While the effects of Hurricane Sandy were felt up and down the east coast, the sea communities of New York and New Jersey were the hardest hit. Ocean County, N.J. saw more than 250 public health department employees working day and night to help the county’s 576,000 residents—providing medical care, shelter, clean water and even a safe place for pets.

As part of its coverage on the public health response to Hurricane Sandy, the Robert Wood Johnson Foundation created a series of videos featuring public health officials and those touched by the disaster.

>> Go here to read more about Hurricane Sandy and watched the RWJF video "Unwavering: Public Health's Dedication in the Wake of Hurricane Sandy."

In this first video, Daniel Regenye, Coordinator for the Ocean County Health Department, describes how the state of emergency brought government agencies, non-profit organizations and for-profit organizations together to meet the needs of the community in new ways. Medical needs shelters opened their doors for 24-hour-a-day service for weeks following the storm, with staff members showing incredible dedication by prioritizing the community over their own needs.

Clear, effective communication before and during a major natural disaster plays a major role in saving lives. In this video, Leslie Terjesen, Public Information Officer for the Ocean County Health Department, describes how the department shared information regarding flood preparedness; food and water safety; and keeping medical devices and equipment safe was shared in creative ways given power outages across the county.

Read more of our coverage of Hurricane Sandy.

Communities and people are at their most vulnerable during a disaster. In a crisis, the public looks to government officials to take command, provide answers and restore normalcy. Media—and increasingly social media—play a vital role in influencing public expectations in response and recovery efforts. But, are these expectations realistic? How can public health preparedness leaders and other partners shape public expectations prior to a disaster and encourage personal responsibility? How can they instill confidence in response and recovery efforts while assuring the public that activities being undertaken are in the public’s best interest?

Richard Besser, MD, is ABC News’ Chief Health and Medical Editor and previously served as acting director of the U.S. Centers for Disease Control and Prevention (CDC), where he led the agency’s response to the H1N1 influenza outbreak. He also served as director of the Coordinating Office for Terrorism Preparedness and Emergency Response at CDC. He recently moderated the session “Great Expectations: Maintaining Public Trust and Instilling Confidence Before, During, and After a Disaster,” at the Public Health Preparedness Summit 2013 in Atlanta, Ga.

>>Read more NewPublicHealth coverage from the Public Health Preparedness Summit.

NewPublicHealth spoke with Dr. Besser about how public officials should balance the needs to be both fast and correct during a disaster.

NewPublicHealth: What is most important for public health to know about communicating effectively before, during and after an emergency?

Richard Besser: It’s really important to realize that the needs in each of those different phases are very different. It’s extremely hard to get people’s attention before an event. Once there’s a signal that an event is coming, like you’ll often get with a weather event, people are interested. Using that time as a teachable moment—not just for those in the path of the event, but for everyone—is critical. The Israelis are a model for doing that. They have a lot of prepackaged messages and PSAs that they know people will be interested in when an event comes. They’ll use it as a time to teach.

During the event, you’ve got several different communication objectives. There’s what you want to achieve for people who are facing the disaster. The messages for them are messages that help them get through—safely accessing food, water and heat. In surrounding areas there are those who want to contribute and do something to help people. But then it’s also the time for those people to be prepared. The statistics on U.S. preparedness are pretty dreadful. Fewer than 10 percent of Americans have an emergency kit. That’s because people don’t believe an emergency is something that can happen to them. The statistics would say that that’s not at all true. Every state has had a natural disaster in the past 25 years. So they’re more common than people realize, but it’s easy for people to say this is something that is happening elsewhere.

Resilience is about how quickly a community bounces back to where they were before a public health emergency. But it’s not as simple as that.

“Resilience is conceptually messy. We’re all struggling with what is it and how to measure it,” said Anita Chandra, DrPH, Senior Policy Researcher and director of the behavioral and policy sciences department at the RAND Corporation.

A group of public health professionals came together at the Public Health Preparedness Summit in Atlanta, Ga. this week to discuss just how to think about, plan for, measure and improve community resilience in the face of any kind of emergency, be it a hurricane or an act of mass violence.

