Letter from Lt. James Hall, stationed in Baton Rouge, Louisiana

LT James Hall, USPHS

September 4, 2005

Having arrived six days after Hurricane Katrina, when we set foot on the LSU campus, operations were well underway. The first thing that caught my eye was the large presence of evacuees. Army soldiers were everywhere, sirens from ambulances were ever present in the background as they arrived in groups of 10's or 15 at a time, and helicopters were steadily landing on the field rushing people into the field hospital located adjacent to the PMAC.

When inside the center, the USPHS was incredible. It was my first glance at the impact we make out in the field. If there ever was a definition of healthcare, this was it, at its best moment!

Mission Operations onsite at the LSU Campus included the following:

PMAC - The USPHS worked jointly with volunteers, local, state, and federal resources to provide healthcare assistance to a large number of New Orleans evacuees. There were hundreds of beds setup, with great assistance and logistics from the Illinois Medical Emergency Response Team (IMERT), and equipment provided through the National Stockpile. It's been reported that since the night of the hurricane, which literally defaced New Orleans, there were over 20,000 people processed through the PMAC, CMFH, and Bernie Moore Track Stadium - all located on LSU's campus. Assistance also came in the form of USPHS Triage to determine medical needs. If a medical need was not evident, evacuees were provided food, beverages, donated clothing, toys for kids, etc. Thereafter, Shelter assistance and transportation was provided through the Red Cross.

If an evacuee was triaged and admissible, they could have been further processed through General Care, Pediatrics, ICU, Mental Health Services, have labs drawn, where courier's volunteered to take the labs to Our Lady of Lake laboratory. Also, a pharmacy was available, respiratory therapy, physical therapy, wound care, orthopedics, surgery, surgical supplies, general supplies, infectious disease unit, and social services with care coordinators for discharge, among other services.

Carl Maddox Field House (CMFH) - The CMFH was utilized as a shelter and special needs care facility.

Bernie Moore Track Stadium - I don't know what day the Track was cleared for use as helicopter landing strip, but it was located adjacent to the PMAC where evacuees could be easily shuttled into the facility.

Other Operations included the Belmont Hotel, which was primarily used as a site to administer immunizations to first responders. At the same time, there were Hotel and Shelter Assessments conducted by combinations of Physicians, RN's and Environmental Health Officers. There were Clinic Teams staffed by USPHS officers in New Orleans as well. Our epidemiologist played a significant role as well.

Epidemiology

The USPHS Epidemiology Team deployed on August 28, 2005. The team consisted of medical and nurse epidemiologists and environmental health officers. Their responsibilities included the following:

Compile significant events related to the deployment, calculate quantitative markers of unit activities, and generate reports for the command:

• Assist the unit's service components to document measurable information (e.g., patient load, prescription medication and vaccine distribution, laboratory services provided, and mental health services utilized)
• Provide analyses and interpretations of the data and significant clinical and public health events gathered

Identify diseases and conditions of public health significance and mitigate their consequences in the PMAC and CMFH

• Provide infection control and preventive care practice consultations and protocols for clinical care providers at PMAC and CMFH
• Develop and apply surveillance and response protocol for gastroenteritis case detection among inpatients and triaged patients
• Conduct laboratory surveillance to determine the magnitude and trends of etiologies of identified cases of gastroenteritis

Provide disease and injury surveillance and epidemiologic assistance to the Louisiana Department of Health and Hospitals (via its Office of Public Health) and the American Red Cross emergency shelter relief efforts:

• Implement standard procedures for disease and injury (a) surveillance, (b) case investigation, and (c) outbreak investigation at 150 general shelters
• Coordinate general shelter disease and injury surveillance activities with volunteer epidemiologists
• Implement multidisciplinary (medical, nursing, pharmacy, environmental health, epidemiology, and administrative) USPHS field teams to provide or assist in providing healthcare delivery, clinic management, sanitation, surveillance, and logistic activities at general shelters

Collaborate with local Federal Emergency Management Agency (FEMA) to apply disease surveillance among deployed Disaster Management Assistance Teams (DMATs) that is consistent with the CDC Hurricane Katrina Surveillance Injury and Illness Report:

• Assist in the development of standardized health screening, vaccination, and personal protection education of DMAT personnel before deployment, and disease and injury and hazardous material exposure surveillance during and after deployment
• Analyze and apply public health interventions as indicated and notify applicable state health departments

So, that is an outlay of the big picture, from the Batan Rouge, LA perspective. Next, I will discuss my role and the role of other USPHS officers who have taken the time out to provide me with a short interview and/or some notes to add to the Blog. Thereafter, I'll take you to the heart of the action in New Orleans, where I am currently deployed to provide IT/Communication support at the New Orleans Convention Center.

LT James Hall, USPHS in the field hospital set up at the Pete Maravich Assembly Center on the Campus of Louisiana State University in Baton Rouge.

Last revised: January 4, 2007