June 2-5, 2018 Pasadena, CA Pasadena Convention Center. #aphl

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June 2-5, 2018 Pasadena, CA Pasadena Convention Center #aphl

Florida s Response to Natural Disasters Andrew Cannons, Ph.D. Laboratory Director Bureau of Public Health Laboratories (BPHL)-Tampa Florida Department of Health (DOH)

Outline How the Bureau of Public Health Laboratories prepares Comprehensive Laboratory Response Plan (CLRP) Memorandum of Understanding (MOU) Exercises Hurricane Irma, 2017 Preparation Response Mitigation How Public Health Laboratories Support Each Other Surge capacity (e.g. Zika) Technical Expertise Assessments

How the Bureau of Public Health Laboratories Prepares

Preparing for Natural Disasters Natural Disasters and Florida (FL) Fires Floods Tropical storms Hurricanes Thunderstorms/lightning Tornados Earthquakes and Sinkholes

Preparing for Natural Disasters Tools in Place: Continuity of Operations Plan (COOP) FL DOH COOP BPHL COOP Overall plan for laboratory Identified & prioritized Mission Essential Functions (MEFs) COOP daily/weekly/monthly Equipment failure Staff shortages Weather problems

Preparing for Natural Disasters Tools in Place: Chemical, Biological, Radiological Incident Resources Guide (FKA CLRP): Partnerships- State, Private, Hospitals, University Partnerships- Civil Support Teams, Law Enforcement Memoranda of Understanding: Department of Agriculture and Consumer Services Texas Public Health Laboratory, Newborn Screening

Preparing for Natural Disasters Building: Generators maintained/tested Structural upkeep Tree trimming Hurricane preparedness plan annual review Staff: Annual exercise-evacuations, shelter in place Provide hurricane preparedness guide/information for personal/family preparedness

Preparing for Natural Disasters Exercises: Hurricane exercises Statewide exercises (full scale, tabletop) 2013 hurricane exercise hit all public health laboratories in FL! Shelter in place exercises Tornado drills Everbridge notification exercises Quarterly statewide Semi-annual, BPHL specific

Hurricane Irma, 2017 (Source: Reuters)

Impact of Hurricane Irma -early timeline August 26 Tropical wave develops from west Africa August 30 Tropical Storm Irma formed August 31 Hurricane Irma formed September 4 Irma is a category 4 storm Governor declares a state of emergency in Florida September 5 Irma is a category 5 storm Hurricane Irma, Sept 6

Impact of Hurricane Irma -predictions September 4 Labor Day The need to prepare for a hurricane very likely Laboratory preparations begin September 5

Impact of Hurricane Irma -predictions, cont. September 6 Irma hits Leeward Islands Path is predicted to track up the east coast of FL Cone of uncertainty covers the whole state of FL Laboratory preparations continue

Impact of Hurricane Irma -predictions, cont. September 8 Irma hits Puerto Rico on Sept 7 Path is predicted to track up the center of FL Cone of uncertainty covers the whole state of FL Laboratory preparations completed and labs closed except for volunteer workers

Impact of Hurricane Irma -predictions, cont. September 9 Irma hits north coast of Cuba Path is now predicted to track up the west coast of FL Cone of uncertainty still covers the whole state of FL BPHLs closed except for volunteer workers

Impact of Hurricane Irma -reality for FL September 10 From Cuba, Irma hit Cudjoe Key (Key West) as a category 4 storm Made second landfall at Naples as a category 4 storm Early September 11 Downgraded to category 1, tracks to the east of Tampa

Hurricane Irma BPHL Prepares Building Preparation: Completed by COB, September 7 Generators, security cameras, fire alarms, building security fully operational Non-critical equipment, computers unplugged Everything moved away from windows and off the floor Servers backed up offsite and turned off All instrumentation covered Sandbags placed at doors on final day

Hurricane Irma BPHL Prepares, cont. Emergency Testing Services (labs closed 9/8, 9/11, 9/12) Rabies last day of testing, September 8. All victims after would need treatment Newborn screening and Tuberculosis Volunteers completed testing by Sept 9 BioWatch and BioThreat testing completed testing September 9

Hurricane Irma BPHL Prepares, cont. Notifications: Federal agencies (CDC, DHS) and other partners Security guard and janitorial services identify last day/time of operations Security alarm company Check courier and delivery services Ensure staff are aware of building closures and how they will be notified Staff: Ensure staff are adequately preparing themselves Evacuation, family, home preparation

Hurricane Irma Effect on Florida Over 6 million ordered to evacuate Approximately 73% lost power at some point: 1-7 days Storm surge caused significant localized flooding Estimated $50 billion in structural damages Estimated $2.5 billion damage to agriculture Interstate I4, Polk County, 9/9/2017 By Andrew Heneen By U.S. Fish and Wildlife Service Southeast Region

Hurricane Irma Effect on BPHL BPHL-Miami: Power outages in grid meant laboratory was on generator power for 17 hours Generator powers the whole building No loss of samples or supplies Minor leaking due to small cracks Biggest effect some staff could not get to work on Sept 13 due to destruction and tree damage in outlying areas

Hurricane Irma Effect on BPHL, cont. BPHL-Jacksonville: Hogan s Creek overflowed 8-10 inches of flooding Loss of supplies ($$$) Major clean-up effort Leaking roof with water damage to ceiling Power outages, on generator power for a few hours Fully operational on September 13 even though: Schools were closed Power & water outages throughout the city

Hurricane Irma Effect on BPHL, cont. BPHL-Tampa: No power loss to building No leaking at doors, roof, windows Two tiles pushed from ceiling due to wind Some tree limbs down Retention pond behind lab did not breach its banks All staff back to work September 13 Schools were closed Power outages throughout the city

Hurricane Irma Effect on BPHL, cont. After Action Report Conducted: 1. Were you aware of the hurricane preparedness plans for your department or lab section? -100% YES 2. Did the Tampa lab administration or your supervisor provide good communication about hurricane Irma and what to expect in regard to your job in the lab? -100% YES 3. Were the Everbridge cell phone texts/calls about the lab being open or closed helpful? What would make them better? -100% YES, but notifications can be late and contradictory 4. Are you aware of ICS and COOP? - <50%. Staff training already given on both

How Public Health Laboratories Support Each Other

How Public Health Laboratories Supporting Each Other Providing Surge Capacity E.g. during Zika, H1N1 outbreaks In state and using partner labs out of state Sharing Technical Expertise and Specimens Positive specimens for test validations Reach out to public health laboratories (PHLs) with experience Texas reached out to Florida for help with urine surveys during Zika outbreak, 2016 Florida reached out to Indiana for help with second case of Middle Eastern Respiratory syndrome Coronovirus (MERs), 2014

How Public Health Laboratories Supporting Each Other, cont. Providing assessments for PHLs: Assessment of Puerto Rico public health laboratory system after Hurricane Maria (October 2017) APHL organized an assessment team of state PHL directors What happened Current status What's needed

Conclusions Florida is subject to natural disasters such as tornadoes, tropical storms and hurricanes BPHL must be prepared for these disasters 2017 was a historic year for hurricanes; Harvey, Irma, Maria While Florida was severely hit by Irma, the BPHL came through relatively unscathed Public Health Laboratories are there for each other

Contact Information Andrew Cannons (813) 233-2277 Andrew.cannons@flhealth.gov