Part of the reason resilience is so complicated is that so many different things influence community resilience — not the least of which is how well a community is doing before an emergency hits.

“You can’t have community resilience without healthy communities,” said Jonathan Fielding, MD, MPH, MBA, director of Los Angeles County Department of Public Health. “We can’t just be concerned with what goes on in the health sector. We have to think about root causes. If we don’t think about that and sell that to others, we’re in trouble.”

On July 20, 2012, during a midnight showing at a local movie theatre in Aurora, Colorado, a gunman opened fire, killing and injuring unsuspecting moviegoers. Ultimately the massacre killed 12 and injured 57 — presenting an enormous challenge for local emergency dispatch, fire departments, police, hospitals, public health, and more, and requiring all to work together on an integrated response in the midst and the wake of a chaotic, unprecedented active shooter situation. Partners came together to share their lessons learned at the 2013 Public Health Preparedness Summit.

>>Read continued NewPublicHealth coverage from the Summit.

When the first 9-1-1 calls came in following the shooting, the University of Colorado Hospital, a level II trauma center, already had full emergency department — 49 out of 50 beds were filled.

“We’d been notified we were going to get three to five gun shot victims,” said Patrick Conroy, manager of support services and safety officer for the University of Colorado Hospital. “But we had this queasy feeling something was not quite right. We started notifying emergency services to get ready.”

"When the day comes that we’re not able to respond in the way that we think we should, that there will be a price to pay."

The U.S. Centers for Disease Control and Prevention and the National Association of County and City Health Officials (NACCHO) are among the partners hosting this week’s 2013 Public Health Preparedness Summit, which provides a national forum for public health and health care professionals, emergency managers, and other leaders to collaborate, learn, and share best practices—especially as budget cuts threaten strides that have been made to better prepare communities for disasters.

Conferences sessions include presentations on catastrophic preparedness, community resilience, biosurveillance, volunteer management, mass prophylaxis, public health law, and crisis standards of care.

NewPublicHealth will be on the ground at the Preparedness Summit in Atlanta this week covering sessions, exploring new tools at the conference expo and talking with plenary speakers and other leaders. Follow the conversation on Twitter at #PHPS13 and follow our coverage here.

In advance of the conference NewPublicHealth spoke with Jack Herrmann, senior advisor for public health preparedness at NACCHO.

NewPublicHealth: How do disasters that happen during the course of the year—such as Superstorm Sandy and the past year’s mass shootings in Colorado and Connecticut—impact the sessions at the Summit?

Jack Herrmann: Unfortunately over the last number of years we’ve always had some kind of event that we’ve had to focus on during the summit, some disaster that has occurred, so this year really is not unique. Last year we also had hurricanes and major tornadoes, and so we found ourselves having to rally around major disasters and pointing out how poignant the Preparedness Summit is because of the events that unfolded. This year, the Aurora shooting, the Newtown shooting, Hurricane Sandy and other events that have occurred really define why we all come together each year for this summit.

It is an opportunity to reflect back and remember how important it is for us to be able to prepare for events every day. I suspect many of the people who have sat in the audience never expected a disaster to occur in their community. So, it is a lesson for all of us in that we never know when disaster is going to strike and that it’s critically important that we’re always on our toes and looking for ways that we can enhance and build the preparedness efforts across our communities and across our nation.

Hurricane Sandy devastated much of the East Coast last fall, with sea communities in New York and New Jersey such as Ocean County bearing a disproportionate share of the damage. In Ocean County alone, 40,000 buildings were damaged by the storm’s monstrous gusts and floodwaters and the county suffered nearly half the damage recorded throughout New Jersey, according to the Federal Emergency Management Agency.

>>A new video produced by the Robert Wood Johnson Foundation about the public health response to Hurricane Sandy features health department officials including Dan Regenye, coordinator of the Ocean County Public Health Department, and New Jersey Health Commissioner Mary O’Dowd. Watch the video:

For more than a week after the storm ended, more than 250 employees of the public health department worked day and night to help the county’s 576,000 residents. The county provided medical needs sheltering for more than 1,000 residents, three times the number expected. And many shelters that housed displaced residents were also able to shelter their pets­–a critical need for many people who might not have evacuated otherwise.

