James M. Shultz MS PhD 1 Zelde Espinel MD MA MPH 2 Andreas Rechkemmer MA Dr rer pol 3

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National Academy of Sciences: Data matters: ethics, data, and international research collaboration in a changing world Domain-specific examples: Disasters James M. Shultz MS PhD 1 Zelde Espinel MD MA MPH 2 Andreas Rechkemmer MA Dr rer pol 3 (1) University of Miami Miller School of Medicine, Miami, FL (2) University of Miami Miller School of Medicine / Jackson Memorial Medical Center, Miami, FL (3) University of Denver, Denver, CO

Disaster definition A disaster is characterized as an encounter between forces of harm (hazard) and a human population in harms way (vulnerability) influenced by the ecological context where the encounter creates demands that exceed the coping capacity of the affected community DEMAND CAPACITY

Disaster ecology model Societal/structural context Community context Risk factors Individual/family context Forces of harm Disaster impact Affected population Resilience factors Individual/family context Community context Societal/structural context

Disaster taxonomy Natural disasters Anthropogenic disasters meteorological Non-intentional hydrological geophysical climatological biological technological Intentional mass violence extraterrestrial terrorism Complex emergencies/ humanitarian crises

Disaster taxonomy Natural disasters Anthropogenic disasters hurricanes, tornadoes, storms floods, precipitation, waves, mudslides earthquakes, landslides, volcanoes epidemics, blights, infestations asteroids, meteoroids wildfires, heat/cold extremes Non-intentional technological Intentional mass violence terrorism Complex emergencies/ humanitarian crises

Disaster taxonomy Natural disasters Anthropogenic disasters hurricanes, tornadoes, storms floods, precipitation, waves, mudslides earthquakes, landslides, volcanoes epidemics, blights, infestations asteroids, meteoroids wildfires, heat/cold extremes Non-intentional technological Intentional mass violence terrorism Complex emergencies/ humanitarian crises

2017 Prominent Climate Drivers Elevated ocean temperatures Elevated air temperatures Sea level rise El Niño neutral conditions Minimal vertical wind shear High thermal potential Emergency Management (EM) Disaster Response Challenges Economic limitations on pre-storm mitigation Inability to pre-position and stage supplies Severe damage to infrastructure limiting response Disabled government and EM operations Delayed response: time needed to transport personnel Delayed response: time needed to transport materiel Inoperable and incompatible communications Limited available situational information Simultaneous responses to dispersed populations Heterogeneity of response partners Diverse national jurisdictions Political considerations affecting response priorities Issues of environmental injustice Complexity: disasters create disasters Hurricane Disaster Risks for SIDS: Function of Hazard x Vulnerability 2017 Atlantic Basin Hurricane Hazard Characteristics 2017 seasonal characteristics Above average number of storms (17) Above average number of hurricanes (10) Above average major hurricanes (6) Larger storms Prolonged storm season Multiple locale impacts per storm Multiple storm impacts per locale Wind hazards Increased maximum peak wind speeds Rapid intensification prior to landfall Increased high intensity storm duration Water hazards Increased atmospheric moistureholding capacity Record-setting precipitation rates Record-setting rainfall amounts Severe overland flooding Mudslides in steep terrain Sea level rise Severe storm surge impacts Severe coastal wave action Decreased flood drainage Small Island Developing States (SIDS) Vulnerabilities Located in the MDR 360 o coastal perimeter Minimal elevation Mountainous terrain Physically remote Geographically isolated Clusters of islands Developing states Resource limitations Limited EM capacity 2017 Atlantic Hurricane Season Disaster Consequences for SIDS 2017 Hurricane Disaster Consequences General effects Disabling economic crises Disruption of government functions Extensive structural / home damage Population displacement Lack of food, clean water Infrastructure impacts Power outages Communication disruptions Transportation disruptions Fuel shortages Port/airport damage/closures Health system impacts Hospital closures Healthcare services disruptions Life-saving treatment disruptions Lack of medications Agricultural impacts Crop/livestock losses Diminished agricultural production Systems impacts School damage/closures Worksite damage/closures Public Health Consequences Impact phase mortality Post-impact phase mortality Morbidity: physical injury Morbidity: heat-related injury Morbidity: chronic disease exacerbation Morbidity: vector-borne diseases Morbidity: water-borne diseases Morbidity: environmental hazard exposure Morbidity: psychological distress Morbidity: psychopathology

