Communication for the 2018 Hurricane Season - Transcript
Moderator: Haley McCalla
Presenters: Bill Rich, AAS, CEM, EMT-P; Vivi Siegel, MPH
Date/Time: June 19, 2018, 1:00pm ET
>> Good afternoon everyone. My name is Hailey McCalla from CDC’s Office of Public Health Preparedness and Response Division of Emergency Operations, and I’d like to welcome you to today’s emergency partners information connection webinar titled Communicate for the 2018 Hurricane Season. Today we will hear from CDC’s Bill Rich and Vivi Siegel who are from the National Center for Environmental Health. If you do not wish for your participation to be recorded, please exit at this time. You can earn continuing education by completing this webinar. Please follow the instructions that are linked in the invitation you received for this webinar. The course access code is Epic0619 with all letters capitalized. To repeat the course access code is capital EPIC0619. Today’s webinar is interactive. To make a comment, click the chat button on your screen and then enter your thoughts. To ask a question, please use the Q and A button. The Q and A session will begin after both presenters have presented. We will now transition to our first presenter, Bill Rich. Bill serves as the emergency management specialist and disaster planner. He helped to found the National Disaster Medical System becoming a founding member of Disaster Medical Assistance Team GA30. While at CDC, Bill has taught first responder mass casualty management, basic and advanced cardiac life support, disaster planning, and all hazards preparedness in 12 countries and numerous domestic areas. He has completed an extensive list of mission deployments as a medical officer and logistics responder. Thank you so much for joining us, Bill. We’ll bring up your slides and then you can begin.
>> Okay. Am I actually coming through? It’s a great day. Good afternoon. This will be a little different. Usually I’m stomping around on the stage intimidating people so this time we’ll be doing it by camera. You can relax. We’ll be talking about health impacts of hurricanes and the fact that they cover a lot more than people used to think they did until our multi-hurricane challenge of last year. Scroll ahead. The forecast. Everybody lives for the forecast this time of year and good thing you’re listening to that because this year is going to be about like last year depending on whose forecast you believe. I look at about 10 or 12 of them and the average of them is that we’ve got about 14 named storms supposed to show up, seven hurricanes, and three majors. That’s for the Colorado State University prediction center. They’re pretty good most years. Don’t count on the weather getting the memo. I got questioned on this bullet and climate is what you expect and weather is what you get. So if the weather does something that the prediction didn’t predict, it’s not its fault. It’s ours. And I always tell people to prepare for the worst then you’ll only have good surprises. I’m a professional pessimist. We have lots of other people that are paid to be optimists. Not me. Next. A lot of our plans are written plans rely on a 120 hour before landfall warning model. We’re not going to get many of those this year or last year as you may have noticed. A lot of our storms jumped up and 24 to 48 hours later they were already impacting the shorelines, especially the ones that came out of the Gulf. Preparing yourself is not just selfishness. How many of you jumped up today, got ready for work because you couldn’t wait to get there and be totally insignificant? Me neither. If you’re being paid to come in and work on this stuff, you’re important. We need you here. We need what you do. The only way you can do that is to make sure your family is ready for your absence while here at work whether that’s just for your shift or for multiple days like we do when we get deployed. If you have not set them up with food, water, shelter, and decision making capability, they’re not ready and you’re not ready, and it’s going to directly impact how you do your job. We need all of you so please get you and your family ready for this stuff. Not being too pessimistic but durable power of attorney is something that often gets forgotten. Direct storm impacts don’t have to — you don’t have to be right in the path of the storm to have personal and professional impacts from a hurricane or any other big storm. If a storm hits Texas hard, I’m often the first one out the door as a liaison either to Washington or to the impact area. So I’m being professionally and personally impacted right away even though I’m nowhere near the event. That happens to a lot of other folks in my audience today, and some of the worst damage, and this is something that’s happening right this second if I can point that out down in Texas is not from hurricanes. It’s from slow moving or stalled tropical storms or other large rain events. The rain is far more dangerous in my opinion than the hurricane wave and wind impacts that you see on TV all the time, and there’s a lot of