Tornadoes that struck Oklahoma just a few weeks ago have left more than 40 people dead, scores injured and billions in losses, including whole neighborhoods wiped out. The devastating weather of the past year—including superstorm Sandy, which wreaked havoc on the Northeast, especially New Jersey and New York City—has called even greater attention to the critical need for public health departments to be ready to respond at all times. Health departments in the communities and states where disasters happen have to be nimble enough to respond to the expected and the unexpected—as you’ll see from three interviews NewPublicHealth recently conducted with the health commissioners of New Jersey and Oklahoma, as well as with the health director of Oklahoma City, the most recent area to be rocked by severe weather.

And because disasters don’t honor state lines and devastated areas may not have the capacity on their own to handle the myriad of disaster health issues, the manpower and equipment of even far-flung health departments can be critical—making preparedness a year-round, 24/7 responsibility for everyone in public health.

Read the first installment in the series, a conversation with Terry Cline, MD, the Commissioner of Health in Oklahoma. 

NPH: With the recent tornadoes, what were you able to prepare for and what was unexpected?

Terry Cline: Unfortunately, in Oklahoma we have a lot of experience in dealing with disasters and we have what I consider to be a well-oiled machine in place. So overall, I think the response to this tragic situation went very well. The multiple tornados were a bit of a surprise though. It’s not unusual to have several tornados in the same area, but it’s unusual to have two significant tornados and then have one of those go through an urban area. I think a critical impact that was not anticipated was the flooding during the most recent tornado. The bottom line is that you need to have a strong infrastructure in place because Mother Nature has a way of always having the upper hand.

Millions of cell phone customers might have heard their phones let out a high pitched alarm and spontaneously shake yesterday afternoon. The mobile siren is an indication that the severe weather is threatening the area—and roughly 62 million Americans were in the path of severe weather along the East Coast yesterday, as the region was wracked with severe thunder storms, tornados and flooding.

The mobile shake, rattle and siren is a free service from the Federal Emergency Management Agency and many nationwide cell phone carriers. You can find out if you’re covered by pressing 6-1-1 on your cell phone, which is your carrier’s customer service line. Earlier this week a NewPublichealth reporter, unaware of the service, suddenly felt his phone shake and was alerted to potential life-threatening flooding along his commuting route.

The service is actually two years old, but to get consumers to pay attention to the alerts, and the threats they’re warning about, FEMA recently partnered with the Ad Council on a new public service announcement.

The specific warnings come through as text messages with no more than 90 characters. Categories of alerts include extreme weather, AMBER alerts indicating a child has been abducted, and Presidential alerts during a national emergency.

One of the best features of the service is that it automatically tunes to weather where you are, not where you’re from. Go on vacation to the Outer Banks of North Carolina from Missouri, for example, and you will get alerts, if needed, about whether out on the barrier island. That’s important. Gary Cox, health director of Oklahoma City, which recently saw devastating tornadoes that killed and injured scores of people, said among those killed and injured were travelers to the area who hadn’t tuned into weather forecasts and didn’t know to take cover.

>>Bonus Link: Read an FAQ from FEMA on the wireless alerts.

American Institute of Architects, Others Launch Ideas Competition to Rebuild Sustainable Communities
The American Institute of Architects (AIA), Make It Right, St. Bernard Project and Architecture for Humanity have launched a new “Designing Recovery” ideas competition to help rebuild sustainable, resilient communities in areas hit by natural disasters. The announcement came at the annual Commitment to Action at CGI America. "The cities of New Orleans, New York and Joplin are all stark reminders of the emerging threat of severe-weather disasters brought on by a changing climate,” said Eric Cesal, Director of Reconstruction and Resiliency at Architecture for Humanity. “Every city can learn from the successes and failures of these three cities and their response to disaster. Designers and architects have a responsibility to do more — and to do better. We hope this competition will draw out the best and brightest new ideas for a world of new risks." Read more on disasters.

On World Blood Donor Day, HHS Highlights Need for More Resources
Today is World Blood Donor Day. The United States is one of only 62 countries that collect 100 percent of their blood from voluntary, unpaid donors; the World Health Organization has this goal for all countries by the year 2020. About 8 million people donate blood in the United States each year. While this number is substantial, the U.S. Department of Health and Human Services (HHS) says even more donations are needed to help surgical patients, cancer patients, victims of natural disasters and people who suffer battlefield injuries.

According to HHS:

• Forty or more units of blood may be needed for a single trauma victim
• Eight units of platelets may be required daily by leukemia patients undergoing treatment
• A single pint of blood can sustain a premature infant’s life for two weeks

Read more on global health.

Supreme Court Rules Naturally Occurring Human Genes Cannot be Patented
In a unanimous decision, the U.S. Supreme Court ruled that naturally occurring human genes cannot be patented, although synthetically produced genetic material can be. The ruling struck down Myriad Genetics Inc.’s patents on the BRCA1 and BRCA2 genes linked to breast and ovarian cancer. Robert Darnell, MD, president and scientific director of the New York Genome Center, said the ruling "sets a fair and level playing field for open and responsible use of genetic information" and that “it does not preclude the opportunity for innovation in the genetic world." Read more on research.