2017 Prominent Climate Drivers Elevated ocean temperatures Elevated air temperatures Sea level rise El Niño neutral conditions Minimal vertical wind shear High thermal potential Emergency Management (EM) Disaster Response Challenges Economic limitations on pre-storm mitigation Inability to pre-position and stage supplies Severe damage to infrastructure limiting response Disabled government and EM operations Delayed response: time needed to transport personnel Delayed response: time needed to transport materiel Inoperable and incompatible communications Limited available situational information Simultaneous responses to dispersed populations Heterogeneity of response partners Diverse national jurisdictions Political considerations affecting response priorities Issues of environmental injustice Complexity: disasters create disasters Hurricane Disaster Risks for SIDS: Function of Hazard x Vulnerability 2017 Atlantic Basin Hurricane Hazard Characteristics 2017 DATA seasonal characteristics Water hazards Above average number of storms (17) Increased atmospheric moistureholding capacity Above average number of hurricanes (10) Above average major hurricanes (6) Record-setting precipitation rates Larger storms Record-setting rainfall amounts Prolonged storm season Severe overland flooding Multiple locale impacts per storm Mudslides in steep terrain Multiple storm impacts per locale Sea level rise Wind hazards Severe storm surge impacts Increased maximum peak wind speeds Severe coastal wave action Rapid intensification prior to landfall Decreased flood drainage Increased high intensity storm duration DATA 2017 Hurricane Disaster Consequences General effects Health system impacts Disabling economic crises Hospital closures Disruption DATA of government functions Healthcare services disruptions Extensive structural / home damage Life-saving treatment disruptions Population displacement Lack of medications Lack of food, clean water Agricultural impacts Infrastructure impacts Crop/livestock losses Power outages Diminished agricultural production Communication disruptions Systems impacts Transportation disruptions School damage/closures Fuel shortages Worksite damage/closures Port/airport damage/closures Small Island Developing States (SIDS) Vulnerabilities Located in the MDR 360 o coastal perimeter Minimal elevation Mountainous terrain Physically remote Geographically isolated Clusters of islands Developing states Resource limitations Limited EM capacity 2017 Atlantic Hurricane Season Disaster Consequences for SIDS Public Health Consequences Impact phase mortality Post-impact phase mortality Morbidity: physical injury Morbidity: heat-related injury Morbidity: chronic disease exacerbation Morbidity: vector-borne diseases Morbidity: water-borne diseases Morbidity: environmental hazard exposure Morbidity: psychological distress Morbidity: psychopathology

HAZARD: Climate influences on 2017 Atlantic basin hurricane hazard characteristics 2017 Prominent climate drivers 2017 Atlantic basin hurricane hazard characteristics Elevated ocean temperatures Elevated air temperatures Sea level rise El Niño neutral conditions Minimal vertical wind shear High thermal potential 2017 seasonal characteristics Above average number of storms (17) Above average number of hurricanes (10) Above average major hurricanes (6) Larger storms Prolonged storm season Multiple locale impacts per storm Multiple storm impacts per locale Wind hazards Increased maximum peak wind speeds Rapid intensification prior to landfall Increased high intensity storm duration Water hazards Increased atmospheric moistureholding capacity Record-setting precipitation rates Record-setting rainfall amounts Severe overland flooding Mudslides in steep terrain Sea level rise Severe storm surge impacts Severe coastal wave action Decreased flood drainage

Increased frequency of disaster-generating climate events (tropical cyclones, heat waves, droughts, and floods) 2015 Pacific typhoon season

Increased frequency of disaster-generating climate events (tropical cyclones, heat waves, droughts, and floods) 2015 Pacific typhoon season 2016 Pacific typhoon season

Increased frequency of disaster-generating climate events (tropical cyclones, heat waves, droughts, and floods) 2017 Atlantic hurricane season

2017 Atlantic basin hurricane season: 17 named storms

2017 Atlantic basin hurricane season: publications

VULNERABILITY: Small Island Developing States (SIDS) Small Island Developing States (SIDS) Vulnerabilities Located in the MDR 360 o coastal perimeter Minimal elevation Mountainous terrain Physically remote Geographically isolated Clusters of islands Developing states Resource limitations Limited emergency management capacity Vanuatu: extreme sea level rise vulnerability Maldives: capital city of Male

VULNERABILITY: Small Island Developing States (SIDS) Pacific Region: 20 Caribbean Region: 29 AIMS Region: 8

VULNERABILITY: Worldwide distribution of tropical cyclone paths

2017 Atlantic basin hurricane season: publications

2017 Atlantic basin hurricane season: key findings 9-of-17 named storms brought tropical storm or hurricane force winds to at least 1 SIDS 22-of-29 Caribbean Region SIDS were impacted by at least one of the 2017 Atlantic storms 4 SIDS were impacted by 1 storm; 13 SIDS were impacted by 2 storms; 5 SIDS were impacted by 3 storms For 11 SIDS, maximal storm winds were tropical storm force For 11 SIDS, maximal storm winds were major hurricane force 9 SIDS experienced the direct landfall of a major hurricane ETHICS: Environmental injustice SIDS contribute minimally to climate change and greenhouse gas emissions but are sentinels for the most severe impacts of rising temperatures, sea-level rise, climate-related disasters