This week at the annual Public Health Preparedness Summit hosted by the Centers for Disease Control and Prevention and the National Association of County and City Health Officials, the Ocean County Health Department will present a poster on response to and recovery from disaster. Follow NewPublicHealth coverage of the conference and other preparedness news.

In advance of the conference, NewPublicHealth spoke with Dan Regenye.

NewPublicHealth: How is your community doing?

Dan Regenye: I think it’s going to take a long time for total recovery to happen, and the reality is that it’s never going to be what it was. Some things will be better, some things will be worse. Our residents are dealing with their own personal issues and circumstances on a case-by-case basis. I think it’s the navigation part that’s so difficult for so many people between all the different agencies—local, state and federal—and private organizations. They need to look at FEMA (Federal Emergency Management Agency) maps and have to interact with insurers, contractors and others. It’s challenging.

NPH: What is the health department’s role in the recovery?

Three years after a devastating earthquake took the lives of 200,000 Haitians, displaced millions more and disrupted the public health infrastructure of the country, two new public health buildings opened yesterday in the country’s capital city of Port-Au-Prince with funding by the CDC Foundation and several partners including the Robert Wood Johnson Foundation, the GE Foundation and Kaiser Permanente. The CDC Foundation was established by Congress to forge partnerships between the Centers for Disease Control and Prevention (CDC) and corporations, foundations and individuals to support CDC's work in the U.S. and abroad.

“‘Building back better’ isn't just a slogan, it's a reality in public health. These buildings represent an important step forward to save lives in Haiti,” said CDC director Thomas Frieden, MD, MPH, at the opening in Port-Au-Prince. "These new buildings have an importance far beyond their physical presence—they will serve as a basis and catalyst for programs that will save literally tens of thousands of lives,” Frieden said.

One building replaces the Haiti Health Ministry, which was destroyed in the earthquake. The second building will house some of the ministry’s surveillance, epidemiology and laboratory staff as well as Haiti-based CDC staff, who are now working side-by-side in the country.

Representatives of the partners critical to the funding of the new buildings were on hand in Port-Au-Prince for the buildings’ ribbon cutting ceremony, including Susan Mende, senior program officer at the Robert Wood Johnson Foundation. “The earthquake in Haiti wrought great destruction and suffering to some of the most vulnerable in society as well as to the health and public health infrastructure so critical to the nation’s health,” said Mende. “The Robert Wood Johnson Foundation made a $500,000 grant to help build a public health laboratory research center to be used by Haiti’s Ministry of Public Health and Population. The Foundation recognizes that a stronger public health system is the network that protects communities, saves lives and directly improves people’s health and well being.”

To learn about the significance of the new buildings and the continuing efforts to improve public health in Haiti, NewPublicHealth spoke with Charles Stokes, president of the CDC Foundation, and Justin Tappero, MD, MPH, Director for the Health Systems Reconstruction Office in the Center for Global Health at CDC. Both were on hand for the ceremonies this week.

Three months have passed since Hurricane Sandy hit the East Coast. And while the number of people displaced by the storm has gone down from tens of thousands to the hundreds in different communities, some people are still without power or a permanent place to live. Others face the daunting task of rebuilding businesses and homes while protecting against mold and dust, which can cause or exacerbate respiratory problems. For many, the stress has rekindled mental health issues that might have been at bay, or created new ones or just made tough times even worse.

NewPublicHealth spoke with Patricia Yang, DrPH, Chief Operating Officer and Executive Deputy Commissioner at the New York City Department of Health and Mental Hygiene.

NewPublicHealth: Hurricane Sandy hit just over two months ago. How’s the city doing now?

Dr. Yang: There are people in parts of the city for whom the storm is a distant memory, and their daily lives are virtually unaffected apart from what they might hear on the news or read in the papers. But in the areas that were most directly affected by the hurricane, life for many is far from normal and may never return to what it was pre-storm. Those areas in particular are parts of the Rockaways and Coney Island and Staten Island. So there are still thousands of people who don’t have basic utilities and for whom grid power and heat have not returned. And we’re heading into the coldest winter months.

