Beryl will be responsible for deaths for years to come

On July 1, 2024, Beryl incessantly pummelled St. Vincent and the Grenadines for hours before finally relenting, just before nightfall. This horrific experience sharply brought into focus the extremely destructive force of a Category IV hurricane, and by extension, our multifaceted vulnerabilities to similar systems.

Beryl was a run-of-the-mill tropical depression less than 48 hours before its eye made landfall in the Southern Grenadines. By then it had morphed into a Category IV hurricane with a minimum wind speed of 130 mph (209 kph) .

Dangerous hurricanes such as Beryl can liquidate a family’s assets (and lives), and significantly exsanguinate a country’s socioeconomic resources within hours.
Most are oblivious to the fact that following the passage of a hurricane through any society, in its aftermath, there is up to a 33.4% increase in the death rate among the impacted population.

This revelation was uncovered via robust retrospective and longitudinal medical studies conducted over the last 20 to 30 years.

Unfortunately, fuelled by climate change, the evolving tempestological characteristics of hurricanes will result in the Caribbean experiencing an increasing number of record-breaking and treacherously savage storms. This does not auger well for the public (and socioeconomic) health of our region.

Against this backdrop, it’s imperative that officialdom have a pragmatic, comprehensive, dynamic, expeditable, and implementable plan that can mitigate the disease burden that inevitably follows a hurricane.

The Caribbean Public Health Agency (CARPHA) is ideally positioned to develop, provide leadership, establish goals and objectives, advance the process, implement, simplify, coordinate, monitor, update, tweak, and manage such a plan.

The Caribbean is extremely vulnerable to deaths following a hurricane, primarily because we are economically disadvantaged, we are home to an overwhelming number of suboptimally constructed structures, and there is a relative dearth of fundamental resources.

Medical Conditions That Can Lead To Death

The medical conditions that are likely to follow in the paths of hurricanes, and contribute to an increase in the death rate include:

1. Injuries – often underappreciated initially. Deaths related to injuries peak within the first month after the passage of the hurricane.

2. Infections – these are generally food-borne, waterborne, droplet spread, vector spread, and wound-related. The most common infections are skin, eye, gastrointestinal, ENT, dengue, and leptospirosis.

3. Parasitic disease – this peaks two months later.

4. Heart attacks

5. Strokes

6. Heart disease – arrhythmias, Takotsubo cardiomyopathy (broken heart syndrome).

7. Neuropsychiatric conditions – psychosis, depression, anxiety, and cognitive decline.

8. Respiratory – asthma, COPD.

9. NCDs – hypertension, diabetes.

10. Alcohol and drug abuse.

Studies have shown that hurricane-related deaths from four through 10 can extend for many years after the passage of the hurricane.

Factors That Play A Role In Negative Health Outcomes

After the passage of a hurricane, the following factors play a central role in negative health outcomes:

• Persons with NCDs not having access to their medicines (e.g. asthmatics, hypertensives, diabetics, etc.).
• Unavailability of appropriate and timely medical care.
•  Inadequate or absent wound care supplies.
• Unavailability of tetanus vaccine.
• Exposure to the elements.
• Living in overcrowded shelters.
• Poor diets.
• Inadequate hydration.
• Suboptimal sanitation.
• Post-traumatic stress.
• Deteriorating mental health – stress, anxiety, depression.
• Insomnia.
• Dementia
• Sedentary existence.
• Lack of access to basic monitoring equipment such as glucometers and blood pressure machines.
• Stagnant collection of water (e.g. in containers, flower pots, trash, bins, buckets, discarded tires, etc.) facilitates mosquito breeding.
• Economic hardship.
• Long-term displacement from one’s normal place of residence.
• An expansion in the rodent population.
• Increase in the growth of bacteria and mold.

Those Most Vulnerable

While everyone is vulnerable, those who are most susceptible to the health impacts of a hurricane include:

• Children
• Pregnant women.
• Elderly
• Those with NCDs.
• Homeless
• Mentally ill – especially those with untreated psychotic illnesses.
• Persons with outdoor jobs.
• Individuals with physical or mental disabilities.
• Economically disadvantaged.
• Those living in remote areas.
• Those without essential utilities (e.g. water and electricity) for extended periods.
•  Living in overcrowded shelters.
•  Suboptimal healthcare.

Mitigating The Negative Health Impacts

The following can mitigate the negative health impact of hurricanes:

•  Increase public awareness about how to prepare for hurricanes.
• Legislate and enforce updated building codes; especially roof related.
• Identify and ban building construction in flood-prone areas.
•  Develop evacuation plans for the most vulnerable.
•  Ensure that there is a readily accessible stockpile of critical medicines and medical supplies.
•  Improve the weatherproofing of the energy grid.
•  Construct sea walls in the most vulnerable coastal areas.
•  Provide incentives (e.g. duty and VAT waivers) on water storage units, generators, and roof-securing appliances.
•  Constantly review ways to improve one’s efficiency and ability to seamlessly and comprehensively respond to a hurricane disaster.
• Cultivate a culture of volunteerism so that a wide cross-section of society is willing to gift their time, help, expertise, and other resources to those impacted by a hurricane.

“Hurricanes may knock us down, however, we should never allow them to knock us out” – Annonymous.

• Author: Dr. C. Malcolm Grant – Family Physician, Family Care Clinic, Arnos Vale.
  Former tutor in the Faculty of Medical Sciences, University of the West Indies, Cave Hill, Barbados. For appointments: 1(784)570-9300 (Office), 1(784)455-0376 (WhatsApp). Walk-ins welcome.
  Disclaimer: The information provided in the above article is for educational purposes only and does not substitute for professional medical advice. Please consult a medical professional or healthcare provider if you are seeking medical advice, diagnoses, or treatment. Dr. C. Malcolm Grant, Family Care Clinic or The Searchlight Newspaper or their associates, respectively, are not liable for risks or issues associated with using or acting upon the information provided above.