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A Flood of Problems ^RO YYN aK^O\] L_^ YX +_Q


# YP MSKV] ^RO\O aO\O ^YVN K XOK\Lc YYN MYX^\YV


dam was giving way. “We were told that the dam was going to bust,” he said. “So as a precaution,


aO MVY]ON ^RO RY]ZS^KV E^Y XOa K\\S`KV]G PY\ RY_\] ^Y Z\OZK\O PY\ ^RO YYN v That was a huge inconvenience for the many people who needed the hospital,


WY]^ YP aRYW RKN ^Y QY SX^Y WY\O LKNVc YYNON K\OK] ^Y QO^ ROKV^R MK\O “But we didn’t have any choice,” said Dr. Garcia, the 2015–16 TMA president.


“We have 200 patients in our hospital, and we’ve got to take care of what we’ve got.”


>RO POK\] YP YYNSXQ KV]Y WOKX^ ^RO ]^KPP RKN ^Y WY`O KVV ^RO O[_SZWOX^ P\YW


^RO \]^ YY\ ^Y ^RO ]OMYXN YY\ KXN MVY]O S^] OWO\QOXMc NOZK\^WOX^ 7Y\O importantly, all the patients had to be evacuated. “We called in 12 helicopters,” he said. “One would land, we’d put the patient


in, and they would go to Dallas. And another one would land, and we’d put another one in, and that one would go to San Antonio. Our ICU was vacant within four hours.”


Public health concerns


+Xc WKTY\ YYN MK_]O] ]O\SY_] OX`S\YXWOX^KV ROKV^R ^R\OK^] ]Kc] .\ 7_^^O\ the Columbia University professor. Increased mold in soggy buildings causes respiratory problems for those with asthma and allergies. Mosquitoes breed more easily in the stagnant storm water, making viral infections like West Nile, dengue, and Zika more likely. But he says concerns about mosquitoes and mold can often be overblown because those problems are treatable or preventable. For instance, in the weeks that followed Harvey, the U.S. military conducted aerial spraying for mosqui- toes in most coastal counties. “[Mold and mosquitoes are] an issue, but they’re not a dramatic issue,” he said. “There may be a couple of cases. But we know how to deal with mosqui- toes. That’s not new. And we know how to deal with mold. It’s not new, either.” Water-borne illnesses and infections will remain a problem for months as


ZOYZVO MVOKX _Z YYN NKWKQON RYWO] KXN YYN aK^O\] N\KSX KaKc ]Kc] .\ Ziebell, the Dell Medical School professor. One of the deaths attributed to Har- `Oc aK] MK_]ON Lc XOM\Y^SdSXQ PK]MSS^S] LO^^O\ UXYaX K] O]R OK^SXQ LKM^O\SK “One of the things I don’t think people realize is that the sewer system is under-


ground, and it’s connected to the outside world with pipes and tubes and whatnot, KXN aROX cY_ YYN KVV YP ^RK^ ^RK^ WOKX] ^RO YYNaK^O\ KXN ^RO ]OaO\ aK^O\ K\O in contact with each other,” Dr. Ziebell said. “So we start to see a lot more infec- tions with things that would be present in sewage. We’ll be watching for things like E. coli infections in wounds and things like that. But also things like cholera and food-borne illness and hepatitis and that kind of stuff can also spike up.” +P^O\ O`O\c YYN ^YbSM MROWSMKV] VSUO QK]YVSXO KXN YSV P\YW ]aKWZON MK\]


VOKU SX^Y ^RO YYN aK^O\ 3X WY]^ MK]O] S^ S] ^YY NSV_^ON ^Y LO K ]SQXS MKX^ ^R\OK^ L_^ 2Y_]^YX Z\O]OX^] ]ZOMSKV Z\YLVOW]$ >RO \OQSYX ^RK^ aK] YYNON S] \O]ZYX sible for 40 percent of the nation’s petrochemical production and 30 percent of S^] YSV \O XSXQ According to the Houston Chronicle, more than a dozen chemical and re-


XSXQ ZVKX^] \OZY\^ON NKWKQON ]^Y\KQO ^KXU] \_Z^_\ON MYX^KSXWOX^ ]c]^OW] and malfunctioning pressure relief valves because of Hurricane Harvey. Harvey KV]Y YYNON K^ VOK]^ =_ZO\P_XN ]S^O] aRO\O ^YbSM aK]^O aK] PY\WO\Vc ]^Y\ON


28 TEXAS MEDICINE November 2017


Health problems from these mishaps could linger for years. Volunteer physicians working at shelters saw few signs of toxic poison- SXQ KWYXQ \]^ \O]ZYXNO\] Y\ ZOYZVO who spent time in the water in the days KP^O\ ^RO YYN .\ /R\VSMR ]Kc] ,_^ K special task force of state and federal en- vironmental specialists has been named to monitor the problem long-term. Jeffrey Levin, MD, professor of oc- cupational and environmental medi- cine at The University of Texas Health Northeast in Tyler, says physicians also should be on the lookout for more common types of toxic poisoning. For SX]^KXMO ZOYZVO MVOKXSXQ _Z YYN damaged houses could come into con- tact with lead paint. u>RK^t] WY\O NSP M_V^ ^Y NSKQXY]O in some cases,” he said. “But it is also more insidious and chronic.”


“There was the smell, and there


were no lights” >RO YP MO YP /]^OLKX ,O\LO\SKX 7. at the East Houston Regional Medical Center building was almost complete- Vc aSZON Y_^ SX ^RO \OMY\N YYNSXQ “We spent a couple of days going


^R\Y_QR ^RO YVN YP MO aRSMR aK] KLY_^ seven feet under water, … trying to sal-


Flood waters reached about seven feet high in the of ice of


Esteban Berberian, MD. Photo by Tammy Anderson/Mark Owens


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