General Honore - "Lessons Learned from Hurricane Katrina"

LTG Ret .Russel L. Honoré CDR JTF-Katrina

Lessons Learned from Hurricane Katrina

42% of US Population Lives within 20 miles of Ocean Coastline, Mississippi River & Great Lakes – a “target rich” environment!

US Population Concentrations

Data based on 2003 US Census Data

60%

54%

42%

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3

 See First

 Understand First

 Act First Russel L. Honoré, LTG, U.S. Army

Decision Superiority

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Who

ELSE

Needs to Know?

[email protected] Russel L. Honoré, LTG, U.S. Army

The US Army Corps of Engineers had 800 giant sandbags weighing 6,000 to 15,000 pounds on hand just in case, and ordered 2,500 more to shore up low

spots and plug any new breaches.

500,000 to 1,000,000 Citizens

DOD

Information Management

Satellite Communications

Sea/Water

Air

Land

Private Industry Federal State Local

Capability

Authority

Capacity to Confront a Catastrophic Disaster


Search and Rescue

Dynamic Data Requirements - Crossing Domains

STATE AND LOCAL ORGANIZATIONS PROVIDED KEY GIS DATA DURING

KATRINA

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Dr. Juliette Saussy, Director of Emergency Services for the City of New Orleans, supervised the medical triage efforts at the Convention Center, evacuating over 19,000 patients in one day

Heroes Rise

HEALTHCARE IN LOUISIANA Need for Health Care and Health Coverage

50th - Ranking on health of population prior to Katrina 5th - Ranking on rate of uninsured prior to Katrina 17th - Ranking on proportion of low-income uninsured children prior to Katrina 761,000 - Number of uninsured people in Louisiana prior to Katrina 71% - Percent of low-income (< 200% of poverty) Louisianans who have Medicaid coverage or who are uninsured 653,175 - Number of Medicaid beneficiaries in affected parishes prior to Katrina 40% - Percent of individuals denied Medicaid coverage in Baton Rouge since Katrina who meet income rules but not other eligibility rules 22% - Percent of Louisianans living in poverty 1.1 million - Number of people in Louisiana displaced by Katrina 39,000 - Number of people in Louisiana in shelters as of 10/4 52% - Percent of Houston Astrodome evacuees who were uninsured 33% - Percent of Houston Astrodome evacuees hurt or ill due to Katrina 41% - Percent of Houston Astrodome evacuees with some chronic health problems

HEALTHCARE IN LOUISIANA Damage and Destruction of Health System Capacity (1 of 2)

23 - Number of hospitals in Orleans Parish before Katrina with 3,679 beds

1 - Number of hospitals operating in Orleans Parish after Katrina – the temporary US Comfort medical ship with 270 beds

54% - Percent of total charges for uninsured patients served at Charity / University Hospital in New Orleans; Charity Hospital is no longer open

11 - Number of hospitals in Jefferson Parish before Katrina with 2,108 beds

5 - Number of hospitals operating in Jefferson Parish after Katrina with 1,068 beds

53 - Number of nursing homes operating in Jefferson, Orleans, Plaquemines, and St. Bernard Parishes before Katrina

6 - Number of nursing homes operating in Jefferson, Orleans, Plaquemines, and St. Bernard Parishes after Katrina

HEALTHCARE IN LOUISIANA Damage and Destruction of Health System Capacity (2 of 2)

1,850 - Annual number of mental health acute unit admissions at Medical Center of Louisiana at New Orleans, which no longer is open 1,974 - Annual number of mental health outpatient clinic visits in New Orleans at clinics that are no longer open 6,821 - Annual number of individuals served in New Orleans outpatient substance abuse programs that are no longer open 16,488 - Number of basic health care providers in Jefferson, Orleans, Plaquemines, and St. Bernard Parishes prior to Katrina, many of whom are no longer there, including:

• 1,479 primary care doctors • 9,442 licensed nurses • 1,105 pharmacists • 3,047 emergency medical technicians • 1,415 mental health workers (psychiatrists and social workers)

