ARTICLE SECTIONS

1. Hurricane Harvey Medical Emergencies
2. The Power of Waters
3. Effects of Hurricane Harvey
4. Health Effects of Mold
5. Advice for Those in Hurricane Zone
6. Mental Health Issues
7. Summary

As we watched Hurricane Florence bear down on the east coast, it is incredible to think that it has been a year since the devastating Hurricane Harvey wreaked havoc on Texas.

The August 25, 2017 storm was historic in a catastrophic way.

Hurricane Harvey Medical Emergencies

In a storm like Harvey, there are many medical emergencies. Some occur right away, as people are left stranded in floodwaters. Others occur as people begin to recover in the days after the storm.

Still other emergencies occur because of lingering health problems long after Harvey has gone.

Dr. Peter Hotez, dean of the National School of Tropical Medicine at Houston’s Baylor College of Medicine, categorizes the injuries this way: “I distill it down to short term, long term and big picture.”

At SignatureCare Emergency Center, we have certainly seen our share of all three of the injury types that Dr. Hotez describes, and we’ve seen these medical emergencies at all of our locations in Houston and other cities in Texas.

We wanted to share some of them with you.

In the short term, we saw immediate dangers caused by people wading through flood waters.

After days and weeks, longer term issues like mold set in, meaning respiratory issues set in, too.

Big picture items as described by Dr. Hotez are the prolonged stress and mental health issues that Harvey brought to so many Houstonians.

The Power of Water

Most people underestimate the sheer power of moving water. The National Weather Service (NWS) continuously cautions people about this, stating that even a mere six inches of water can knock over an adult, if the water is moving fast enough.

It was definitely moving fast enough in the days surrounding Hurricane Harvey.

Rushing water is very dangerous, and at SignatureCare Emergency Center, we routinely treated cuts and abrasions and even broken bones after Harvey—all stemming from people being in the water when they shouldn’t have.

Why do people underestimate the power of water? Social scientist Julia Becker studied behaviors of people during natural disasters like Harvey, and found that they routinely underestimated the power of flood waters.

People even knowingly go into flood waters as if it were a swimming pool, to play and splash around, and some people actually walk or drive to flooded areas just to sightsee.

These behaviors are dangerous and even water that appears calm can be very unsafe.

Effects of Hurricane Harvey

We treated countless cuts and administered thousands of stitches during Harvey because of injuries caused by stepping on or touching shards of glass or sharp, jagged metal that was floating in the floodwaters.

Infections

For many people who cut themselves on metal debris, one of their first thoughts was “I wonder if my tetanus shot is up to date”?

In the aftermath of Harvey, Texas health officials urged people not only to stay out of the water, but to also get their tetanus boosters to protect themselves against the disease.

Tetanus also comes from a microbe found in soil.

Tetanus definitely enters the body through cuts, and at SignatureCare Emergency Center, we had a tremendous influx of people needing tetanus boosters in the days and weeks after Harvey.

Tetanus is not the only thing lurking in flood water. Flood waters are just plain nasty.

Microbes and infectious diseases of all sorts are lurking in their depths. If your home or business was classified as contamination Category 3, that means black water, also known as sewage water in buildings.

In Kingwood , a suburb of northeast Houston, six of nine buildings on the campus of Lone Star College Kingwood were flooded with black water. The cleanup alone cost $11 million.

Sewage systems across the city overflowed with human waste that flowed freely into flood waters.

Even a year after Harvey, the West Fork Watershed Partnership just finalized a plan to reduce the fecal matter that is polluting the west fork of the San Jacinto River.

Fecal matter is just one disgusting example of the contamination that is likely in flood water.

Dr. Hotez says that it is not easy to predict the microbes that will be in the waters, but we know that at SignatureCare Emergency Center, we saw many people with infected areas come in for treatment.

Cuts and Lacerations

A large majority of these were cuts on the feet that had become infected.

We even saw many toes that were infected. People had not worn adequate foot protection in the water. Even the least little amount of water can seep in and infect your body.

Many people told us they didn’t have cuts, so they didn’t understand how their toes became infected. Often, bacteria from flood waters can seep into openings in your toenail or fingernail cuticle and infect your body that way.

In one day, we had four patients come in with fairly severe infected toes. They had waited, thinking that applying topical antibiotic creams would do the trick, only to find that their infections worsened day after day.

Many people were so busy trying to salvage their homes and property that they felt they could not take the time to go to the emergency room.

Don’t wait. Take the time to seek treatment. In all four of the cases we saw that day regarding infected toes, if the patients had waited one or two more days, they would have had much more serious problems, perhaps even requiring amputation.

Watch for Cellulitis

If you notice redness, swelling and pus (cellulitis) around an open cut, be vigilant. Wounds that appear “red and angry” need immediate attention.

Our SignatureCare ER physicians note that infections like this can progress to serious levels in as little as 10 hours. Fever and chills could be an indicator that your infection has gone systemic.

