Assessing Electronic Death Registration and American Red Cross Systems for Mortality Surveillance During Hurricane Sandy, October 29–November 10, 2012, New York City

Abstract

Objective We briefly describe 2 systems that provided disaster-related mortality surveillance during and after Hurricane Sandy in New York City, namely, the New York City Health Department Electronic Death Registration System (EDRS) and the American Red Cross paper-based tracking system. Methods Red Cross fatality data were linked with New York City EDRS records by using decedent name and date of birth. We analyzed cases identified by both systems for completeness and agreement across selected variables and the time interval between death and reporting in the system. Results Red Cross captured 93% (41/44) of all Sandy-related deaths; the completeness and quality varied by item, and timeliness was difficult to determine. The circumstances leading to death captured by Red Cross were particularly useful for identifying reasons individuals stayed in evacuation zones. EDRS variables were nearly 100% complete, and the median interval between date of death and reporting was 6 days (range: 0–43 days). Conclusions Our findings indicate that a number of steps have the potential to improve disaster-related mortality surveillance, including updating Red Cross surveillance forms and electronic databases to enhance timeliness assessments, greater collaboration across agencies to share and use data for public health preparedness, and continued expansion of electronic death registration systems.

Changes in extreme events and the potential impacts on human health

“…The cascading impacts of electricity loss included hospital and subway closures, telecommunication outages, halted pipeline fuel distribution, and food delivery disruption (Haraguchi et al 2016). The total number of excess deaths increased immediately after the event and remained elevated for 2 months (Howland et al 2014). Understanding these relationships and pathways is key to reducing health impacts.…”

Evaluation of Real-Time Mortality Surveillance Based on Media Reports

“…NYC used its eDRS to track deaths in real time. NYC has a centralized medical examiner system and protocols for attributing hurricane as cause of death; hence, their public health officials were able to access preliminary death certificate data, flag disaster-related deaths, and search cause of death text fields for hurricane-related terms during the response 29 . However, because none of the states initially provided death records of Sandy-related deaths using those methods, we provided them with a list we had obtained from online media reports that contained the number of deaths, the decedent’s name(s), county, city and location of death, date of death or body recovery, age, sex, and possible cause and circumstance of death to facilitate the search for the records by using single or combined variables of the list provided.…”

“…Unlike NYC, many states, including Connecticut, North Carolina, Pennsylvania, and Virginia, do not have eDRS or do not have the ability to leverage eDRS for “near to real-time” disaster mortality surveillance 29 30 For states that cannot use eDRS for disaster mortality surveillance, death certification and registration can be time-intensive and delay public health emergency response 9…”

Injury Deaths Related to Hurricane Sandy, New York City, 2012

“…The Centers for Disease Control and Prevention partners with the American Red Cross to obtain mortality data during natural disasters. American Red Cross data were collected by Red Cross volunteers working on condolence teams across the Sandy-affected region to offer services to families of the decedents after the disaster 26 . During Hurricane Sandy, the Red Cross worked closely with NYC’s OCME to follow up with the decedents’ families for all possible Sandy-related deaths prior to certification 26 .…”

“…American Red Cross data were collected by Red Cross volunteers working on condolence teams across the Sandy-affected region to offer services to families of the decedents after the disaster 26 . During Hurricane Sandy, the Red Cross worked closely with NYC’s OCME to follow up with the decedents’ families for all possible Sandy-related deaths prior to certification 26 . The Red Cross typically works with medical examiners/coroners, hospitals, and first responders during a disaster to reach decedents’ families and collect data.…”