2017 Hurricane Irma impacted 14 SIDS, including 8 at major hurricane force

2017 Hurricane Maria impacted 16 SIDS, including 5 at major hurricane force

HAZARD: Atlantic basin hurricane hazards Increased frequency of major hurricanes Increased peak wind speeds Rapid intensification Increased atmospheric moisture content Increased precipitation rate Increased rainfall totals Rising sea levels: increased storm/tidal surge 2017 Hurricane Jose 2017: The perfect storm season 2017 Hurricane Maria

HAZARD: Atlantic basin hurricane hazards Puerto Rico Puerto Rico Dominica

Public health consequences Public Health Consequences Impact phase mortality Post-impact phase mortality Morbidity: physical injury Morbidity: heat-related injury Morbidity: chronic disease exacerbation Morbidity: vector-borne diseases Morbidity: water-borne diseases Morbidity: environmental hazard exposure Morbidity: psychological distress Morbidity: psychopathology

HAZARDS: Impact/post-impact phase Impact phase: potentially-traumatizing exposures (PTEs) to hazards: Wind hazards: hurricane (Category 4/5) tornado Water hazards: deluging rains storm surge coastal surge inland flooding mudslides Storm-related physical injury: Impact phase: blunt trauma from projectile debris Post-impact: falls, lacerations, puncture wounds, chainsaw injuries Heat stress / heat-related illness Injury-related psychological distress Exposure to vectors for Zika, dengue, chikungunya

HAZARDS: Impact/post-impact phase Storm destruction / roof loss leading to: Exposure to the elements Exposure to mosquitoes/ vectors Elevated risks for Zika, dengue, chikungunya

HAZARDS: Impact/post-impact phase Damage to infrastructure Island-wide power outages heat stress/exhaustion/stroke Extreme water shortage Lack of communications Lack of information Lack of timely response

HAZARDS: Impact/post-impact phase Inland flooding: Exposure to contaminated water and water-borne infectious diseases Enhanced breeding conditions for mosquitoes

Disaster behavioral health precepts In a disaster, the size of the psychological footprint greatly exceeds the size of the medical footprint

Disaster behavioral health precepts In a disaster, psychosocial consequences extend along a spectrum of severity. Severity relates to the degree and intensity of exposure Fear and distress Harmful behaviors/ risky actions Psychiatric disorders Disaster impact

Disaster behavioral health precepts In a disaster, psychosocial consequences expand across a range of duration Forces of harm Affected population Disaster impact Hazard Resource/human losses Enduring life changes Time from impact

2017 Prominent Climate Drivers Elevated ocean temperatures Elevated air temperatures Sea level rise El Niño neutral conditions Minimal vertical wind shear High thermal potential Emergency Management (EM) Disaster Response Challenges Economic limitations on pre-storm mitigation Inability to pre-position and stage supplies Severe damage to infrastructure limiting response Disabled government and EM operations Delayed response: time needed to transport personnel Delayed response: time needed to transport materiel Inoperable and incompatible communications Limited available situational information Simultaneous responses to dispersed populations Heterogeneity of response partners Diverse national jurisdictions Political considerations affecting response priorities Issues of environmental injustice Complexity: disasters create disasters Hurricane Disaster Risks for SIDS: Function of Hazard x Vulnerability 2017 Atlantic Basin Hurricane Hazard Characteristics 2017 seasonal characteristics Above average number of storms (17) Above average number of hurricanes (10) Above average major hurricanes (6) Larger storms Prolonged storm season Multiple locale impacts per storm Multiple storm impacts per locale Wind hazards Increased maximum peak wind speeds Rapid intensification prior to landfall Increased high intensity storm duration Water hazards Increased atmospheric moistureholding capacity Record-setting precipitation rates Record-setting rainfall amounts Severe overland flooding Mudslides in steep terrain Sea level rise Severe storm surge impacts Severe coastal wave action Decreased flood drainage Small Island Developing States (SIDS) Vulnerabilities Located in the MDR 360 o coastal perimeter Minimal elevation Mountainous terrain Physically remote Geographically isolated Clusters of islands Developing states Resource limitations Limited EM capacity 2017 Atlantic Hurricane Season Disaster Consequences for SIDS 2017 Hurricane Disaster Consequences General effects Disabling economic crises Disruption of government functions Extensive structural / home damage Population displacement Lack of food, clean water Infrastructure impacts Power outages Communication disruptions Transportation disruptions Fuel shortages Port/airport damage/closures Health system impacts Hospital closures Healthcare services disruptions Life-saving treatment disruptions Lack of medications Agricultural impacts Crop/livestock losses Diminished agricultural production Systems impacts School damage/closures Worksite damage/closures Public Health Consequences Impact phase mortality Post-impact phase mortality Morbidity: physical injury Morbidity: heat-related injury Morbidity: chronic disease exacerbation Morbidity: vector-borne diseases Morbidity: water-borne diseases Morbidity: environmental hazard exposure Morbidity: psychological distress Morbidity: psychopathology

National Academy of Sciences: Data matters: ethics, data, and international research collaboration in a changing world Domain-specific examples: Disasters Thank you very much. James M. Shultz jshultz1@med.miami.edu 305-219-9011