Sidebar: Hurricanes and Public Health Preparedness

September is National Preparedness Month and for the local communities throughout our beautiful state, preparedness holds many different meanings. For those of us who live and work on the coast of North Carolina, our location requires extensive yearlong planning and discussions with regard to hurricane preparedness. As a state that is routinely affected by hurricanes and tropical storms, historically the personal and economic impacts have been devastating, and it is predicted that they will continue to be so. Although technology has made these storms predictable in location and strength, the impact and aftermath on the land and lives of a community is never certain.

In my four years serving as health director of the New Hanover County Health Department, and over 25 years serving the citizens of this state, I have been privileged to witness local public health, alongside local and state government and community agencies, be informers and responders to those impacted by natural disasters in their community, and tackle public health issues such as disease outbreaks, man-made attacks, and preventable injuries in each storm's aftermath.

At its core, public health protects and improves the health of the community it serves by the promotion of safety and healthy lifestyles and the prevention, detection, and response to infectious disease. This certainly still holds true during a natural disaster, when the stakes are higher and resources are scarce. To achieve success for this kind of event, public health workers must prepare themselves and their communities well in advance of a disaster in order to adhere to public health mandates and to best meet community health demands and needs.

This can be accomplished by continual health monitoring, informing and educating the public, utilizing community partnerships, assuring a competent workforce, and continual evaluation and improvement methods. Additionally, public health has the ability to be agile and offer flexibility in delivery and dissemination of information and resources, which is crucial to conducting preparedness activities efficiently and effectively.

Members of our competent workforce embrace their responsibility to provide assistance in preparation and recovery. They create and disseminate preparedness information and education through various methods to a variety of audiences throughout the community. Each public health department in the state is required to maintain an extensive preparedness plan, which requires staff training and hands-on exercises that equip our workforce for various scenarios and events specific to community needs.

Through continual community health monitoring, including the social drivers of health, public health can understand and best address community needs and concerns that will likely amplify due to a hurricane impact such as housing, violence, and unemployment. We also conduct enhanced disease surveillance during a storm in our communities and citizen shelters to ensure timely, direct, and coordinated care; environmental health inspections for reopenings of food establishments; and direct observation for vector outbreaks to avoid mosquito-borne illnesses for many weeks after.

During a hurricane, our provision of services and scope of service may alter, which requires us to practice flexibility based on community need. In order to provide services that meet community demand, we rely heavily on our established local and state alliances to leverage needed resources and service provision. We work strategically in forming and maintaining partnerships in an effort to create policies and written emergency plans (exercised and vetted) that allow partnering agencies to carry out their own responsibilities for their functional and jurisdictional areas. This coordinated and collective approach is the only way to ensure families are reconnected safely to their affected communities with clean food and water, clothing, and vaccinations that protect them from the most devastating of illnesses.

Additionally, in preparation for anticipated hurricanes, we utilize ongoing evaluation of our training activities and immediate after-action reviews that provide insight on the successes and areas for improvement from staff and community members who worked during hurricane response. These evaluations offer various perspectives and allow public health and its partners to best prepare for the next inevitable event.

In recognition of National Preparedness Month, local public health and its partners will continue to be on the front lines of responses to disasters that occur and the efforts that provide the ability for our communities to recover, whether it be from COVID-19, pandemic influenza, or a hurricane. These local entities, along with the many community-minded organizations in this state, have played a vital role in protecting North Carolina's more than 10 million residents and nearly 50 million annual visitors from these disasters through early warning, preparation, and recovery efforts.

Our motto in public health is preparedness is prevention because we know that planning creates opportunities to build stronger and more efficient ways to protect human life. This requires us to be more proactive and less reactionary. It's what we should all do to save lives.

• ©2020 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.