Episode 5: Extreme Weather and Emergency Preparedness

[00:00:00] Sophia Gauthier: Welcome back. I am Sophia Gauthier. And I’m Graham Aufricht. We are pediatricians and hosts of this podcast Clinicians, Kids, and the Changing Climate. For

[00:00:11] Graham Aufricht: five long days in August 2017, Category 4 Hurricane Harvey made landfall in Texas and Louisiana, dumping 33 trillion gallons of water. The storm resulted in catastrophic flooding that impacted 13 million people, damaged over 100, 000 homes, and caused over 100 billion of damage, on par with Hurricane Katrina 12 years prior.

[00:00:34] Sophia Gauthier: A few years later, in 2021, Texas experienced a record breaking quote big freeze, which was a cold wave thought to be the result of a meteorological phenomenon called Polar vortex stretching that caused almost 150 deaths and at least 20 billion in damages.

[00:00:54] Graham Aufricht: Okay. So I am sensing a theme for today’s episode.

[00:00:58] Sophia Gauthier: Yeah. Just like heat waves and wildfires, the risk of extreme weather, whether that be hurricanes or storm surge and flooding or extreme temperatures is projected to become more and more frequent with the changing global climate.

[00:01:12] Matthew Wilkinson: My name is Matt Wilkinson. I am an Associate Professor in the Department of Pediatrics at Dell Medical School in Austin, Texas.

Uh, I’m also the Research Director for the Pediatric Emergency Medicine Fellowship and the Assistant Chair of Clinical Research for the Department of Pediatrics. I also am a practicing Pediatric Emergency Medicine Physician, uh, since… Uh, here since 2008. Just two years ago, uh, we had, we experienced the big freeze in Austin, Texas.

Um, you know, and this is something that, uh, I don’t know, once in a century event where the temperatures actually dropped below freezing, I think for four or five straight days. Um, and almost caused a catastrophic power grid failure. Um, they say that they were minutes away from losing the entire power grid in Texas.

Um, but what it did cause, uh, for us, uh, that were on the ground in the emergency department, uh, it just, it shows you what happens to a system that’s already stressed, um, by bad weather that’s getting influx of sick people that maybe can’t handle it because their power is out or their water is out. All the things that you take for granted, uh, in a hospital, in an emergency department, suddenly losing them and, and, you know, trying to take care of sick people.

Uh, at a higher rate when, you know, you don’t have the things that you’re used to having. I’ve seen reports about the, you know, the carbon monoxide poisonings that occurred after that event. You know, in the days, right after the beginning of the freeze, spiked something like 50 times. Like a 50 fold increase in, uh, the number of, um, you know, patients being seen in the ED for, uh, carbon monoxide poisoning, which is…

is pretty stressful on a system, again, that’s already dealing with, um, all of these, these issues created by the weather event itself. Going back, and most of us remember Hurricane Katrina, uh, and the way that that devastated many states, but particularly Louisiana and New Orleans in particular, uh, where multiple hospitals were flooded and shut down with patients inside and closer to home.

Uh, I think many of us will also remember, uh, Tropical Storm Allison. Uh, that hit the Houston area in, uh, I believe 2001, um, and completely devastated the medical center there. There was massive flooding, there was decades of research lost, um, and the infrastructure was heavily damaged and it took a very long time, uh, to recover from that.

Um, and then, you know, fast forward to 2017, uh, when Hurricane Harvey hit, um, is actually one of the, um, great successes of, you know, preparation for this sort of climate event. The medical center, um, they sort of learned their lesson and had done quite a bit of work to protect the area with levees and these like submarine style, uh, storm doors on basements.

Uh, and they came out relatively unscathed. So. Um, I think it’s a little bit of a model, uh, for how we should be thinking about, um, some of these things in these areas that are really prone to having bad weather events.

[00:04:21] Sophia Gauthier: So, according to the United Nations, flooding is the most common natural disaster worldwide in both industrialized and developing nations alike.

Sustained rise in the number of floods and storms has pushed the average annual total up to 335 disasters per year after 2005, 14 percent higher than in the previous decade and more than twice the level ever recorded between 1980 and 1989.

[00:04:48] Graham Aufricht: Wow, those numbers are incredible. Uh, Sophia, who is at the greatest risk for this type of flooding?

[00:04:55] Sophia Gauthier: So, coastal areas, people who live in coastal areas are at particular risk because of flooding from storm surges as well as global sea level rise. In 2023, the EPA Issued a report titled, quote, climate change and children’s health and well being in the U. S. They report that if no additional adaptation measures are taken approximately 185, 000 children are projected to lose their homes due to coastal flooding if global sea rise exceeds 20 inches.

[00:05:23] Graham Aufricht: So, acutely, I can see how flooding poses a risk for children with drownings and injuries related to mental trauma, property damage. But what are some of the other risks that there are related to flooding?