A new study from Columbia University finds that deaths linked to a warming climate may rise by as much as 20 percent by the 2020s. The study was published in Nature Climate Change, by an interdisciplinary team at Columbia University’s Earth Institute and the Mailman School of Public Health.

“This serves as a reminder that heat events are one of the greatest hazards faced by urban populations around the globe,” said coauthor Radley Horton, PhD, a climate scientist at the Center for Climate Systems Research. In fact, although tornadoes are currently trending as the most common “weather word” right now, according to the Centers for Disease Control and Prevention, extreme heat kills more Americans each year than tornadoes, hurricanes, flooding and earthquakes combined.

Cities could be hit harder than other areas, according to the new research that found that daily records from Central Park in Manhattan show that average monthly temperatures already increased by 3.6 degrees Fahrenheit from 1901 to 2000—substantially higher than the global and U.S. trends, according to the researchers, who say that cities tend to concentrate heat. Buildings and pavement soak it up during the day and give it off at night. Last year was the warmest year on record for New York City.

Resilience is about how quickly a community bounces back to where they were before a public health emergency—and only a healthy community can do that effectively.

RWJF President and CEO Risa Lavizzo-Mourey, MD, weighed in on what it takes to create healthy, resilient communities—and shared examples of some communities that have done just that—through a post on the professional social networking site, LinkedIn. Dr. Lavizzo-Mourey is one of about 300 LinkedIn Influencers. Read an excerpt of the LinkedIn post below.

It is a testament to the American spirit that less than a day after a tornado brought a 20-mile-wide swath of death and destruction to Moore, OK, public officials and residents unequivocally pledged to rebuild the community. “We will rebuild and we will regain our strength,” Gov. Mary Fallin told a news conference after viewing the devastation.

Similar assertions were made after Hurricane Sandy wiped out entire neighborhoods on the New York and New Jersey coasts eight months ago, and I am sure they will be made again after future natural disasters. I applaud the can-do determination. But I also suggest that we take a minute and think, not just about rebuilding, but creating something better. Why not rebuild communities where health and wellness is a top priority?

Imagine rebuilding neighborhoods that make healthy living an easy and fun choice, that offer more places to safely walk or bike, more open spaces where families can exercise and play, and more restaurants that offer healthy choices and provide nutritional information on their menus.

This is not just some do-gooder’s pipe dream. New Orleans has shown us that it can be done.

Aiding in the response and recovery effort in Oklahoma following last week’s tornadoes are several state disaster medical assistance teams (DMATs), requested by Oklahoma governor Mary Fallin. The New Mexico DMAT includes a member, Cliff Rees, who is experienced in law as it pertains to public health emergencies. Rees is the practice director of the Network for Public Health Law’s Western Region.

NewPublicHealth spoke with James G. Hodge, Jr., JD, LLM, Principal Investigator/Director of the Network for Public Health Law’s Western Region, about how knowledge of law during an emergency can help speed assistance to victims.

NewPublicHealth: What is Cliff Rees’ role on the ground?

James Hodge: As a member of the DMAT team, he is well trained in many areas of response and is working with his team to provide needed assistance on multiple fronts. However, Cliff is also capable of assessing legal concerns on the ground if they come up.

NPH: What are some of those concerns?

FDA Releases Safety Checklist for ‘Hurricane Preparedness Week’
The U.S. Food and Drug Administration (FDA) has made available a Hurricane Safety Checklist for Hurricane Preparedness Week, which runs from May 26 to June 1. The list includes tips and steps to ensure water, food and medical supplies are safe not only during hurricanes, but also during flooding and lengthy power outages that may follow. Emergency medication and supplies are especially critical for those with serious health concerns or at particular risk, such as people with chronic conditions or the elderly. The checklist is also available in Spanish. Hurricane season in the Atlantic runs from June to November and in the Eastern Pacific from May 15 to November 30, according to Ready.gov. Read more on preparedness.

Study: Mother’s Obesity Surgery Decreases Child’s Risk of Obesity
A woman’s obesity surgery can reduce the risk of having an overweight or obese child later in life, according to a new study. Researchers from Laval University in Quebec, Canada looked at 20 mothers who had children before and after gastrointestinal bypass or a biliopancreatic bypass weight-loss surgeries, finding an actual genetic effect on the later offspring. They are at decreased risk of not only obesity, but also diabetes and cardiovascular disease. While the study is small, the researchers say this is the first step toward better identifying and even blocking “obese” genes. Read more on obesity.