NPH: What’s the role of the public health department both now to help people deal with the aftermath, and looking ahead to prepare for the next disaster?

Just several weeks after Hurricane Sandy hit the New York City area, New York State Governor Andrew Cuomo appointed Irwin Redlener, MD, director of the National Center for Disaster Preparedness at Columbia University’s Mailman School of Public Health, to co-chair the New York State Ready Commission. The role of the Commission is to determine ways to ensure that critical systems and services are in place to respond to future natural disasters and other emergencies.

The specific areas for which the commission was asked to make recommendations include:

• Addressing vulnerabilities in the state’s health care, energy, transportation, communications and other systems
• Ensuring that new, modified and existing construction is resilient
• Ensuring the availability of adequate equipment, fuel, food, water and other emergency supplies
• Ensuring that first responders and other critical personnel are able to communicate efficiently and have access to adequate resources
• Ensuring the availability of reliable real-time information for decision-makers
• Ensuring that lines of authority are clear and officials have the authority to react rapidly to emergency situations

Both the Ready Commission and the 2100 Commission, which was tasked with finding ways to improve the resilience and strength of the state’s infrastructure in the face of natural disasters and other emergencies, submitted their reports to the governor earlier this week. Recommendations of the Ready Commission included:

• Create a statewide network of unified emergency training, coordination, protocols and communication
• Update the New York State Building Code
• Expand use of Vulnerable Populations Databases so first responders; outreach workers; and health care and human services personnel can find and serve those who may need assistance
• Require that gas stations in strategic locations have access to onsite back-up power capacity

NewPublicHealth spoke with Dr. Redlener about the Commission and the storm’s impact on New York residents.

>>Read about the 2012 edition of its Ready or Not? report from Trust for America’s Health, which looks at strengths and vulnerabilities in each state’s emergency preparedness status.

NewPublicHealth: You were appointed to co-chair the Ready Commission by Governor Cuomo in November. What is the specific focus of the Commission?

Redlener: What we are going to do is assess the current resilience of the city in terms of its preparedness efforts. Are we ready? Are we prepared? What are the missing elements right now in trying to make us more prepared for the next events than we were for this one? Some of this is not all that complicated and unfortunately these are problems that we have seen in prior disasters. Some of the things that we are seeing here were basically exactly what we saw in the Gulf and in New Orleans after Katrina. It isn’t like we haven’t been thinking about these things. I think that is why we were able to provide some reasonable recommendations, because these are not altogether new problems or challenges.

NPH: How strong is disaster preparedness training at schools of public health and within governmental public health?

Preparing for disasters like Hurricane Sandy is critical, even more so because of the massive devastation this storm has brought to Staten Island, New York, where hundreds are still without power, and thousands must rebuild their homes and businesses. Thanks to some critical partnerships that have developed among non-profits and businesses in Staten Island in the last few years, some vital relationships that help to facilitate rapid response were already in place when the super storm hit.

NewPublicHealth spoke with David Sorkin, executive director of the Jewish Community Center of Staten Island, who is a also a founding board member and past president of the Staten Island Not-For-Profit Association and former chairman of the Staten Island Economic Development Corporation Business Council.

NewPublicHealth: How did prior relationships help you serve the community when the hurricane hit?

David Sorkin: The Staten Island Not-For-Profit Association is a collective of about 150 not-for-profits on Staten Island who have been networking, training, and learning together over the past four or five years. We already had relationships and interconnections, which allowed us all to react very, very quickly to issues and concerns as well as emergencies because we have emergencies almost every day, though different from a super storm.

A “normal” emergency not related to a storm is when we have a family or an individual who’s in crisis and needs a variety of support such as economic, legal, financial, counseling or a combination of all of them. So, we work together on a regular basis. The other avenue we work through is the Staten Island Economic Development Corporation, which is a coalition of businesses on Staten Island. Because we’re a part of that, I was able to access quality services from businesses and corporations on Staten Island with good relationships already built in. So, I don’t have to worry about vetting these companies and organizations during an emergency and I know that they can come to our assistance very, very quickly.