DISASTER CONDITIONS – RIPE FOR SPREAD OF DISEASE

•  Heat, high humidity, standing water

•  Perfect breeding conditions for mosquitoes

•  Numerous bio-hazards in water people waded through

•  Close quarters for evacuees

•  Reduced immune systems due to fatigue, stress, dehydration

•  New Orleans has a history with yellow fever (41,000 deaths between 1815 and 1905 – 7,849 in 1853)

•  West Nile Virus (117 cases in LA in 2005) and encephalitis (Missouri outbreak 1975) also possible concerns

RELIEF OPERATIONS SUMMARY

•  Search and Rescue: 41,789 Saves •  Civilian personnel treated: 13,612 •  DOD forces treated: 4,784 •  Civilian patients evacuated: 2,750 •  Food inspections: 715,081 lbs •  Water inspections: 275,024 •  Meals: 164, 874 •  Animals treated: 1,120 •  Immunizations administered: 23,329 •  Aerial Insecticide Spraying: 2.8 mil acres

FEDERAL RECOMMENDATIONS FOR FUTURE PUBLIC HEALTH CRISES

•  Develop a comprehensive plan to ID, deploy, track Federal public health and medical assets

•  Propose legislation to transfer National Defense Medical System from DHS to HHS

•  Train, equip and roster preconfigured, deployable healthcare teams

•  HHS oversight and coordination of emergency, bioterrorism, and public health preparedness needs

•  Communicate public health and individual/community preparedness guidance to the American people

•  Create and maintain dedicated/deployable teams of commissioned U.S. Public Health Service officers to provide on-site expertise

•  Assist local and state health infrastructures to increase capacity

•  Foster widespread use of interoperable electronic health records (HER) systems to support emergency responders

•  Arriving on the scene in a disaster – must be the calm in the storm. •  Work through the chaos and confusion – don’t add to it. •  Can’t do everything at once – establish a Priority of Work. •  Look for quick wins. •  In a disaster, you are the priority – if you ask for it, you’ll get it. •  Need decision superiority – See first, Understand first, Act first. •  Collaboration is key – everybody’s got a boss – unity of effort, not unity

of command. •  Who else needs to know? •  Public information critical in a disaster situation – poor communications. •  Must give media access – if you’re not speaking, someone else will

speak for you. •  Stay connected with those responsible – Mayor, Governor, President,

Military Agencies. •  Track what key leaders are saying to avoid contradictions. •  Deal with the misinformation put out by others. •  Audio and video have to match.

Leadership During Crisis (1 of 2)


•  See first, understand first, act first. •  In crisis first report is usually wrong. •  Invest yourself personally in your subordinates success. •  Ability to listen to bad news...don't shoot the messenger. •  Real art of leadership is getting people to willingly follow you. •  Who else needs to know? Collaboration. •  Listen, you have 2 ears and 1 mouth, Do two times more listening. •  Leader can't just be an observer, must be a player. •  Leader takes responsibility for what happens - good, bad, or ugly. •  Your people are #1.

–  QOL - Health –  Security

•  Life time Learner. •  Best case / worst case. •  Be aware of quicker, better, faster, cheaper. •  Be a champion of change.

Leadership During Crisis (2 of 2)


Creating A Culture Of Preparedness

WHAT IT SHOULD BE

National Response Framework

Creating a Culture of Preparedness

National Preparedness Plan? (NPP)

POLITICAL

RIGHT LEFT

WHAT IT IS

Money Spent on Preparedness

GOVERNANCE

ECONOMY ACT

STAFFORD ACT

HELMS-BIDEN ACT

Prepared?

Recover

Respond Mitigate?

DIPLOMATIC

GOVERNMENT HEALTH

LOCAL

STATE

FEDERAL

Disaster Strikes

Presidential Declaration

ECONOMIC

EDUCATION

HOME


Search and Rescue

Heroes Rise

Questions?


General Honore - "Lessons Learned from Hurricane Katrina"

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