This is the first Q&A in a series about hurricane preparation and response during the COVID-19 pandemic.
In the early days of the COVID-19 pandemic, local governments had to quickly adapt their emergency preparedness plans to make space for social distancing. Throughout the 2020 hurricane season, cities and towns spread out over multiple shelters and provided PPE; officials had to communicate about crises remotely, often with fewer staff and the same budget.
Now, more than two years into the pandemic, mask mandates are no longer required in most places, and vaccination rates —particularly in Southern states—lag behind other countries. Still, cases are on the rise again, and public health researchers warn that the prevalence of home tests means national testing data might be undercounting cases.
As federal pandemic policies come to an end, state and local emergency operations may return to a pre-pandemic normal in some states, as well. In the middle of hurricane season, that means Gulf Coast residents may soon need to decide how to evacuate and shelter safely if a storm comes to pass.
Southerly spoke to Angela Clendenin, an assistant professor at Texas A&M University who researches emergency management and risk communication, about how emergency management and public health officials should work together to adapt to infectious disease spread, and how to keep yourself safe as the burden falls on individuals to navigate the pandemic.
Southerly: What are the major obstacles to setting up mass shelters during a hurricane within a pandemic?
Angela Clendenin: Number one, if you’re an emergency manager in a reception city where evacuees would go to, or if you’re in a county that’s hit and you’re having to set up shelter, there are limited spaces that can handle a large number of people. And when I say large numbers, it could be anywhere from 100 to 1,000 people.
Without even considering a pandemic, you have to think about the logistics of, these people need places to sleep and you have to have places for them to eat. So you’re looking at shelters in school gyms or cafeterias because they have kitchens. And you have to have restrooms.
But then when you add the complications of a pandemic, the physical distancing issues, the masking, and then you start looking at the airflow of the buildings so that we’re not containing viruses and things like that. So it just added a whole extra level of complication for people that are planning evacuation sheltering operations.
As a society, we have to realize that COVID is not going anywhere. It’s going to become endemic. That’s when a disease is so prevalent in a society that it has plenty of hosts and it’s hopping round and round and mutating– and there’s not sufficient mitigation measures to build a wall around it. It just persists in that society, it persists in that population, and it’s just there. So, for instance, the flu is endemic in our society. We get used to it, we know what the symptoms are and you stay home. So we coexist with influenza. That’s what I mean by endemic.
COVID is something that is going to be circulating in our population for quite some time because of the rapid mutation of the virus, low vaccination rates, and low mask wearing. People are wanting to get back to normal.
But in evacuations, we are going to have people coming in of unknown vaccine status and we’re going to have people who aren’t going to want to wear a mask. Probably the best bet is to still try to provide some sort of distancing within the shelter itself.
In my mind, public health really needs to be instrumental in the day-to-day operations of those shelters. We can watch for people who may be showing signs of respiratory illness and find space nearby where those people can then be isolated and make sure that they get the care that they need. And whether it’s flu, or whether it’s COVID, it’s just a good idea when you have large congregate sheltering operations to plan space for people that may show up and have some sort of infectious condition.
How can we improve communications between emergency management offices and public health experts?
AC: Texas has always been a model state: We do emergency management for wildfires and hurricanes really well. The state department of health does a good job in their role.
Typically, your emergency management enterprise takes the lead role, and public health provides that support role and deals with the public health issues that arise from these different types of manmade or natural disasters. However, when there’s a pandemic, there’s an inherent need to flip that, where public health then takes the lead role, and emergency management then does all of the logistical support, getting masks and tests, then setting up testing centers and and vaccination centers and things like that under the guidance of public health authorities.
I don’t think any one state really flipped that switch very well. I do not think state departments of health were very prepared to have to take that lead role. So you saw a lot of emergency managers kind of stepping in to help with the logistics of testing [and vaccines]. But you didn’t really see the public health people stepping up. They did in the beginning, you know, with guidance and things like that. But as there was sort of a backlash against the public health measures at the national level about the science and guidance changing from week to week– I don’t think public health really stepped up to say, okay, here’s the deal with science and why guidance had to change every week. This is a new virus. We don’t know anything about it.