[00:05:35] Sophia Gauthier: So, we touched on this a little bit in the last episode, but flooding poses a risk for waterborne diseases.

Well, for example, data have linked heavy precipitation episodes with subsequent spikes in diarrheal illness presentation to local emergency departments as a result of overwhelming older sewage systems. It’s predicted that climate change will increase the instance of diarrheal illnesses, which is already a cause of significant mortality in children in low and middle income nations.

And

[00:06:02] Graham Aufricht: are there long term effects of

[00:06:03] Sophia Gauthier: flooding? So longitudinally, homes that experience flooding are more likely to have dangerous levels of mold, which is linked to the development of Childhood asthma. And I imagine

[00:06:12] Graham Aufricht: the risks are not evenly distributed either.

[00:06:14] Sophia Gauthier: No, they generally are not. So the impact of flooding is often felt more acutely in low income neighborhoods, as evidenced by the neighborhoods most affected by Hurricane Harvey in Houston.

Over time, wealthier residents who have the means to retreat inland displace low income populations, which leads to sort of climate change related gentrification. Okay, so some pearls from this episode.

[00:06:38] Graham Aufricht: First, extreme weather, including hurricanes, thunderstorms, and temperature extremes are predicted to become more commonplace with climate

[00:06:45] Sophia Gauthier: change.

Second flooding is the most common natural disaster worldwide. This is in contrast to extreme heat, which is the deadliest environmental hazard. Flooding

[00:06:55] Graham Aufricht: poses both short-term risks, such as the risk of injury or death with flash flooding, as well as the mental trauma of experiencing extreme weather events that can lead to loss of a home.

We

[00:07:06] Sophia Gauthier: can also project the longitudinal risks of displacement due to coastal flooding. Homes that experience flooding events are also at higher risk for mold development, which is harmful to respiratory

[00:07:15] Graham Aufricht: health. So how can we help as

[00:07:17] Sophia Gauthier: pediatricians? So as always, patient education and anticipatory guidance is key.

In extreme weather events, we can screen families for housing insecurity and connect them with local resources to affordably and safely insulate the home. We

[00:07:32] Graham Aufricht: can also teach families about the importance of water safety skills, swimming skills, and advice children not to play in storm runoff.

[00:07:40] Sophia Gauthier: Another good rule of thumb to remember in acute flood events is 6 inches of water is enough to cause car tires to lose traction, and 12 inches is enough to float most vehicles.

So if you see a flooded road, Charlie should not be driving through it. And

[00:07:55] Graham Aufricht: lastly, disaster preparedness. Helping families, especially those with medically complex kids, think about getting a backup generator. We also wanna remind people to think about having spare supplies on hand for emergency departments.

It’s important to start thinking about how the department might maintain staff in cases of extreme weather, where accessing the hospital might be challenging. Ensuring water and power security in the hospital. I

[00:08:20] Sophia Gauthier: asked Dr. Wilkinson about a 2019 statement from the American College of Emergency Physicians.

It addresses how emergency medicine doctors can change their practice to adapt to a changing climate. I think the

[00:08:32] Matthew Wilkinson: ASAP, uh, statement, uh, was a good first start. And so that was, uh, yeah, back in 2019, uh, and sort of had six points to it. Um, the first was to raise awareness of the implications of climate change.

Uh, and how it would affect the way emergency physicians practice. Um, you know, they, they also bring up the importance of research. You know, we want the things that we’re doing and the things that we’re saying to be based in evidence and not politics or hysteria. And I think, um, you know, the science is catching up and, and starting to, to show that, obviously the things that we’re saying, the claims that we’re making, they’re very strongly um, rooted in science.

Um, Also to advocate for policies and practices, uh, that mitigate the effects of climate change on health. Um, and advocating for, you know, increased public health, uh, infrastructure, increased surveillance of emerging diseases, things like that, that are all, uh, thought to be affected by climate change. Um, you know, they, they also make a point to talk about, Reducing our own carbon footprint.

You know, hospitals historically are one of the, you know, the biggest, um, contributors to climate change to carbon output. Um, very, very inefficient often, uh, structures. And so, you know, we’re very proud here at Dell Children’s Hospital to be, um, you know, part of the, I think they were the first Leeds Platinum Certified Green Hospital.

Um, which is, is a pretty big deal and should be a model for. You know, other hospital systems going forward.

[00:10:08] Sophia Gauthier: So that is all for today. Join us for our next episode on climate and mental Health. This podcast was researched and written by myself, Dr. Sophia Guttier. A massive thank you to my friend and co-host, Dr.

Graham Aufricht, as well as our guest, Dr. Matthew Wilkinson, for his expertise in pediatric emergency. The podcast was produced by the fantastic audio engineers at the University of Texas at Austin Liberal Arts Instructional Technology Services team with funding via a pediatric medical education grant and instructional support from the Medical Education Fellowship at the University of Texas Dell Medical School.