people in Texas right now that can raise their hands and go, “Yes. You betcha,” because their whole lives were impacted last year by the rain much more than by the wind. Next please. Just some of the medical services that were compromised last year and had been compromised in most of the hurricanes I’ve been to, which is, I think I’m up to 35 name storms now that I’ve responded to in one form or another over the past numerous years. Dialysis clinics are a big thing for us and a big thing for the federal health and human services. We always track it. We always try to stay on top of it because they’re vulnerable. They will have issues if power is impacted, if pure water is impacted, if travel and access from their patients are impacted. The same thing for oxygen service. The home IV therapy, if they can’t get to your home you’ve got an issue. Power loss at the service companies. Hospitals with fuel storage for generators. I don’t know how many of you were in this line of work back when Texas had a lot of flooding in an area where they had built half a dozen hospitals and all of them had their generators in the basement and they all flooded out and they all were taken out of service in one day. That was tedious in the extreme. Hopefully we’ve moved beyond that. The other thing is that a lot of people, a lot of facilities have limited budgets so they don’t store as much fuel as you might think. They think in terms of the power being out for several hours if somebody hits a pole. Not in terms of power being out for a month because the flood has taken out all of the normal power distribution infrastructure. They have to be serviced. If the flood waters don’t let the trucks to service the fuel, plan B comes charging up to the front. Limited communications back up at medical facilities. Usually a hospital relies on telephones, computer linkage, and if they have an emergency room they’ll have a radio link out to the ambulance, and that’s about it. If you’re involved in this line of work, you may wish to see what plan B would be for your facility, and if you don’t have one, now is the moment. Not when the storm is beating on your windows. Loss of medical refrigeration. As soon as the refrigerator stopped working from power loss, the clock is ticking at a certain point. At a certain temperature, all of that stuff is no longer medication, is it? It is no longer allowable to be used into a human body. And this can happen at home, at the pharmacy, at the hospital, at your clinics, anywhere that the medications are stored under controlled conditions. Once those conditions are not controlled, you’ve got to stop what’s going on. Know what it is for your particular medications at your facility and know what your limits are and have a plan B and a plan C. Plan A is the one that looks really good but it’ll never work so don’t worry too much about it. Make sure B and C are up to speed. And a lot of facilities, not just medical, if you lose security because of power failure and you lose lighting, they’re going to close. How many CVS’s would stay open in the dark to hand out medications? Did you know that many motel chains and hotel chains have a policy that if the power drops, they have to get everybody out of the building. This is tedious when there’s a storm outside your building. This happened in Houston during what was it, Ike. The storm came ashore in Galveston. It ripped up all the way through Houston. It shut down the power grid. The hotels were told to dump people out in the parking lot. It took a rather [inaudible] intervention by our command group to get that stopped. This is a discussion slide. I’m not sure how we’re going to handle this but how have past hurricanes affected access to medical services for your clients? We’ve got a very big audience today. A lot of you folks have been impacted by this. Hailey, how are we doing that?
>> So people can put their responses in the chat so we can give people a couple of seconds to do so right now.
>> Boy, this is just a technical world these days. Dearly fine print challenge.
>> So we’ve got some responses coming in already. Roads have been washed out flooded. Transportation is limited or stopped. Flooding made roads inaccessible so to employees and patients. Complete shutdown before and after hurricane days.
>> Just as a stimulus, how many people remember hurricane impacts to the infrastructure and the transportation here in Atlanta from hurricanes? It’s not a new thing for us. It may be for you depending on how many years you’ve been involved with this. Hurricane Opal hit here and tore things up pretty badly while I was deployed to St. Thomas for Hurricane Marilyn. So back here our families were getting whomped while we were in a hurricane area, and I lost communication with my family for three or four days which is tedious when you’re out in a disaster already. Do you have a plan for that?
>> We had a couple of more responses about contraflow and hospital evacuation is always the emphasis especially in the ATL. Lack of pharmacies, dialysis clinic closures, store closures.