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What policies are in place today that can keep people safe in mass shelters?
AC: Inherently, we’re at a point where protecting yourself from infectious disease, whether it’s COVID, the flu, salmonella, E.coli, cholera, whatever it may be, is becoming more and more of an individual responsibility and not the responsibility of any kind of governmental enterprise.
And so from an emergency management perspective, I don’t know that there will be policies put in place. The mask mandates have been removed. There’s no vaccine mandate. So when it comes to responding to a hurricane, if you’re running a shelter, there may not be policies in place to keep your evacuees safe. But what you can do is use physical remedies, like putting in a little extra spacing with people.
You can offer people a rapid flu test or rapid COVID test if they want it. But the main thing is to be able to have an extra sort of space so that if someone in a shelter falls ill, they can be treated privately, respectfully and with dignity. But at the same time, they’re not around the general group of people where they might be spreading more infections.
How have other infectious diseases impacted emergency operations?
AC: Flu season is typically late fall to early spring, over the winter months– that’s not hurricane season. So you don’t really worry too much about the flu when you’re talking about evacuations from hurricanes. But when the Texas power grid failed in 2021 during Winter Storm Uri, we had to open up warming stations. There were issues because we had people with flu, we had people with COVID that we needed to have a place where they could get warm. So how do we try to set up a space where people can come in and get warm, that we can keep them far enough apart from others, so that if somebody comes in and maybe they’re asymptomatic with COVID, they’re not spreading it? At the time we could say you have to wear a mask indoors.
Now, if you’re worried that you’re going to get sick in a shelter, maybe you should take a mask and maybe you should go ahead and get vaccinated. But really, I think one of the big challenges to evacuation shelters, what you really worry about, is gastrointestinal disease– people being exposed to contaminated water or eating something bad because the refrigerator went out. And so you end up with salmonella or E coli infections. And then, you know, you have a hundred people trying to use bathrooms that were set up maybe for 50 or 20. So I think historically you could look at evacuation shelters and those types of hygiene related illnesses are the ones that are the most prevalent.
Is there a disparity in the type of public health resources that rural and urban counties can access?
AC: Not every county in the state of Texas has a health department, and I’m certain that that’s the same across any of the Gulf states particularly in rural, underserved areas– there probably isn’t a true local health authority. So then that’s where the state needs to come in and the state health department can be very involved in the community level planning. Most state departments of health are very involved in hospital preparedness planning so that hospitals are prepared to receive, you know, mass numbers of people in the event of a disaster. But I think we really need to talk through evacuation plans with public health, and come up with a shelter response plan for what happens when someone with a contagious disease comes in. And make that part of the training from this point forward.
It seems that a lot of the decisions that people may need to make this year will have to be made at the individual or family level. What should people be aware of as they make emergency plans for this year’s hurricane season?
AC: I really think if you if you are in a situation where you have to evacuate, not only do you need to have your normal preparedness items that we talk about all the time, but you need to be vaccinated, you need to carry a box of masks with you, and you need to be mindful of your surroundings.
Every member of your family can now get vaccinated– from a public health perspective, it is absolutely the right decision. The vaccines are safe, very effective. They keep you from getting severely ill and they can protect you, particularly in a shelter situation. The other thing is, when you’re indoors at the shelter, wear a mask.
Buy a few home tests so that if you start feeling bad, you can do a quick rapid test. Right now, it would be your responsibility to notify the shelter staff that you came down with COVID. They have an obligation to report it to the health department, and they can help you find places like hotels where you might be able to go.
People are hesitant to report that they have COVID. There’s still a lot of stigma around it, and then it percolates up to the idea of, “Now I’m in a shelter and I can’t afford to go anywhere else, I don’t have any family nearby.” It becomes one of those health disparity situations, and that’s why it’s so important for emergency managers to think this through in terms of public health.
Maybe COVID is this wakeup call where we start to say, you know, we need to have a plan in place for people who cannot afford to go somewhere else. But we can protect the main part of the population in a shelter while also caring for the people who come down with an infectious condition.
Amal Ahmed is Southerly’s disaster preparedness and recovery reporter. She is based in Texas.