Although 2017 was a historic year for natural disasters, 2018 is turning out to be more of the same. Filled with wildfires, tornadoes, floods, tropical systems, and the devastating Hurricanes Florence and Michael, it appears the frequency of natural disasters is increasing. Preparedness professionals face challenges meeting the needs of everyone impacted by such events, especially those with chronic conditions. Fortunately, with pre-disaster planning and post-disaster recovery and evaluation, preparedness professionals can better help the most vulnerable access the resources they need.
Individuals with chronic conditions typically face an array of daily challenges – even without an impending natural disaster. Taking multiple medications, relying on essential treatments, using medical equipment, and making regular visits to a health care provider are often part of the routine. When a disaster strikes, all that is upended. Critical medications, treatments, and caregivers may not be available. Mobility may be restricted and, if the power is out, medical equipment may not work. Without needed health care, a chronic condition can quickly lead to failing health – even death.
To make matters worse, data from the U.S. Centers for Disease Control and Prevention (CDC) indicate that individuals with chronic conditions are prevalent in many states that are most susceptible to natural disasters. Nursing@USC, the online FNP program from the University of Southern California, created a visualization that depicts the number of people living with chronic conditions in each state.
Planning for Disaster
Preparedness professionals can help the vulnerable in their communities by encouraging them and their caregivers to create a contingency plan before disaster strikes. It should include:
- A clear understanding of all medical conditions, needed medications, and treatments;
- An updated list of medications and any significant health history that may affect care;
- A medical alert bracelet that identifies a chronic condition or specific care requirement;
- A 10-day supply of all necessary medications;
- A plan to deal with loss of power – especially if there is equipment dependent on electricity, such as an oxygen concentrator;
- A supply of emergency food, battery-operated flashlights, and a change of clothes;
- Devices at home that monitor vital signs and changes in physical health;
- Assurance that family members and close neighbors know how to administer care;
- An evacuation plan, including identifying stable buildings in the community for shelter and registering with first responders to assist with evacuation needs;
- Sign-up for community warning systems for weather alerts;
- Communication plan with family members in the event of lost power; and
- A list of emergency phone numbers for providers and medical facilities in an accessible place.
It is also important for preparedness professionals to help the vulnerable in their communities learn more about available resources, so they will know where to seek help after a natural disaster. For instance, Healthcare Ready provides an array of resources for those impacted by disasters, including Rx Open, which lists pharmacies that are open in an affected disaster area.
Providing Care During & After a Disaster
During and after a disaster, one of the greatest challenges for individuals with chronic conditions is achieving continuity of care. Hospitals and clinics may not be available, shelters may lack essential supplies, and individuals may be trapped in their homes. First responders and health care volunteers must establish priorities and remain flexible.
Since local resources are rarely adequate to deal with such challenges, partnering with government and relief organizations is essential to gain access to vulnerable populations and provide needed supplies and care. For instance, in the Carolina regions devastated by Florence-related flooding, Direct Relief staff members were on the ground pre- and post-storm delivering requested emergency medical aid and coordinating with local health staff. The organization also provided emergency medical backpacks filled with medicines to manage chronic conditions and other critical medicines and supplies to one local clinic. This made it possible for the clinic’s staff to provide medical care at a local shelter where several hundred residents had been living since Florence hit.
Once the event has passed, the difficulties for those with chronic conditions may be just starting. When medications run out, when oxygen tanks are empty, when it is time for another session of dialysis, the most vulnerable populations may begin to feel the deepest impact of the disaster.
That is why pre-disaster planning is so essential. When preparedness professionals take time to understand the needs of individuals in their communities, they are better prepared to follow up and provide the type of support required to address chronic health issues. Some are even using predictive algorithms to better understand who may need the most help after a disaster.
Post-disaster evaluation is also critical to better understand which pre-disaster strategies were most effective and where improvement is needed. For instance, in “Emergency and Disaster Preparedness for Chronically Ill Patients: A Review of Recommendations,” the authors used specific criteria to conduct a retrospective analysis of relevant guidelines addressing the needs of individuals with chronic illnesses during disasters. Although they were able to create a summary of disaster preparedness recommendations for major chronic illnesses, the authors also introduced three suggestions to improve disaster preparedness:
- More evidence-based recommendations, because many were based on anecdotal evidence or expert opinions;
- More consistent messaging regarding recommendations to prevent confusion for patients and health care providers; and
- Increased feasibility for patients, because what is theoretically sound may not be practical for patients who are often limited in a variety of ways.
When a natural disaster strikes, individuals with chronic illnesses are among the most vulnerable. With effective pre-disaster planning and post-disaster recovery, preparedness and response professionals can help those in need better weather the storm.