USA: Climate change, wildfires, and how public health leaders can rise to the challenge

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Health Affairs Blog

By Barbara Ferrer

The largest near-term impacts of climate change on society come in the form of weather and climate extremes. Experts estimate that as many as 10,000 people lost their lives from natural disasters in 2018, compared to 50,000 in the prior 30 years combined. In Southern California, the region I call home, drought and warm temperatures recently brought a second year of historic wildfires, where the Thomas, Rye, and Skirball fires burned an area nearly the size of the city of San Antonio, Texas, and the Woolsey fire scorched an area roughly the size of the city of Denver, Colorado. The Woolsey Fire alone destroyed more than 1,500 homes and structures. The blaze forced evacuations of more than 295,000 people and resulted in prolonged power outages for more than 40,000 people. 

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Preparedness

One of the main sources of federal support for communities facing emergencies such as these is through the Center for Disease Control and Prevention’s Public Health Emergency Preparedness (PHEP) Cooperative Agreement program. Serving a county with more than 10.2 million residents, our department received $19.6 million in PHEP funding for fiscal year 2017–18. PHEP grant funding allows us to exercise, train, build, and sustain skilled personnel and capabilities for a broad range of public health emergencies including natural disasters such as the fires; emerging infectious diseases; and chemical, radiological, nuclear, and bioterrorism attacks. 

Our county’s ability to prepare for the level of rapid response for the Woolsey Fire was a result of the PHEP support for personnel and resources to plan and prepare for all kinds of public health emergencies. Before the fire even started burning, our department conducted hazard vulnerability assessments; developed, trained, and exercised emergency plans; purchased and staged medical supplies and equipment; and strengthened community resilience by engaging stakeholders across all levels of government, business, community, education, health care, and emergency management to assure coordinated countywide response, communications, information sharing, and resource management during emergencies.

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Coordination

Coordinating with other municipal departments to ensure continuity of service proved essential. We provided information on extremely vulnerable populations to local fire departments, to assist with evacuating in at-risk fire zones. These populations included elderly residents dependent on electricity-powered medical equipment and other life-saving services. Our department supported the evacuation and transfer of medically fragile patients from skilled nursing facilities and congregate living facilities impacted by the fire. 

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