Federal Epidemiology Response
to Hurricane Sandy
Amy Wolkin, MSPH
Disaster Epidemiology and Response Team
Health Studies Branch
National Center for Environmental Health
Centers for Disease Control and Prevention
National Center for Environmental Health
Division of Environmental Hazards and Health Effects
Federal Response
Disaster Epidemiology Activities
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Rapid Needs Assessment
 NYC assess mental health impact
 Modified CASPER sampling strategy
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Surveillance
Future studies with Supplemental Sandy funds
Disaster Epidemiology Activities

Rapid Needs Assessment
 NYC assess mental health impact
 Modified CASPER sampling strategy


Surveillance
Future studies with Supplemental Sandy funds
Surveillance
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Challenges to Surveillance in Disaster Settings
 Infrastructure damage
• Widespread power outages
• Damage to phone lines
 Travel challenges
• Roads flooded, washed away
• Roads blocked with downed trees and power lines
• Gasoline shortages and rationing
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Sources
 American Red Cross Morbidity Surveillance
 American Red Cross Mortality Surveillance
American Red Cross Shelter Surveillance
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Since 1987 CDC has collaborated with Red Cross on
disaster health surveillance
MOU to advance coordination of post disaster
surveillance activities
Data on disaster-related fatalities collected during
condolence visits by Red Cross volunteers
Data collected from shelters with medical stations
using client health data transmitted to CDC, analyzed
at CDC, and reported back to Red Cross and partners
Shelter Surveillance- New Jersey
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Red Cross volunteers in NJ overwhelmed; requested
assistance from CDC to collect shelter surveillance data
CDC collaborated with NJ DOH to collect shelter data
and implement a sustainable method for remote
reporting
Field team focused on largest shelters, those expecting
to remain open the longest and those with Red Cross
Health Services (21 of 93 NJ shelters)
Data sent daily to CDC; data was aggregated and
summarized in daily report
Shelter Surveillance- New Jersey
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Aggregate, syndromic data
 Captured health needs: acute, follow-up, exacerbation of chronic
condition, injury
 About 50% presented with acute symptoms; 33% follow-up care
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Data collection more complete and timely with
deployed staff; once established, process continued
with smart phones
Based on recommendations, simplified surveillance
form and created additional training materials
Alice Shumate will present results at conference –
Wednesday 10:30 Environmental Health Session
Shelter Surveillance- New York
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NY data collected via Red Cross volunteers (CDC not
deployed to assist)
Surveillance in Red Cross shelters, NY shelters (after 2
first 2 weeks)
Surveillance with outreach services
 Includes household visits, hotline calls, distribution centers, hotel
visits
 Outreach teams targeted multiple geographic areas
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Most common reason for visits were follow-up care,
mental health and exacerbation of chronic conditions
EOC Surveillance Reports
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Collate data from various surveillance sources
Create comprehensive national picture
Difficult because of varied data collection methods
Red Cross Mortality Surveillance
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Red Cross tracks disaster-related deaths to provide
condolence services to surviving family members
Actively search for reports of deaths (e.g., funeral home
directors, FEMA, hospitals, media)
Red Cross Condolence Teams (health services, disaster
mental health, spiritual care) complete Mortality Forms
Captured demographics, circumstance of death,
categorized as direct/indirect, location of injury/death
Deaths Associated with Hurricane Sandy
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Red Cross surveillance captured 117 deaths in 6 states
up to Nov. 30, 2012
 57% directly-related (34% drowning, 16% trauma)
 32% indirectly-related (e.g., CO poisoning, fall)
Deaths Associated with Hurricane SandyFindings
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Despite advances in hurricane warning and evacuation
system, drowning remains leading cause of hurricanerelated deaths (1/3 of deaths)
Over half of drowning deaths occurred in decedent's
home
Majority of homes were located in NYC evacuation zone
that flooded
Hurricane response plans should ensure persons
receive and comprehend evacuation messages and
have necessary resources to comply with them
Future studies with Supplemental Sandy funds

Characterization of morbidity and mortality among
populations impacted by Sandy
 FOA to provide research in priority areas to aid recovery from the
public health impact of Sandy
 Characterize outcomes, mental health impact, risk factors
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Study with Poison Centers to investigate CO exposures
 Survey CO exposures to understand circumstance of exposure
 Determine risk factor and prevention strategies
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Mortality surveillance evaluation
 Compare death certificates, Red Cross data, and media reports
 Determine accuracy of media reports for use as timely data
Questions?
Contact information
Amy Wolkin
ajf9@cdc.gov
770-488-3402
The findings and conclusions in this presentation are those of the authors and do not necessarily
represent the official position of the Centers for Disease Control and Prevention