>> Okay. All of that stuff sounds about what we expected to hear. All of them are serious impacts if you are the person being impacted. We need to have a plan to either respond to it, manage it, or get around it. And we’ll have a little question and answer session later in the event. We wanted to move on. Let me see if I can get rid of a distractor. Okay. Great. Direct impacts for the citizens. They’re going to lose their power. They’re going to lose their lights on their refrigeration and their access to news, and this is horrifying. One of the major requests we get when we move into a major disaster zone, people want to find out what’s happening not just here but elsewhere like where their families are at or living or where there kids are in camp or in college. And if nobody gives them accurate news, they’ll make it up. Somebody will and rumors will run wild inside the disaster zone and that won’t help anything. Outages won’t immediately, may not immediately impact landlines because they are powered by a different system but sooner or later it’s going to shut down landline phones if any of you still have those. I do but I’m a dinosaur. Loss of cellphone charging capabilities. The phone may be working and the cell tower may be up but if you don’t have electricity where you are, how are you going to charge them? If your car is not underwater and you have a car charger, you could deal with it in that method. That’s two ifs in one sense. That’s usually a danger sign. Loss of thermostability due to heating and air conditioning failure. If you are five or six pounds overweight like I am typically, you don’t deal with heat all that well. This is something you’re going to have to deal with especially if you have gradual people in your facility or in your home. If you have folks who cannot manage their own thermostability, you’re going to have to manage it for them and you’re going to have to have a plan B and a plan C. Plan C may be moving from where they’re standing because it’s not tenable anymore. And you got to have two plans to get around because a lot of peoples plan A didn’t work in Houston. Didn’t work in Texas. Didn’t work in a lot of places. Have another plan. And we already spoke about the hotel company policies and that’s realistically that’s to limit their liability. That’s one of those plans that wasn’t thought all the way out when you have a category four hurricane dumping storm and wind out in the parking lot. This is not to the time to shove mom and pop out into the yard. Fallen power lines. Don’t touch them. Don’t walk near them. Don’t go over and take pictures of them to send to your people in other places. We don’t know if they’re live or not. You don’t know. Wait for the power guys to come by and say, “It’s safe now.” Watch out for lines that are overhead but they’re not as far overhead as they were yesterday. If they’re only 10 feet off the ground and your truck or van is 10 feet 6 inches tall, you’re going to have an issue. Flooded homes. This was a big killer and frightening event and surprise to a lot of people that didn’t think they were in a flood zone. Well, they weren’t until we had a historic level storm. If you can find a dry way to do it, turn off the power. This is counterintuitive. You don’t want to turn your own lights and air conditioning off but if the home is flooding, it’s got to happen. If you can’t do it safely don’t try. Get out and let a professional do it. And never turn the power on or off or use an electric tool or appliance while standing in water. You would think that would be a stupid bullet for me to have to put in a presentation but guess what folks? That’s like those warnings on the coffee cups that say caution contents are hot. You wouldn’t think but people have proven us wrong so there it is. Water damaged power tools. Don’t use them. You don’t know if it’s still wet inside and if you’re holding a wet power tool and hit the switch and electricity flows through it, it becomes fascinating for a few seconds. If it’s still plugged in turn the power off at the main breaker. Have any of you all seen the little spark that happens when you plug and unplug an electrical device? And wait for an electrician to check it before you use it. If you can’t, wait a long time before you test it. Next. Electric shock is a terrible thing. It almost killed me as a child. I still carry scars from it and that was a little one. Please describe the advice you’re going to give your employees, your volunteers, your co-workers to avoid electrocution during post hurricane response work. If they’re going out to do anything there, they need to be safe and what are you going to tell them to help them be safe? And I guess we’ll give you some time to accomplish that.
>> Remember if you have a response to give, click the chat button on your screen and write your response there. So one of our first responses is be aware of their surroundings and don’t move things hastily. Use situational awareness. Assess the environment and never make assumptions. Look for the usual locations for downed power lines. I think that should be a top priority when entering the location. They also say that they would have them watch a live line demo from a local utility company. And listen to authorities that tell them that they’re in the clear.