In 2005 during Hurricane Katrina, a group of New Orleans evacuees were sent to Dallas and soon, there were 30 cases of infections with antibiotic-resistant staphylococcus bacterium, commonly known as MRSA, which the Centers for Disease Control (CDC) determined came from a water borne source.

During Harvey, people around the city were infected with Vibrio vulnificus pathogens, more commonly known as flesh-eating bacteria.

Our emergency room saw all sorts of skin infections and rashes. Vibrio infections are extremely rare, but during floods, these deadly microbes are swept in from the open ocean into urban areas.

E. coli Risks

The floodwaters after Harvey contained literally billions of various pathogens and bacteria, even E. coli that comes from fecal matter.

When ingested, E. coli can make people very ill, with severe diarrhea and other intestinal symptoms.

Water testing in many homes revealed bacteria levels hundreds of times above the safe level. It is very important to remember that floodwater mixes with everything below it—fields with pesticides, manure, broken sewer pipes—everything.

Flood waters carry microbes from swept up soil, microbes from ocean waters and microbes from human waste and other contaminants.

Injuries from Animals

Microbes, metal and glass are joined in floodwaters by all sorts of critters. We can’t tell you how many fire ants stings we treated at SignatureCare Emergency Center ERs across the city.

Fire ants clump together in the water and will use any floating object as a raft. The ants will even cling together and form their own raft even if they’re not floating on top of any object.

During Harvey, there were so many floating colonies of ants that were so large, people didn’t realize they were ants until it was too late.

Snakes are also very prevalent in the water. Snakes naturally seek higher ground, so there can be many snakes in the floodwater and emergency rooms across Houston definitely saw their share of snakebite cases, whether venomous or non-venomous.

Perhaps one of the worst issues was mosquitoes.

This was not an immediate problem, because the flood waters washed away much of the larvae, but as soon as the floodwaters receded and there were once again stagnant pools of water around, mosquitoes once again began laying their eggs in force.

These pests carry all kinds of diseases like West Nile virus and Zika. For example, Katrina data shows us that West Nile virus infections more than doubled in communities that had been affected by the hurricane.

Mold

Mold is always a problem in the humid climate of Houston, but it was a rampant problem after Harvey. Mold formed in the days and weeks after the hurricane.

As homes became visibly dry, they really are far from it. Mold can form in wet sheetrock between walls and in insulation.

The proper mold remediation process certainly takes care of it, but Houston had all sorts of issues after Harvey.

There are only so many local contractors, and even with the large influx of contractors from out of state, many homeowners were forced to wait for someone to do the remediation process.

If your home was flooded, mold is usually not at the top of your list of concerns, but in the days and weeks after Harvey, it quickly moves to the top of the list.

A homeowner can be forced to spend weeks away from their homes while the remediation is done; many homeowners do not realize it will take that long.

As many of us who have lived in Houston for some time know, our climate is a perfect breeding ground for mold. Our warm, humid client and the waterlogged conditions made our homes and businesses a perfect breeding ground.

Molds grow out of control, relatively fast within days. If you were not proactive on combating it, the mold likely quickly took hold of your home.

Health Effects of Mold

Molds are incredibly irritating to the respiratory tract. They can create irritation and damage and are a particular concern in people who suffer from asthma, chronic sinusitis, COPD, emphysema and other respiratory issues.

Many people who were perfectly healthy before Harvey developed respiratory issues from prolonged exposure to these molds.

Our SignatureCare ER physicians advise people to pay attention to any changes regarding not only their respiratory health, but also their overall health.

You may experience a change to your sensitivity to things like mold.

Dr. Sumita Khatri, co-director of the Asthma Center at Cleveland Clinic, explains that there have been many studies showing how chronic exposure to mold can greatly complicate any respiratory issue you already have.

Khatri says, “no matter what medications you’re on, unless you’re removed from the mold, it can cause progression of the condition where even the medications won’t help you that much.”

Still, Khatri says that it is important to remain on your medications.

The worst symptoms we see from routine mold exposure are allergic reactions, which can complicate other health problems the person may have.

Experts like Khatri always advise to wear masks and rubber gloves to avoid breathing in or touching the mold. Always wear a proper facemask designed to keep out irritants.

Khatri says a handkerchief tied over your nose and mouth won’t cut it. She also advises not to stay in any home that has mold, which was hard to do, considering Houstonians were trying to save their own homes.

Always wear protection when returning to a flooded home. Khatri says there is no such thing as going in and out of the home “really quick”.

She says if there is a large enough mold infestation, the spores are everywhere and you can be exposed immediately upon entering the home.

Khatri says that mold can continue to grow even a year after the hurricane, so that means that today, many Houstonians can still be experiencing respiratory issues.

If you’re one of them, come in and visit us at SignatureCare Emergency Center. We are here to help.

