’s multifaceted. These type of emergencies are very complex emergency– complex disasters. And Harvey– what’s unique, it’s the first time that we’ve had a major hurricane hit the United States in 12 years. And then on top of that, it was a large major urban area that has over 6 million people in it, that has received, as of recently, at least 49 inches of rain. And it’s still raining. And that’s totally unprecedented.

So a combination of the initial winds along the coast that caused damage and some surge– and it had a lot of damage. But now, just a little bit inland to Houston, they’ve had this 49 inches of rain that is, as I said, unprecedented. It’s tough to figure out. We have people who can go, and how they are able to get out of their homes and into a shelter.

Noah Leavitt: And this might be difficult to assess because the storm is still ongoing. But from a public health perspective, what are some of the major issues we’re seeing in Houston? I mean, are there concerns about water safety, disease outbreaks? I mean, do we have a sense of the situation in that regard?

Richard Serino: It’s a little too early for that. The people are very much aware of it. The Assistant Secretary of Preparedness and Response at Health and Human Services has a number of teams that are on site. They’ve sent a number of disaster medical assistance teams down to help staff some of the shelters where people are going, to try and get a heads up on not just the regular medical problems, but also to look at any public health potential disease outbreaks, and have a number of people there, as well. There’s a number of US public health service staff that are being deployed or are already on site. And that’s what we’re looking at is how to keep ahead of that.

Noah Leavitt: You touched on, in the beginning, that emergency responders were kind of in a good position before the storm came in. Would you say that Houston was well prepared for this storm? Are there things that first responders could have done a little bit differently?

Richard Serino: Well, it’s really even too early to look at any sort of after-action. As I said, it’s still in the life safety mode. Houston, Texas, has had a number of flooding incidents over the last number of years. They have a lot of experience.

Houston– when I was the deputy administrator of FEMA, we went down there and looked at some of the mitigation tools they have in place, both for the city and also with some of the hospitals. They were some of the best in the country.

So they’ve been preparing for flooding for quite awhile. And the Texas State Emergency Management Director, Nim Kidd, is somebody who is, again, a very experienced, very knowledgeable emergency manager. And a combination of those and the drills they’ve had have helped.

But now is not the time to criticize. Now’s the time for everybody to come together. Because no one agency can do this alone. This is something that we need to have everybody coming together, and not just save lives, but also help shelter people. Because I think that that’s going to be the next big issue is sheltering, food, and water for the tens of thousands of people that have lost their homes.

Noah Leavitt: And for people who may be watching this response just by watching news coverage, can you give a sense of the scope of the response? I mean, can you kind of describe what it does take to respond to a storm of this magnitude– the number of agencies, the number of people involved?

Richard Serino: Sure. This is in the hundreds of thousands of people that are involved in the response, from all across the nation, supporting Texas and the governor of Texas, who’s supporting the local communities. There will be representatives from all federal agencies that are involved. FEMA has sent a couple of thousand people down. There’s another thousand that will be coming down throughout Department of Homeland Security, Health and Human Services, Department of Defense, Energy, Small Business Administration, across the gamut from the federal area, are coming in to help.

But then also throughout the state, the governor has activated the entire National Guard for the state of Texas. In addition to that, all the first responders– the urban search and rescue teams from around the country– have responded. But then we also have all the voluntary agencies. I mentioned the Red Cross.

In addition to the Red Cross, there’s the Salvation Army, Samaritan’s Purse, Team Rubicon– literally hundreds of volunteer organizations that are coming in. And as I mentioned earlier, this is a complex emergency. And with complex emergencies, that’s when we need to have good coordination in order to serve the most people and get the right people to the right location at the right time.

Noah Leavitt: I think that one of the challenges, I’m guessing, of a disaster like this is that you can’t really necessarily predict how much rain will fall, what the winds will be like, until it occurs. So how do agencies try to prepare for things like this? What sort of drills can they run to be prepared for when disaster does strike?

Richard Serino: I think one of the things that’s important is to look at how people are prepared and they take the opportunity to have drills similarly. You may not know exactly how much rain is going to fall. But you certainly can prepare, as we call it, all hazards.

One of the things that we look at is, historically, in the emergency management, people look at the four C’s– communication, cooperation, coordination, and collaboration. And I add a fifth one, as well– compassion. Because I think we have to remember, it’s about the people and it’s about the survivors.