Task Force: Screen All Pregnant Women for Gestational Diabetes after 24 Weeks
A new draft recommendation statement from the U.S. Preventive Services Task Force (USPSTF) says that all pregnant women should be screened for gestational diabetes after 24 weeks. The screening should be performed even for those women who haven’t shown symptoms. Gestational diabetes increases the risk of various labor and birth complications; the babies are also at increased risk of increased birth weight, birth injuries, glucose intolerance and childhood obesity. "It's always better to prevent a disease than to be diagnosed with one," said task force member Wanda Nicholson, MD, in a release. "Women should have a conversation with their doctor before getting pregnant or in the early stages of pregnancy about steps they can take—such as improving their diet, being physically active or other strategies—to reduce their risk of developing gestational diabetes." Read more on maternal and infant health.

The tornado that ripped through Moore, Okla., on May 20 left at least 24 people dead and nearly 400 injured. More than a mile wide in places, the tornado left billions of dollars in damage in its wake. The people of Moore and the surrounding area are now burying the friends and family members lost that day and the slow process of rebuilding has begun.

Among the first to respond to the natural disaster was Team Rubicon, a collection of hundreds of U.S. military veterans who have been provided disaster relief around the world since the organization was founded in 2010. The name for the Moore effort is “Operation: Starting Gun”—both for their quick response to the tornado’s devastation and for the Sooners of the Oklahoma Land Rush. They expect as many as 250 volunteers, of which 90 percent are veterans.

USDA and HUD Offer Housing Help for People Affected by the Tornadoes in Oklahoma
The U.S. Department of Agriculture (USDA) and the U.S. Department of Housing and Urban Development (HUD) have announced efforts to help find housing for Oklahoma residents displaced by the recent tornadoes. The USDA is offering help through its Rural Development portfolio, which has programs designed to help improve life in rural communities. HUD is offering help through foreclosure assistance, temporary housing, and federally guaranteed loans for repair. Click here for more information on HUD assistance following a disaster. Read more on disasters.

New CDC Campaign Encourages Smokers to Talk with their Doctor about Quitting
The U.S. Centers for Disease Control (CDC) and Prevention has launched a new campaign to urge smokers to speak with their doctors about strategies for quitting. CDC research finds that getting help from a physician can double the odds of quitting smoking. To help promote the campaign, CDC is partnering with five physician groups: the American Medical Association, the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, and the American Congress of Obstetricians and Gynecologists. The campaign also encourages clinicians to ask patients if they smoke and offer assistance in helping them to quit. Almost 70 percent of smokers say they want to quit, according to the National Health Interview Survey. Through the physician group partnerships, doctors will be offered training on cessation interventions. Read more on tobacco.

DOT 2013 ‘Click It or Ticket’ Campaign Focuses on Night Time Driving
The annual Click It or Ticket Campaign to increase seat belt use from the U.S. Department of Transportation (DOT) takes place around Memorial Day weekend and this year will focus attention especially on night time driving—although police officers will be on the lookout for unbuckled drivers during the day and night this weekend. While DOT data shows that daytime seat belt use is up to 86 percent, night time use of seat belts continues to be lower. According to National Highway Traffic Safety Administration, the risk of being involved in a serious crash is greater at night than during the day. In 2011, 62 percent of motorists who died in a crash that occurred at night did not have their seat belts on, buckled compared to 43 percent of those who died in a crash during the day. Read more on safety.

Immediately after the explosions at the Boston Marathon yesterday, both the U.S. Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA) updated their crisis management resources and moved the information to the top of their home pages.

Yesterday, NPR reported that business owners near the blast site are beginning to return and reopen their doors.

"They fled in a panic last week and returned both eager and anxious," said NPR reporter Tovia Smith. The piece describes how business owners returned to find food left half-eaten and rotting, because so many left in such a hurry, and blood splattered in some spots from those who were injured.

To help make sure businesses get the help they need to reopen safely, public health inspectors played a role in visiting every building on every block. "They also stood ready with trauma counselors, pro-bono attorneys and clean-up crews," said Smith.

But the public health response to any disaster goes beyond helping to restore normalcy in the immediate aftermath. An earlier interview with John Lumpkin, director of the Health Care Group at the Robert Wood Johnson Foundation, about the sustained response to Hurricane Sandy also applies here:

We saw with Katrina and are seeing again now with Sandy, [public health officials] are not only concerned with food, air, and water during and immediately after an emergency, but also with ensuring that services related to health care delivery and mental health are provided when and where they’re needed. It’s an interesting statistic, for instance, that the demand for mental health services was higher five years after Hurricane Katrina than it was immediately after the hurricane hit.

The Boston Public Health Commission announced this week, for example, that the organization has opened a new drop-in center to continue to provide emotional support to anyone affected by the Boston Marathon attack.

"While the physical injuries and destruction that resulted from the bombings might be the most visible signs of trauma, many people experience serious emotional distress based on what they saw, heard, and felt during and after the attack. Sometimes these symptoms do not surface immediately," according to the Commission release. "Understanding the deep impacts of this emotional distress, city officials opened the drop-in center as a safe place for people to come together and talk about their experiences over the past week."

>>Read more about building community resilience to recover from disaster.