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HOUSTON — When Hurricane Harvey hit Houston, a team of students with the Student Epidemic Intelligence Society (SEIS) quickly launched into action.
They were ready. Over the summer, the organization’s leadership worked aggressively to strengthen relationships with local health departments. They offered their support during emergencies, as they had nearly 12 years earlier when Hurricane Katrina evacuees sheltered in Houston.
“Our desire was to bring back the SEIS to its former glory,” says Lauren Leining, the organization’s president and a second-year Master of Public Health Student studying epidemiology at The University of Texas Health Science Center at Houston (UTHealth) School of Public Health. “Our response to Katrina is kind of legendary among students. We had a huge presence doing disease surveillance at Reliant Park and the Astrodome.”
As Harvey’s floodwaters inundated the city, Leining hit the phones.
One of her first calls was to Kristy Murray, D.V.M., Ph.D., at Baylor College of Medicine. Murray founded the SEIS at UTHealth School of Public Health in 2003, and helped led the SEIS team responding to Hurricane Katrina in 2005. That effort set the standard for disease surveillance in emergency shelters, and helped detect a potentially dangerous norovirus outbreak.
Murray contacted her sources at the Houston Health Department and Harris County Health Department. Both enthusiastically accepted her offer for help.
Leining sent out an online sign-up sheet to recruit volunteers, open to students, faculty and staff. They started work on Thursday, Aug. 31, at NRG Center and Friday, Sept. 1, at the George R. Brown Convention Center. In all, about 125 people volunteered.
The SEIS team conducted cot-based surveillance, using their own survey, at the George R. Brown and supported the Harris County Health Department at NRG Center.
Leining and SEIS executive board member Christina Kadine Carstens developed a survey in Google Docs that gathered evacuees’ zip codes, ages, symptoms of illness, and immediate personal needs. The survey could change from day to day depending on what the city needed to know. They also asked whether residents had any other questions or concerns.
Each evening, about 20 to 30 SEIS volunteers gathered at the George R. Brown for a quick briefing on shelter rules and issues, and then fanned out among the three halls in the massive convention center to survey shelter residents. At the peak of the storm, the convention center housed between 9,000 and 10,000 residents. SEIS volunteers surveyed an estimated 500-700 people a night, Leining says.
They accessed the survey on their phones, and each survey was timestamped, allowing shelter officials to give real time updates and request health services teams, staffed by UTHealth School of Nursing students and Red Cross volunteers. Houston Health Department nursing teams coordinated with Red Cross nurses and volunteers.
“Their surveillance was helpful because it rounded out our awareness of what was going on in the shelter,” says Kirstin Short, M.P.H., bureau chief of epidemiology at the Houston Health Department, who oversaw relief efforts at the George R. Brown. “People don’t always go to the doctor for symptoms they consider to be more minor. Sometimes that can be exacerbated in disaster scenarios. It reassured us that we were seeing the same level of health complaints in the surveillance efforts as in the clinics. And that there wasn’t any illness bubbling up and ready to explode. It gave us a deeper look into the health of the community.”
The survey found that up to a third of shelter residents were homeless prior to the storm—helping shelter officials bring in the right level of services targeting the homeless population.
Feedback from SEIS volunteers also helped improve shelter operations. The Red Cross designated a special space for families and children, after learning single families had safety concerns, and they kept dinner lines open longer, when they discovered that the line closed while people were still waiting. When they found that diabetics were having a difficult time maintaining their blood sugar, they added a snack line with cookies for diabetics and vegetarian meals and snacks. The health services team also began checking on patients with mobility problems at the bedside, rather than sending them to the clinic at the opposite end of the shelter.
“We were finding out pretty quickly that even though people needed medical attention, they were refusing it because it was too hard for them to get there,” Leining explains. “But if we asked them if they would be interested in seeing someone at their cot, they more open to that.”
SEIS volunteers took care to respect the privacy of shelter residents. They didn’t wake anyone who was sleeping and didn’t record any identifying information. As they returned night after night, they listened to the residents and responded to their needs — whatever they might be. Volunteers who spoke Spanish also acted as translators. Other volunteers helped residents navigate the often-confusing shelter environment.
“Our role evolved in several ways,” Leining says. “But the people who volunteered wanted to come back because they knew the value of their work; it was extremely valuable for everybody: for the residents, for the shelter, for the city and even for us.”
The team has received requests for information about their disease surveillance methods from Dallas, where Harvey evacuees also sheltered, as well as cities in Florida in advance of Hurricane Irma. Leining says they are happy they could help, and are ready to respond in the future.
“We all had an itch to get involved with Hurricane Harvey. We are very grateful to have a way to do that that blends our career with relief efforts.”