Doctors are bracing themselves for what they call a “second disaster” as residents of New Orleans and surrounding areas return to their devastated city.
While environmentalists fear the long-term danger to health from possibly polluted floodwaters and rumors of disease swirl, front-line emergency doctors say the actual health danger will come from accidents.
“The second wave of disaster is when you welcome the people back and the infrastructure of the city is not in place,” said Dr. Peter Deblieux, an emergency room doctor at downtown New Orleans’ Charity Hospital.
Officials in New Orleans and surrounding Jefferson Parish began allowing residents to return over the weekend and say everyone can come back by mid-week. But residents whose homes were not completely destroyed will confront fallen trees, wrecked roofs and streets full of nails.
Someone will have to clean it up.
“We will see the chainsaw people -- lacerations of the left thigh, lacerations of the left forearm,” Deblieux said in an interview. “There will be people falling off the scaffolding.”
Public health experts concur. After Hurricane Charley hit Florida in 2004, 77 percent of the deaths blamed on the hurricane were classified as unintentional injury,
Deblieux is concerned about plans to allow more than 180,000 people to return to New Orleans with only four area hospitals up and running, and only one of those in New Orleans proper.
Charity, the city’s free public hospital, remains closed, its electricity panels destroyed by flooding. “Where will people get treatment?” asked Deblieux.
Some areas still will lack electricity and clean drinking water.
Alerts to invisible dangers
The U.S. Centers for Disease Control and Prevention is launching an education effort to caution people about the danger of carbon monoxide poisoning if they use generators.
While some areas have uncontaminated water, 90 percent of the population does not, the CDC said on Saturday.
“Raw sewage is being discharged into the Mississippi River.” the CDC said in a report.
“It is contaminated with human and animal waste. But there isn’t this sort of toxic soup out there,” said Dr. Tom Clark, an infectious disease specialist at the CDC.
Medical teams have seen cases of diarrhea, stomach upset and respiratory irritation, and CDC epidemiologists are studying the data to see if they are more common than they were before the hurricane struck.
The CDC and Environmental Protection Agency are both telling people to wash off mud or dirt as soon as possible and to avoid getting floodwaters on them.
There are heavy metals, oil products such as diesel, as solvents in the water -- but not huge amounts. And as the mud dries, some compounds, especially the metals such as lead and arsenic, will remain in the dirt.
There has been some diarrhea but no epidemics and despite fears, evacuees are not spreading diseases widely. And if people are careful, the contaminated tap water should no pose any great threat, the CDC said.
“E. coli in general are normal flora of the gastrointestinal tracts of people and animals,” Clark said.
Some are toxic -- such as the E. coli 0157 strain that can cause deadly food poisoning, especially in children.
But the E. coli being measured in city water is a more general bacteria that is not in itself harmful but which, if it is there, means the water is contaminated.
“If there is fecal contamination of water, then the potential is there for viral causes of diarrheal illness --like norovirus, like hepatitis -- if people had it before,” Clark said.
“A lot of the time what you see (after a disaster like this) is an increase of what was already there before.”