>> Okay. And again, we’re going to have Q and A available to us after mine and Vivi’s presentations. The situational awareness thing. One of my favorite sayings to new team members is don’t just do something. Stand there when you first enter the zone. Don’t rush in and start doing things until you have taken a very careful look around and made sure that the square foot you’re standing on is a place you can stay alive. If it isn’t, move. When I walked into the work zone at the World Trade Center, I looked around in total shock. At the sheer amount of destruction I was standing in, the hazards that were not dealt with. It was horrifying, and I’d been doing this for years at that point. Don’t let your new people charge off to the bus or to the plane and immediately jump in to work without checking for safety and then check it all the time. Keep your head swiveling around like you notice really experienced people doing in these events. Food. I hear a lot of contradictory advice on food and water from really well-meaning people, and that’s a shame. If it’s spoiled, if it smells bad, don’t eat it. I don’t care how hungry you are. If you’ve ever heard of the survival hierarchy you know that you can live about three minutes without air and about three hours without shelter including your clothing as shelter. You can live about three days without water and you can live about three weeks without food. It will not be comfortable or enjoyable but you can do it. So don’t make a sandwich your first priority. Look around and make sure you can breathe. Make sure you don’t go hypo or hyperthermic. Make sure that you have water to drink and then worry about food. If people get sick, they’re going to take somebody else to take care of them. You have just reduced the number of responders. This is not good. And some of this advice may or may not have worked the last year. Stockpiling canned food. I know personally of some folks in the Houston area that stockpiled a lot of stuff in their basement which was unfortunate because the water came halfway up the walls of their living room. Canned food is still food until the can is breached or damaged to the point that you can’t swear that it’s not been breached. A lot of people think the can is one solid piece of sealed metal, and it’s not. We’ve got really good Internet nowadays. Look up on the Internet how you actually put a lid on a can with food in it, and you will be horrified to find out how that’s done and then you will never trust food that has been in bad water again. Water. You got to have it within three days or the chemicals in your body stop doing what they normally do and you die. Bottled water is good most day although I have been sickened by bottled water made at places that were no longer as sanitary as they were before the storm. Boiling water is good except for certain chemicals that do not boil out of the water. Bottled water is about your best bet and the good news is that in any domestic disaster, there’s going to be billions of bottles of it around there. As soon as the rain stops falling, they’ll be truckloads of water coming in. You got to tough it out but you’ll get there. Especially for infants and old people and other folks that have problems maintaining their own body processes, use treated water. Use bottled water. Use boiled water. Don’t use just water you scoop up in a cup out of the yard. Carbon monoxide poisoning. We have to send out messaging on this every single event and every single event people that haven’t heard the messaging yet die. If you use a generator, if you use a power compressor or so forth that uses a gasoline or natural gas or any other type of fuel engine, it’s going to generate carbon monoxide. It is odorless. It is colorless. You can’t see it, smell it, taste it, and it will kill you dead as a hammer. Don’t use a generator in your garage. It looks good because it’s out where the car is so you think, “This is safe.” Well, no. Make sure that the engine that’s burning this and generating CO is outside the structure and that the wind is not blowing the exhaust back into the structure. There’s lots and lots of information on this around. Please look some of it up and then take a look at what your personal plans for you and your facility and your home are doing. I have three generators because I’m not a trusting person, but I have them set up to where they will not be the cause of us dying. 3 Charcoal. Back in my distant past which means in the Stone Age for most of you guys, a lot of folks used charcoal hibachis to cook on and some folks bring in their charcoal grills into the house because it’s raining outside the house so they don’t want to cook out there under the porch. That’s unfortunate. It generates CO also. Have a CO detector. They’re cheap. Walmart sells them every day. Don’t run your car if you’re out there plugging in your cell phone in the car to charge it up so you can call people. Don’t run it in the garage attached to the house even with the garage door open. This has taken out some otherwise really nice people in the past. Don’t heat your house with a gas oven. It can be done but it has been done unsuccessfully in the past so I’m telling you don’t do it. Find another way. Put on a sweater. If you have a CO detector and it starts beeping, get out. I don’t care if you have to stand out under an umbrella, that’s okay. It’s better than standing or starring in a funeral. Call 911. Tell them your CO detector just started beeping. Guess what they’ll tell you. Get out of the house. And other things. Oh, here’s the biggest one. The number one way that people die in a hurricane strike is not from wind damage. It’s not from the roof going away. It’s from drowning. And the number one way they drown is they drove into the water. I’ve been saying this for 30 something years, and every time the people who apparently haven’t heard me yet, there’s got to be at least 10 or 12 of them, drive into the flood waters where there was a road yesterday but now there isn’t because you can’t see into the water where it washed away things and they drown. I hate that. Animals and other pests. Dogs especially are incredibly territorial. If the storm and flooding has changed the territory, has washed away the markers that they leave, they’re