And as we start to look at this, taking all of those together really takes great leadership. And having leadership who will be the key is the way that we can bring the unity of efforts– which is now save lives– it will go to the shelter, and then, eventually, housing– and how we’re able to bringing all those people together. And we’ve seen the generosity of spirit across people with their boats. But the Red Cross– people coming in giving supplies, giving food

And now, looking at the housing issues– and we’ve so far seen, there hasn’t been any ego– no ego, no blame throughout this. So people able to come to work together. This is not going to be a quick resolution to this. This is going to take not weeks, not months, but years for them to recover from this disaster.

Noah Leavitt: And that segues well, because I had wanted to ask about the next steps. It sounds like the immediate next step after you deal with saving lives would be assessing the shelter needs for tens of thousands of people. So what are the short term next steps and, then maybe some of the longer term next steps, as you just alluded to?

Richard Serino: Well, I think they’re, again, still very much in the save lives mode now. But once that is taken care of, it’s moved to sheltering– getting people the basics they need– food, water, substance, ability to get clean and dry clothes. Once that’s taken care of, then we move into a period– we’re out of the shelter and hopefully into, at least, a hotel or Airbnb, which has offered their homes for free at no charge.

So I think looking at that– and then also, how do we now turn into short term rentals, to get people into a house for awhile. But there’s only so many openings and availability. And then that moves to that next stage– how do you develop, and how do you get housing for folks, as well?

But then you have to look at getting schools back open, once you’re getting businesses back open. And one you’re be able to get that done, then people feel a sense of community. But again, trying to keep people in their same neighborhoods where there’s total devastation is very difficult.

Noah Leavitt: So it seems like the obvious comparison here is Katrina– not just geographically, in terms of location, but also, what we’re seeing, in terms of the widespread flooding. So can you put in perspective, how does what we’re seeing in Houston now compare to what happened with Katrina more than a decade ago?

Richard Serino: Well, I think there’s a lot of differences. There was a main levee break that happened in New Orleans that people weren’t quite ready for. And that happened. And that flooded the area very quickly.

Even though this is flooded, this has happened over a period of days, as opposed to within hours. That gave people at least some time to be aware of that, as well. Also, since Katrina, there have been a lot of lessons learned. The coordination between the federal, the state, the local agencies– communication with the public– has much improved since then, as well.

Noah Leavitt: And so quickly, kind of jumping off of that, I know that the track of the storm has it next heading to Louisiana and New Orleans. What does the future hold there? Is Louisiana prepared for this? Are we likely to see some of the same damage that we’re seeing in Houston? What do you expect as the storm heads into Louisiana?

Richard Serino: It’s going to depend on the track of the storm and how much rain continues to fall with the storm. I know in Louisiana that they’ve had flooding earlier– recently. They had a large flood last year. So they are being prepared. They had some issues in New Orleans with some of the pumps that they’re trying to get rectified.

So it’s going to be a challenge if this much rain goes into New Orleans, as well. If they get 49 inches of rain in New Orleans, that’s going to cause a lot of problems there, as well.

Noah Leavitt: Just one follow-up there– is that the kind of thing when you get 49 inches of rain, that no matter how well prepared you are, that no matter how much you’ve improved the infrastructure, that you’re going to face some challenges, because that’s just such a large amount of water?

Richard Serino: That’s unprecedented amounts of water that are falling in a fairly short period of time. And anybody could deal with that anywhere– it will be a challenge. And as much as you practice, as much as you drill, we call these disasters for a reason.

This is not going to be an easy fix. This is not something that people are going to be able to just say, oh, tomorrow, we’re going to go back to normal. There’s going to be a new normal in Texas. And hopefully not, but there could be a new normal in Louisiana, as well.

August 31, 2017 — Tropical storm Harvey has caused devastating flooding around Houston, Texas since making landfall as a hurricane on August 26. The storm has dumped nearly 50 inches of rain—and is being blamed for more than two dozen deaths—though that number is likely to rise. Houston is now assessing the damage as Harvey moves to Louisiana. In this week’s episode we speak with Richard Serino, distinguished visiting fellow at the National Preparedness Leadership Initiative at Harvard T.H. Chan School of Public Health and Harvard Kennedy School and former deputy administrator of the Federal Emergency Management Agency (FEMA). Serino says that the focus in Texas and Louisiana right now is still on saving lives—then emergency responders can turn their attention to a recovery that is likely to take years.

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