The Department of Public Health Sciences has implemented Emerging Public Health Topics Seminars that will take place during the Fall 2020 semester. The seminars, open to students, faculty, staff, and community partners, will cover timely public health matters. 

The first of three seminars were held on Friday, August 28, 2020, by James Shultz, Ph.D., director of the Center for Disaster and Extreme Event Preparedness (DEEP Center) at the Department of Public Health Sciences, who spoke about protecting populations from a simultaneous pandemic and an active hurricane season.  

A myriad of states in the U.S., including Florida, are currently facing the twin threats of COVID-19 and climate-driven Atlantic hurricanes. While there are proven mitigation approaches to hurricanes that are known to save lives and minimize physical injuries, the mitigation strategies for COVID-19, while also effective, are not compatible with those of hurricanes. 

A few of the proven approaches for mitigating hurricanes, Dr. Shultz said, include warnings, evacuation, and sheltering. COVID-19 strategies that prevent infection, disease, hospitalization, and death include physical distancing, shutdowns/lockdowns, restrictions on attendance and size of gatherings, handwashing/cleaning surfaces, wearing masks in public, and wearing personal protective equipment in health care and high-risk settings. 

“There is a fundamental incompatibility between the mitigation strategies for hurricanes and COVID-19,” Dr. Shultz said. “For hurricanes, the actions alert, move and gather people together. The actions for COVID-19 separate and move people apart.” 

Among the topics discussed in the seminar were information from papers that Dr. Shultz wrote in collaboration with a multi-disciplinary group of experts. In one of them, published in The New England Journal of Medicine, Renee N. Salas, M.D., M.P.H, assistant professor of emergency medicine at Harvard Medical School, Dr. Shultz, and Caren G. Solomon, M.D., M.P.H., an associate physician at Brigham and Women’s Hospital, provide suggestions to effectively manage the concurrent threats. 

The paper states, “As we collectively reimagine an equitable, all-hazards-responsive health infrastructure, we will need to take concrete actions focused on the key intersections between climate change and the COVID-19 pandemic. The integrated responses should be firmly grounded in science that value health as a fundamental right for all.” 

Short-term efforts include: 

• Increasing the number of available shelter sites, with lower occupancy per site, more separated spaces within sites, and more space per shelter resident, such as using smaller “non-congregate shelters”
• Using standard shelter-registration information, such as name and contact phone number, for all persons entering, to facilitate contact tracing in case COVID-19 is diagnosed in persons who used the shelter.
• Implementing shelter protocols for infection control, including daily symptom checks, isolation of symptomatic persons, the mandatory wearing of face masks, ample supplies of hand sanitizer, hand-washing stations, and meals provided in disposable containers.
• Adapting guidance for minimizing COVID-19 viral transmission in mass care settings for use in-home sheltering as many evacuees shelter with family and friends.

Long-term actions, Dr. Shultz stated, include prioritizing federal and state funding for mitigation plans to prepare for climate-driven intensification of extreme weather and superimposed events like COVID-19. Ongoing adaptations and transformations in health care delivery, prompted by the pandemic, can also be effectively applied. 

The paper also states that the expansion of telemedicine, in areas where computers or phone services are intact, as well as the use of community paramedicine services, can improve our ability to address medical and psychological needs, and minimize COVID-19 exposure for people who cannot readily obtain care. Investments in strengthening our health care infrastructure and delivery systems, such as supply chains, are also essential to ensuring resiliency during a pandemic or climate shocks. 

During the seminar, Dr. Shultz also spoke in-depth on two other papers, published in the Journal of the American Medical Association and Disaster Medicine and Public Health Preparedness. These papers offered several recommendations on how to best prepare and handle hurricane season during COVID-19. 

A few recommendations included educating the public and adapting in-home sheltering, applying lessons from infectious disease outbreaks in shelters during previous hurricanes, improving communications to shape safer evacuation and sheltering, as well as learning from each 2020 storm to refine operations. 

The papers also suggest the need for emergency managers, healthcare providers, and public health preparedness professionals create viable solutions to confront these potential scenarios. 

“This can reduce the possibilities of increased rates of hurricane-related injury and mortality among persons who refuse to evacuate due to fear of COVID-19 and increased spread of COVID-19 cases among hurricane evacuees who shelter together,” said Dr. Shultz. 

For more information on the seminars, please contact Rosa Verdeja, M.Ed., director of academic affairs in the Department of Public Health Sciences, at RVerdeja@med.miami.edu.

Written by Amanda Torres 

Published on September 9, 2020