Addressing Community Needs During the Hurricane Response and Recovery Efforts Through Community Assessments for Public Health Emergency Response (CASPER)—United States Virgin Islands, 2017-2018

Abstract

ObjectivesTwo category 5 storms hit the US Virgin Islands (USVI) within 13 days of each other in September 2017. This caused an almost complete loss of power and devastated critical infrastructure such as the hospitals and airportsMethodsThe USVI Department of Health conducted 2 response Community Assessments for Public Health Emergency Response (CASPERs) in November 2017 and a recovery CASPER in February 2018. CASPER is a 2-stage cluster sampling method designed to provide household-based information about a community’s needs in a timely, inexpensive, and representative manner.ResultsAlmost 70% of homes were damaged or destroyed, 81.2% of homes still needed repair, and 10.4% of respondents felt their home was unsafe to live in approximately 5 months after the storms. Eighteen percent of individual respondents indicated that their mental health was “not good” for 14 or more days in the past month, a significant increase from 2016.ConclusionThe CASPERs helped characterize the status and needs of residents after the devastating hurricanes and illustrate the evolving needs of the community and the progression of the recovery process. CASPER findings were shared with response and recovery partners to promote data-driven recovery efforts, improve the efficiency of the current response and recovery efforts, and strengthen emergency preparedness in USVI. (Disaster Med Public Health Preparedness. 2019;13:53-62)

Community Assessments for Mosquito Prevention and Control Experiences, Attitudes, and Practices — U.S. Virgin Islands, 2017 and 2018

“…These community assessments conducted during the Zika outbreak, hurricane responses, and hurricane recovery in USVI found that households were more concerned about contracting mosquitoborne diseases shortly after the Zika outbreak than during the hurricane response and hurricane recovery, even though reported mosquito biting activity increased, and environmental conditions were more favorable for mosquito breeding and exposure to bites following the hurricanes. In addition, although mosquitoborne diseases are endemic in USVI, and the population might be aware of the risk, households had concerns after the hurricanes that did not exist during the Zika outbreak, such as lack of shelter, clean water, and electricity ( 2 ). These differing levels of concern did not, however, change the community’s support for mosquito spraying, although support for specific spray methods varied.…”

Powerless in the Virgin Islands: Emergency Department and Wound Care Clinic Utilization Following the 2017 Hurricanes Irma and Maria on St. Thomas, U.S. Virgin Islands

“…17,19,28,30 This variance may be correlated with more males remaining in their damaged homes and engaging in activities that engender trauma-related cases, 17,19,28 and possibly inequitable access to and utilization of social support systems to moderate the effect of the disaster. 6,19,26 The storms disturbed many social networks and family cohesion. 6 Numerous individuals departed the territory before landfall, 3 and this mass exodus continued between the storms and increased after the storms, 3 likely undermining the robust social networks and support systems enjoyed by many Disaster Medicine and Public Health Preparedness 5 residents.…”

“…6,19,26 The storms disturbed many social networks and family cohesion. 6 Numerous individuals departed the territory before landfall, 3 and this mass exodus continued between the storms and increased after the storms, 3 likely undermining the robust social networks and support systems enjoyed by many Disaster Medicine and Public Health Preparedness 5 residents. 6,26 A valuable mitigation strategy may be to employ human services in the ED to provide for a range of disaster social work, including psychological first aid, case management, and social services support, during and after the storm.…”

“…6 Numerous individuals departed the territory before landfall, 3 and this mass exodus continued between the storms and increased after the storms, 3 likely undermining the robust social networks and support systems enjoyed by many Disaster Medicine and Public Health Preparedness 5 residents. 6,26 A valuable mitigation strategy may be to employ human services in the ED to provide for a range of disaster social work, including psychological first aid, case management, and social services support, during and after the storm. Social workers and staff that provide services to enhance individual and family welfare may be needed to support early interventions in EDs and facilitate appropriate follow-on services.…”

Centers for Disease Control and Prevention National Center for Environmental Health/Agency for Toxic Substances and Disease Registry Roles in Hurricane Response and Postdisaster Mosquito Control1

“…In response to the 2017 hurricanes, NCEH/ ATSDR supported efforts to identify and minimize favorable mosquito and other vector habitats through the assessments of facilities such as disaster shelters and provided technical assistance to the US Virgin Islands Department of Health (VIDOH) for 2 Community Assessments for Public Health Emergency Response (CASPER) related to mosquito control (Schnall et al 2019). The CDC Shelter Assessment Tool exemplifies the type of comprehensive assessment EH practitioners conduct to evaluate a wide range of environmental factors with bearing on vector presence, such as waste management and integrity of doors, windows, and screens for excluding entry of mosquitoes and other vectors, including rodents (CDC 2008).…”