going to be upset and until they reestablish territory they’re going to not behave like normal pets. They’ll walk up and bite you without barking, growling, or anything else just to establish, “Hi. This is my territory at the moment.” Be aware of them. Animals you trusted yesterday if they have been impacted by the storm, you have to reevaluate them. Psych harm. It gets really psychologically damaging to look around and realize that everything you had in the world is now washed out in the street in a pile of garbage. Besides the psychic damage it’s doing to you and your family, think of what it’s doing to your patients, to your clients, and to people around you that you would normally interact with without a second thought. Be aware that they might have just a few things on their mind right now when you deal with them. One of the things in particular never do when you’re cleaning up after a flood and everybody is hauling all of their pictures and paperwork and everything else out to the curb to be hauled away along with the sheetrock and the carpet, don’t stop and go through the piles looking for neat stuff. I watched this happen in Baton Rouge in two separate storm aftermaths and I’ll tell you folks, guns come out when you do that. You are touching the last possessions of many people and they don’t like you stopping to poke through it and especially if you poke through it and laugh at something. This is dangerous. Don’t do it. During clean up you can get hurt bad. Things are bent, broke, not in their normal place, full of nails, lots of stuff. Be careful. Watch over other people around you and make sure they’re being careful. Mold is a big issue. I’ve got totally separate lectures just on mold, and I don’t know dirt about it but we got real experts here. Call us and ask. And there’s tons and tons of information on the Internet about it. Rest assured, if it is a warm area like all of the Gulf Coast, and it’s damp which it will be after flooding and hurricanes, you’re going to have mold, period. If you can get everything dried out within 24 hours, the chances of it being dangerous to you are greatly reduced. Folks the water didn’t even go down at 24 hours. You’re surely not going to get the house dried out. Just assume that it’s there and take proper precautions and do the proper clean up and I won’t go into that in this presentation. Hypo and hyperthermia. If you’re wet and cold you’re going to lose heat and it’s going to change how your body reacts to things and you could die. If you are being overheated and you don’t have your normal cooling mechanisms, you could die. This is neither of these are good things and they can be planned around, but you got to give them deliberate thought and you got to look at other people around you that work with you and that are in your family and in your household and see if they need extra planning help and preparation. And we’re CDC. We’ve got information about everything folks. We’re the government. We are here to help. Here are some resources you can look up and they will take you to people who are genuine experts and they’ll give you some information on it, and if you need more our name is Bill Rich, Rich. My email is email@example.com. Write to me. If I don’t know it, which does happen, I’ll send you to somebody or put somebody in touch with you that does know the answer rather than lie to you or ignore you. If you just can’t find it anywhere else, write to me.
>> Thank you so much Bill for that excellent presentation. We’re no2 going to transition to Vivi Siegel. Vivi is an experienced health communications supervisor with a journalism and public health background and a professional focus on environmental health and emergency risk communication. She has been a health communications specialist working at CDC since 2005. Her focus is on emergency and environmental risk communication. She has conducted continuous activities on behalf of CDC for every domestic natural disaster requiring CDC assistance since 2009. Thanks so much for joining us, Vivi. We’ll go ahead and get your presentation up and then you may begin
>> Thank you very much, Hailey, and thank you to Bill for that very informative presentation. And thank to you all of you who are here. I’m really impressed. I think we have more than 500 participants, and I’m very much enjoying all of the comments and links and stories that people are posting on the chat; and so, I’d encourage you to keep doing so during my presentation. And like Bill and Hailey said we’ll have some time for questions and answers after the presentations. So I want to take what Bill said about all of the health effects from hurricanes and talk about how we take that information and put it into actionable messages that our audiences can use during or before a natural disaster. So there are a lot of challenges with communicating during a natural disaster, and Hailey we can go ahead and move forward, and we’ll just use this past year as our example. So we were faced with a number of hurricanes in a row; and so, huge hurricanes all impacting the United States in a very short window. And this is not something that we see every year. And so, it is quite scary to think that this year could be even worse, and I’m hoping that we end up with weather that doesn’t listen to the forecast like Bill said. But during 2017 first Hurricane Harvey hit at the end of August. Then Irma hits the Caribbean islands and then it hit Florida. Then we had Maria, and then we had Hurricane Jose which visited all up and down the northeast coast of the United States. So go ahead Hailey, and we saw all of the health impacts that Bill was talking about and more. People drowned. People died of carbon monoxide poisoning. People were displaced. People dealt with long-term power loss and housing damage, contaminated drinking water. All of our public health and medical systems were severely affected and this is something that people are still dealing with today both with mold as a lingering effect and with all of the mental health issues. Also as I know we’ve been reading about in the news lately and a major concern of CDC and other public health is the effect on people who have pre-existing chronic illnesses and what happens during a natural disaster. So if