Stress

Needless to say, Houstonians were under tremendous stress during and after Harvey.

Stress can definitely negatively affect your immune system and it can also affect your brain, too.

The stress of a flooded home, and the stress of a crowded shelter if you were in one, can greatly affect your body’s ability to fight off infection and illness.

People housed closely together in crowded conditions are at a higher risk of getting sick because you’re around people you are normally not around, and the stress just makes it worse.

As if the above is not stressful enough, battling the Houston heat kept many people further stressed out.

Harvey hit the area in late August, during one of the hottest times of the year. The combined effect of the environmental factors and the stress took its toll on many Houstonians.

Chemical Irritants

Mold was not the only driver for respiratory problems. Texas is known for its chemical plants. This is oil country after all, and there are numerous natural gas and oil refineries throughout the area.

In fact, one-third of America’s oil is processed here. Harvey caused many chemical plants to go offline.

Harvey was like nothing anyone expected, and many primary and backup generators at these chemical plants both went offline.

As such, these plants became unstable. Many burned or even exploded and released harmful pollutants into the water and the air.

The explosions at the Arkema plant on the outskirts of Houston were widely covered in the national media.

The pollutants from explosions like Arkema can be skin irritants as well as respiratory irritants.

What many Houstonians didn’t know is that their respiratory problems may have started before Harvey even made landfall.

Before the storm hit, many refineries and chemical plants had no choice but to intentionally burn chemicals in order to dispose of them to hopefully keep the plant safe during the storm.

For example, Chevron Phillips burned nearly 800,000 pounds of chemicals before Hurricane Harvey made a landfall.

Many of these chemicals, about 300,000 pounds in the case of Chevron, are odorless and colorless so you never know what will hit you.

You could be experiencing respiratory issues and wonder why. The combination of the mold spores and a colorless and odorless chemical would wreak havoc on your poor lungs.

Power Lines and Generators

Whenever you watch the weather after a storm, the weather station always warns people to watch for downed power lines.

Severe weather frequently knocks over electrical lines, and this was a huge problem after Harvey.

Houstonians lived for days or even weeks on portable gas-powered generators.

At SignatureCare ER, we do treat people who have injuries related to generators.

First, we see burns that need to be treated. Second, we see patients who may be experiencing some of the effects of inhaling carbon monoxide.

Generators should always be run outdoors in a well-ventilated area to avoid the buildup of carbon monoxide. Avoid breathing the gas fumes as the generator runs.

Advice for Those in Hurricane Zone

If possible before the storm, stock up on medications. Insurance company policies to only give you a 30-day supply do make it difficult to do this sometimes.

If you have an option, go for filling the 90-day supply. People forced to evacuate struggle to get their prescriptions filled in other locations.

This is a particular problem for people with chronic medical conditions who really depend on these meds.

Insulin for example was in very high demand in Houston. It is particularly hard to stockpile close to a storm area because it must be kept cold.

Pharmacies do their best to stockpile medications; nearly 300 Walgreens pharmacies remained open throughout Harvey to serve their communities.

At SignatureCare, we saw many patients in the days and weeks after Harvey who came to us for help in managing their diabetes and other conditions like hypertension.

Mental Health Issues

We would be remiss if we didn’t mention the mental health impacts of Harvey. These impacts are a definite long-term consequence of storms of this magnitude.

Post-traumatic stress disorder (PTSD) and depression are common issues. In fact, many people experienced bigger mental health issues than any threat to their physical health.

People always talk about how folks who live along the Gulf Coast are resilient because they are used to hurricanes, and that is true, but Harvey was like nothing any of us had experienced.

Even the most stalwart people can unravel when homes and businesses are flooded, family members are lost or become ill, and you deal with the days and months of hard work to repair your lives.

Even now that Harvey has passed, many people are finding that bad weather events like the torrential rains we received over July 4 or Labor Day trigger unpleasant memories and fears.

The more people are disadvantaged, the worse these problems typically are. People with less education and lower incomes often have many mental health issues in the aftermath.

It has only been a year, but many people’s homes are still not recovered, so the depression and fear are still very real for many Houstonians.

Psychologist Katie Cherry says that symptoms do dissipate over time, but that certain groups are more vulnerable. Women tend to have more problems than men, as do the elderly and children.

Many elderly people and children experienced great trauma at having to leave their homes. For both groups, the home is their ultimate security, and it is hard to leave.

Our colleagues tell us that they have even seen patients who were deeply affected by Harvey, even though their own homes and businesses did not flood; they’re simply affected by all the pain and suffering around them.

Summary

A year after this devastating storm, it is amazing to realize all the devastating affects Harvey has had on our communities.

All of us here at SignatureCare Emergency Center, are here for you to help you with whatever health concerns you have. We hope you’ll stop by and see us. Let’s celebrate how well we’ve weathered Harvey together.