For those of us living in states where hurricanes are an annual event, we personally prepare for disaster response as a community, as a city, and as a state. I believe that, in general, we are reasonably well prepared to respond to the immediate aftermath of hurricanes, but we could respond better to issues that can appear later, especially those that have long-term impacts. As the recent experience in Puerto Rico revealed, the earthquakes that came soon after the historic 2017 hurricanes showcased our vulnerability and lack of preparedness to respond to multiple disasters of different types. We need to do a better job, particularly when we are faced with two disasters occurring back-to-back or two different types of disasters happening almost simultaneously (10.1542/pir.2018-0208). I do not believe that, as a nation and as individual states, we are prepared for such dual calamities.
We are still struggling to respond effectively to the COVID-19 pandemic. Hospitals and emergency resources are still stretched in many places. States like Florida, Texas, and Louisiana, who are especially vulnerable to hurricanes, saw surges in cases this summer, and Oregon, Washington, and California, all hit hard by the pandemic, are currently battling wildfires and the resultant displacement of nearly half a million people. Preparing for natural disasters alongside coping with the current epidemic is complex and challenging.
Add to this that minorities and low-income are more at risk and struggle more with recovery from natural disasters and COVID-19, and you have a triple disaster. Such a convergence could impact minority communities in such a manner that could make Hurricanes Andrew, Katrina, Maria, and Irma seem like walks in the park.
Hurricane Laura and the continuing fires in the West this summer and fall have highlighted these struggles. Emergency shelters are not conducive to social distancing, mandatory masks are difficult to enforce, and evacuations and recovery operations must be adapted. It would not be surprising to see a rapid and exponential increase in cases of COVID-19.
Moreover, the risk of vaccine-preventable diseases is at an all-time high due to the decrease in childhood immunization rates during the coronavirus pandemic. This is worrisome even without the complications of shelters and post-disaster conditions. My nightmare is an outbreak of measles, pertussis, or rotavirus on top of coronavirus. We may see a severe outbreak of diseases the likes of which we have not seen in our lifetimes.
The already-stressed healthcare systems running at or near capacity in many jurisdictions and nearing their breaking points will be challenged in ways they have never been. The public health system that has been slowly dismantled over the decades will not be able to meet this possible unprecedented challenge, further increasing the risk of infections we have not seen in recent generations.
The states and FEMA need to be preparing to handle the huge challenges of this predictable triple disaster. If there are plans to deal with this triple disaster, they must be made public to increase public confidence—a confidence that has been waning as the pandemic wears on, still lacking a coordinated plan.