you could go forward Hailey. How do you get messages out with no Internet and no power? For many of our messaging at CDC is done over Twitter and Facebook these days. We rely very heavily on social media. We rely on people being able to get to our website and for many disasters that we deal with that’s not an issue. If you need information on Zika you can go to CDC’s website and it’s going to get to you any infectious disease. That’s not going to affect our ability to get messages out in this manner. During a major natural disaster with infrastructure damage, it’s very unlikely that we’ll have power. People will not be able to get Wi-fi and often cell phones are out too. So I’m just going to walk through how we handle this is in a case study. So I was leading CDC’s content team in our joint information center for these hurricanes, and I was part of the first communications team down in US Virgin Islands. And so, I’ll just walk you through some of the ways that we got messages out in Virgin Islands and some of the same tactics were used in Texas and Florida and in Puerto Rico too. And I would love in the chat if anyone wants to share some of their stories about what they did. I know other people are interested in seeing those stories too. So what are the major ways we got information out? Hailey? We used direct mail. We teamed up with the postal service which come wind, rain, hail, or snow even though they had post offices that were completely destroyed, they were able to get back up and running fairly quickly. So CDC collaborated with the Virgin Islands and said what are our top five health issues and health messages for these specific audiences here in St. Croix and St. Thomas and St. John? Because we didn’t want to overwhelm people with too much information. We wanted to be very practical and we wanted to be simple. So we worked with graphic designers to put graphics with everything. We translated it all into Spanish. Made it a one sider front and back and put resources where people could go for more information. So with the assistance of some of our partners, CDC Foundation, US Postal Service, and US Postal Inspection Service which actually flew these flyers from St. Croix to St. Thomas, we were able to get a flyer in the hands of every household in the territory. Can you go forward Hailey? We also harnessed the power of radio and this was in large part due to the groundwork that the US Virgin Islands Department of Health had done over months building relationships, strong relationships with the radio stations in the territory. And when the hurricanes hit we were able to take advantage of those existing relationships and the health department was quickly invited to speak on all of the major radio shows. Even if people didn’t have power in their homes, they either had battery powered radios or they were able to get in their cars and listen to the radio in their car. And so, that was a major way of getting information out. In person we went to every health fair we could find, and I know this was also the case in Puerto Rico. That people with public health, with the department of health, with the CDC, volunteers, all of the partner organizations I know. Some of you are on the phone who were part of this immense effort to reach people in remote areas in person to bring them information they needed when they were not able to get it through their regular channels. We partnered with hardware stores to get displays out to where people were going to purchase supplies to clean up mold. We wanted to make sure that they were cleaning mold safely and so we brought posters and flyers and even showed them how to put together a sample safety kit of everything you would need to safely clean mold. Finally, when people were able to get back on the Internet, and for people who were outside of the area, we put information online to show family and friends who were not in the infected area how to get their family members information. So here’s an image you can share over your social media. Send it a text message. Send an email. Make a phone call and also realizing that family and friends have — are affected by stress too not knowing what’s going on with their family, helping family and friends outside of the affected area get mental health support when they needed it. So, like I said, social media was not available to those in the infected areas immediately but as time went on they were more and more able to get to that information. So we wanted to make sure that we had it when they needed it. So now I’ll go through some of the educational materials we used, and because this is CDC materials, all of our materials are free and available for anyone to use. We love it when our partners share our information. Online you can share it, you can print it out. If you need things in a different language you can request them. We’re not always able to honor translation requests but during an emergency we aim to translate to the languages that people need at the time. So during this response in 2017, we not only translated materials into Spanish, but we worked with translators specializing in Puerto Rican Spanish to make sure that we were using terminology that would resonate in that territory. So here’s a sampling of some of the things we did with mold. You can see we had an infographic you might have seen, eight tips to clean up mold, and we turned it into a video that we could share over social media. And Hailey, could you play that video? We do find that when social media, when a tweet is accompanied by a photo or a video, it gets a lot more attention than just [inaudible]. And we worked on — you’ll see the poster on the right. It was everything you need to wear to safely clean mold damage and mold man we tried to make culturally appropriate depending on where it was going and which audiences it was being used in. So we might change his look or the terminology that we use or the language that we use. This season hopefully we’ll get a mold woman too because I know women are also doing some of the clean up but we started with mold man this year. Bill says most of the cleanup. On the left is a mental health campaign that was done with the US Virgin Islands. On the right, you see some of our safe water materials. This