Search the KHIT Blog

Sunday, September 23, 2018

A literal "shitstorm." What of the public health upshot?





Climate Change Comes Home To Roost In North Carolina
Breached swine lagoons. Overflowing coal waste ponds. Sewage in the streets. The hellish aftermath of climate-fueled Hurricane Florence.

FAYETTEVILLE, N.C. — Florence’s rain came down in sheets ― unrelenting, and for days on end.

The water inundated homes, many still boarded up from Hurricane Matthew two years earlier. It swallowed farm operations, killing millions of chickens and turkeys and overflowing open pits full of hog feces. It flooded coal ash ponds, sending the toxic byproduct of burning coal into area waterways. The smell of human waste tainted neighborhoods; in the small town of Benson, 300,000 gallons of raw sewage spilled into the streets.

On Friday, Charlotte-based Duke Energy reported that a dam containing a lake at one of its power plants in Wilmington had been breached by floodwaters, potentially spilling coal ash from a nearby dump into the Cape Fear River…
Ugh.

One immediate question of concern: what proportion of residents in the affected areas have their medical histories contained in EHRs? And, of those, what sub-proportion are housed in remote cloud-based systems largely immune from storm damage (as opposed to local in-house client-server installs in the-now flooded docs' clinics)? In the aftermath of Katrina, untold thousands of medical records were lost forever. One hopes things have materially improved since then.

I'm not finding much recent news about it. Here's one item:
LESSONS FROM FLORENCE: SET UP ADVANCE HIE CONNECTIONS
With proper disaster prep, Health Information Exchanges play key role in transmitting patient data.
Natural disasters, like Hurricane Florence, present challenges to health systems and providers not only in areas directly impacted, but also to those in neighboring regions who treat patients displaced by the catastrophe. One of the greatest issues: access to patient records.

Health Information Exchanges (HIEs), play a critical role in making these records available. But there's a catch. Electronic connections must be set up in advance by HIEs in the impacted areas and in locations where patients may migrate. And, health systems and providers on both sides of the disaster must participate in an HIE and be connected to a data-sharing network for the data transfer to occur.

Because HIEs are a relatively new resource, a closer look behind the scenes of the nation's most recent widescale natural disasters demonstrates the value these organizations offer and provides lessons as health systems prepare for the future…
That's from the only news article I've thus far found on the topic.

THE LARGER, LONGER-TERM THREAT


Ugh. Raw sewage, dead livestock, fish, pets, etc, overflowing pig farms' excrement ponds, breached power plant coal ash lagoons, massive amounts of household and automotive chemicals -- note the chemical sheens evident in most post-hurricane flooding overhead photos...

Hurricane Florence Is a Public Health Emergency, Too
With its hog manure pits, coal waste ponds, and toxic Superfund sites, North Carolina is among the worst places a major cyclone could hit.

 

...“You don’t want hog waste flowing freely for the same reasons you wouldn’t want sewage flowing freely into the river and the house,” Gisler said. Feces is a breeding ground for bacterial pathogens like salmonella and giardia, and exposure via drinking water could cause experience a number of gastrointestinal problems. Exposure via open wounds or other mucous membranes could cause E. coli.

North Carolina has seen this before. During Hurricane Floyd in 1999, the manure lagoons from dozens of hog farms spilled “over thousands of acres of private and public lands and into the watersheds of four rivers that feed the second-largest estuary system in the nation,” according to the environmental news site Coastal Review. The storm’s extreme rainfall also killed more than 20,000 hogs, whose drowned bodies’ were scattered across the coastal landscape. The state legislature passed a moratorium on new manure lagoons after Floyd, but critics say little has been done to reduce the number of them across the state...
The continuing chronic lack of comprehensive, seamless digital health record "interoperability" (my irasible "Interoperabbable") will yet again result in significant friction hampering aggregate longitudinal public health assessments -- of this, and prior natural disasters.

ERRATUM

I am now one full month out of my open heart SAVR px surgery. So far, so good, overall.

SEPT 29TH UPDATE


Largely off the press radar by now.
_____________

More to come...

No comments:

Post a Comment