Preparing for Disasters in the Age of Covid-19

For the past couple of months, as Covid-19’s foothold in the United States has grown, the American Red Cross has carefully avoided putting displaced people in traditional shelters.

Instead, the organization, which runs more than half of the nation’s official disaster shelters, accommodated them in hotels, college dormitories, and similar facilities that allow them to maintain social distancing during the pandemic.

That is, “up until yesterday,” Brad Kieserman, vice president of disaster operations and logistics, told Direct Relief on May 20.

A New Disaster

The evening before, two dams had collapsed in Midland County, Michigan, after days of heavy rainfall. The nearest hotel-type accommodation, Kieserman explained, was in the flood plain.

At the time of Kieserman’s conversation with Direct Relief, 110 people in Midland County were staying in what’s called, in the disaster-relief world, a “congregate shelter,” where dining and other facilities are shared among shelter residents.

Kieserman was confident that the American Red Cross would find alternate settings for those 110 people.

“The problem is, going into wildfire and hurricane season, that’s not going to scale,” he said. Should a major disaster on the scale of 2017’s Hurricane Harvey rear its head, “you’re not going to have non-congregate shelter for 40,000 people on the first night.”

Hurricane season officially begins on June 1. Although wildfire season is increasingly year-round, it’s often said to start in late spring. Moving into summer, heat will increasingly become a dangerous problem. Every year, disaster management agencies and first responders plan carefully for these events.

They may have their hands full. On May 21, the National Oceanic and Atmospheric Administration predicted a “busy” hurricane season: as many as 19 named storms, up to six of which may be major hurricanes.

The National Interagency Fire Center has warned of warm, dry conditions in parts of the country that could lead to higher-than-normal levels of wildfire activity.

It gets more complicated. Pretty much anyone who’s used to responding to disasters is aware of the health complications they bring – including interruptions to primary care and an increased potential for infectious disease.

But responding to a disaster during a worldwide pandemic brings new challenges and considerations – and fewer resources.

Congregate Settings

Emergency management officials say that some of the problems of responding to disaster in the midst of pandemics are familiar.

“Planning for multiple hazards isn’t something that’s new to emergency management,” said Francisco Sanchez, the deputy emergency management coordinator at the Office of Homeland Security and Emergency Management for Harris County, Texas.

Sanchez was active in the response to Hurricane Harvey’s destruction of the Gulf Coast in 2017, and Harris County, which contains the city of Houston within it, was particularly hard-hit. “Our job, essentially, is to be paranoid,” he said.

Steve Carroll is the Emergency Medical Services administrator for Ventura County, California, which saw the Thomas Fire scorch more than 280,000 acres beginning in late 2017.

“This has always been kind of on our radar as a possibility, but it’s obviously kind of unprecedented,” he said, explaining that his department has planned for emergencies during outbreaks of SARS, H1N1, and other diseases, but never something as wide-ranging as Covid-19.

Congregate shelters, in addition, have always carried the risk of infectious diseases like respiratory and digestive ailments. For example, norovirus broke out at California shelters in the wake of the 2018 Camp Fire, which destroyed much of the town of Paradise.

Covid-19 has the potential to change the way emergency managers respond to disasters over the long term, Carroll said – beginning with congregate sheltering. “The normal way of doing things in the past, of congregate shelters and congregate feedings…is likely not going to work that way in the future,” he said.

Congregate shelters are especially dangerous for precisely the kind of people most likely to end up in them, such as older adults and comorbidities, according to Kieserman. Combine a congregate setting, increased health risks, and “a disease that is at its most dangerous when people are closer together,” and you have a hazardous situation.

In the event of a large-scale disaster, if an alternative shelter arrangement isn’t available, the American Red Cross will screen people at the door, give them a mask, and isolate anyone who’s identified as a possible risk – with separate staff attending to each population.

The organization is also increasing the amount of square footage it gives people – up from 60 square feet to 110 square feet – which means twice the number of facilities will be needed, Kieserman said. The organization is coordinating more closely with public health departments, and ensuring that it has health workers on site 24 hours per day.

Economic Impacts

But congregate sheltering is only the most obvious risk. “Covid would touch almost any aspect of our response,” Sanchez said.

That includes the economic impact, said Angela Blanchard, a Texas-based disaster management expert and a senior fellow at Brown University’s Watson Center for International and Public Affairs.

For one thing, the economic fallout of Covid-19 will create more vulnerable people who don’t have the resources to safely evacuate on their own, which can further strain an overburdened system. Whereas a disaster leaves clear, tangible aftereffects, Covid-19 “has made a lot of invisible suffering,” Blanchard said.

In addition, the charitable giving that frequently comes after a disaster may be lessened by the coronavirus’s effect on the economy. “Generally, you see an outpouring of generosity after storms,” she said. This year, “there won’t be what was anticipated and there won’t be the more that would be needed” during a busy hurricane season.

That’s especially problematic because, according to Sanchez, official relief money can be slow to arrive – and isn’t always sufficient to cover what people have lost. “The buffer until the cavalry gets here is very scarce,” he said.

Slowing Recovery

Covid-19 threatens to slow down building efforts and community response as well, said Andrew MacCalla, Direct Relief’s vice president of emergency response.

He pointed to the example of the Bahamas, where some islands experienced extensive damage during Hurricane Dorian last year, and where progress on construction has been slowed by the pandemic.

MacCalla said that community response efforts – in which medical teams and other relied-upon help flocks to an affected area – might also be compromised if people can’t travel or are wary of exposure.

When a disaster happens, “getting together immediately afterward is just a rite of passage. It’s just an ingrained ritual,” said Blanchard, the disaster response expert.

Now, “anything that involves large groups, 20 to 30 people showing up at a person’s house to muck and gut it…won’t be feasible.”

That may be true even among local governments, explained Carroll, the Ventura County administrator. “If [an emergency] overwhelms local resources, you reach out to your neighboring partners,” he explained. Those neighbors will help supply what’s needed, whether it’s firefighters or ambulances.

But the coronavirus is affecting everyone, all at once. Carroll said that, as a result, neighboring governments may be too overwhelmed to help. “You can’t just reach out to your neighbor and ask for their assistance,” he said. “To not have that capability right now, that’s probably the biggest challenge in addressing that response to Covid.”

As the Season Begins

Covid-19 has already tested officials’ and organizations’ responses to extreme weather.

There were the flooded dams in Michigan. Storms and tornadoes that swept through the south in April killed dozens and left tens of thousands without power. And cooling centers – themselves congregate settings – have already opened in some areas experiencing high heat.

According to Helen Chavez, assistant director for the Los Angeles County Office of Emergency Management, widespread closures have meant that people have fewer options for cooling off, such as malls and movie theaters, when high temperatures hit. “We’ve had to reassess and lower the threshold for when we activate emergency cooling centers,” she said.

To mitigate the risk without depriving people of a place to cool off, Chavez said, Los Angeles County cooling centers have lowered their occupancy levels, require people to keep six feet apart, and provide hand sanitizer and masks.

But even the strain the coronavirus has placed on personal protective equipment (PPE) could be problematic once wildfire and hurricane season are underway, MacCalla said.

In particular, N95 masks, widely needed and extremely scarce during the early stages of the pandemic, and still in short supply, are also used to protect people from particles in the air during a fire.

“All of [Direct Relief’s] emergency response kits have some level of PPE in them” to help health care workers respond more effectively during a disaster, MacCalla said.

Kieserman, worried about strained resources and exhausted team members, summed it up: “It’s going to be a rough summer.”