was translated into Spanish and these were used in Puerto Rico. And this is just a sample. All of these are available on CDC’s website. I’m seeing a question about how active CDC was on Facebook for friends and family. Very active. One of the things that we tried to do on Facebook were find groups of people that were already organizing to help and reach them and let them know that we had these resources available. Because not everyone would go to the CDC Facebook page. Not everyone follows CDC on Twitter so it’s really important to make personal connections, and we had a whole team in the CDC Joint Information Center, the outreach team that was really focused on with working on with you, all of our partners, and trying to get these resources into the hands of anyone who could be able to use them. So go ahead forward, Hailey. Carbon monoxide. Like Bill said, one of the major ways that people die and become ill during a disaster having a working — making sure your batteries are new or still working in your carbon monoxide detector will make all the difference. Go ahead, Hailey. This is the one non-CDC material that I wanted to share just because drowning is such an important issue and avoiding driving in flood water will let us avoid many deaths during hurricanes. We really promote the work of a National Weather Service and work them and NOAA to share their messages. And we like turn around and don’t drown and we promote a lot of their content. We work very closely with FEMA, with all of our federal partners and geo partners and we don’t hesitate to share others materials when we can when it promotes the safety message. Here is a pocket card that was sent out, and this one you’ll see, this was first developed in Louisiana for Hurricane Katrina and then it was — it revised and used again during this hurricane; 2017 hurricane season, as a way to get information on the SAMHSA Disaster Distress helpline to people who needed it. Coordinating messaging. So we’re saying one thing. How do we make sure we’re all on the same page? So CDC uses a phase-based approach to hurricane messaging, and this is something that we developed after Hurricane Katrina and it’s just really simple. We know that different stages of the response, there will be different messaging needs. At the beginning of the response, we’ll have more messages about drowning and flood waters. A few days in you start to think about mosquitoes and a few days after that mold becomes more of an issue. And then into the longer term burdens on safe housing and mental health. So this is adaptable as needed but our risk communication principle that we live by is getting people too much information at once will overwhelm them. So we like to give them just what they need at the time that they need it and if we can coordinate with our partners so that we’re all giving the same message at the same time, it will be that much more effective. So this just goes over our different phases and the different types of messages that we use during these phases. And we rely very heavily on the nickel and the [inaudible] to coordinate with our government partners and with partner calls with Epic and other mechanisms that we are able to reach out to partners to say here’s what we’re focusing on. What is everyone else focusing on? Can we all agree that this week we’ll talk about carbon monoxide or power outage risks and make sure that we can support each other in strengthening those messages? So this requires a lot of advance planning and allowing some feedback, deciding who is on first with each type of message and who plays a supporting role and staying in touch during the response to make sure we’re still in agreement on what messages need to be going out. We know that if we’re sending out different messages then people will become confused and they’ll lose trust in the messages that we are sharing. And I wanted to mention, I’m really excited to share that we have a new resource that is available today, and if you will scroll up on your chat, Mable posted this at the beginning of this talk, and it’s available online. And Hailey, can you also pull that up? What we did is we took the 2017 preparedness messaging, hurricane messaging that we pulled together and this is kind of a compendium of all of our key messages on every health topic you can think of. So food safety, carbon monoxide poisoning, power outage safety, water-bourne diseases, mold, mosquitoes, returning home safely, injury prevention, immunizations. Every part of CDC contributed because a natural disaster really touches every single part of public health and so everyone contributed and this was the kind of home base material that we used to create all of our other materials. And Hailey could you just open it up so everyone can see inside of it what it looks like? It’s not a short document. It’s not terribly long. I think it’s about 60 pages but you can search by topic. And if you see on the left, you can go down to any topic and you’ll see what’s the latest CDC validated scientifically cleared messaging on any of these topics. And we would encourage you to use it as much as you can, as much as it’s useful. To take this if you need messaging for your website, if you’re trying to create materials on flood water safety or air pollution or odors, please feel free. Please use it. Let us know if you have any questions. Let us know any feedback that your audiences are giving you. This will be used during the 2018 hurricane season and it will be revised as we learn more and as things get tailored to specific emergencies. But what we tried to do with this document is untailor it for the specific 2017 emergencies that it was created for and make it general so that we could use it for natural disasters to come. Go ahead, Hailey. Let’s see, I think we might have one or two more slides and then we’ll move to our question and answer period. So this is it. This is just a few more links and we’re going to work to get since that just came out today, it’s not yet up on our hurricanes home page but that link will be up on our hurricanes homepage. And for the time being you can reach it on the link that was shared at the beginning of this. So I think now we’re ready for any questions. So we’ll turn it back over to Hailey.
>> Thank you so much, Vivi. We will now transition to our Q and A session. If you do have a question, you can click the Q and A button on your screen, type it in, and we will try our best to get to it. So I will ask that Mabel go ahead and read our first question.
>> Thank you very much, Hailey. So we do not have many questions today. I think is pretty much an interactive session. We just have a question from Simon Peter who said what about water filtered through open one micron filters? He’s asking if that’s appropriate?
>> I carry three different water filters in my deployment bag all the time. I even carry two in my computer bag to work with me. I believe in them. I also believe that none of them are 100% for every possible contaminant. You need to get the best advice you can from people you trust and then go with it. I’m not really allowed to mention brand names am I? Okay. No, I’d better not. I’d like to stay employed past today. I will say that the ones that have been tested and are in use by the US military are good ones. The ones that are in use by the disaster medical assistance teams are tested and approved and pretty good, and you may be able to ask one of them.
>> And I just wanted to add to that most of the time what we’re working on and after a natural disaster is that the types of water disinfection that normally local water systems recommend are either boiling for a minute or you can also disinfect from biological contaminants by using a small amount of bleach, a few drops of bleach. And CDC’s materials have that information in them. Neither of those ways protect against chemical contaminants. So if we think that there has been heavy metals or chemical contaminants of water usually they’ll recommend that people use bottled water until that’s resolved.
>> I’ve seen a number of failures in filtered water especially when I’ve been backpacking and so forth that appeared to be failures of the filters but weren’t. The filter was working just fine but you weren’t following the procedures. The outside of the filter is going to be as contaminated as your hands or anything else. If the water you are drinking has been in touch with anything that is not sanitary, it doesn’t matter how many times you’ve filtered it. If you put it into an unsanitary container or you allow the contaminated water to drip down the hose into the sanitary container that you’re collecting the filtered water in, you have an issue. The only way around that is to practice good habits before you have to do it for real because your mind is going to be as busy as can be and you won’t remember everything. Make it a muscle memory now and it’s one less thing that you’ve got to remember to do when the event hits.
>> Thank you so much Vivi and Bill for answering those questions. So we have a question from Conrad. Yes, he’s asking are there any excellent resources available on thumb drives or CD-Roms that can be deployed to places without Internet? And are they shared with our partners now in advance of future events?
>> Thank you, Conrad. So all of the resources that I brought up in my part of the presentation are available on CDC’s website for download. And so, I don’t know that we are able to provide them on thumb drive or CD-Rom at this time; however, we would definitely encourage folks to go to the CDC educational materials webpage, download the key messages. You’re absolutely right that when our power goes out it’s going to be too late to download it. So that’s something that everyone can be thinking about now having a hard copy on hand of the ones that you think may be relevant in your areas. And to add to that, if you have the ability to make printed materials now should you lose power you will definitely appreciate that you thought to do that beforehand.
>> Thank you very much Vivi for that. We have one last question and that is from [inaudible]. He says have mass texts been used for storm related communication? For example, [inaudible] warnings, could they used?
>> I do not understand the question.
>> Mass text messages being used for —
>> Oh, yes. We use those all the time. And again, in Hurricane Ike, we pushed out messages through AT and T through people’s cell phones on carbon monoxide. One of my friends in Houston was rather startled to be getting a message on her phone from the Centers for Disease Control and called me up and asked about it. And I said, “Yes, it’s for real.”
>> And this is something that FEMA has that capacity and we work with them to get text messages out to do forced text messages to people who are within a geographic location. Definitely a useful tool when people have working cell phones. And often, text messages are often able to go through even when voice calls are not.
>> Well, we are currently out of time. It is now 2:00. So I’d just like to thank everyone for joining us today. Thank you, Bill and Vivi for sharing your knowledge and these wonderful resources. If you do have additional questions or your question didn’t get answered today, you can email them to firstname.lastname@example.org. That’s email@example.com. As a reminder, today’s presentation has been recorded and you can earn continuing education for your participation. Just follow the instructions that were linked in your invitation that you received and use the course code epic0619 with all letters capitalized. Thank you so much and please have a good day.