Building Resilient Health Infrastructure with ASPR

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MICHAEL ELTRINGHAM: You’re listening to “Building Resilient Health Infrastructure with ASPR,” a podcast from the HHS ASPR Critical Infrastructure Protection Division. If you have any questions about this episode, please email us at [email protected].

Hey everyone thanks for listening I'm Michael Eltringham, a program analyst with the HHS ASPR Critical Infrastructure Protection Division. I'm joined by our division director, Dr. Laura Wolf. How are you, Dr. Wolf?

LW: Great, thanks!

ME: We're back at it. This is the first in our three-part series of lessons learned from each of the major hurricanes: Harvey, Irma, and Maria. Today we'll be talking about Hurricane Harvey. So today's question for the episode: what is a lesson learned from Hurricane Harvey? So Dr. Wolf, what is one -  again these are all - you know, there's a lot of lessons learned from this response and the recovery - but what's one lesson learned you'd like to highlight today?

LW: At the bottom line that the lesson we learned is that even though infrastructure may be resilient to weather or other types of disasters, it may not be resilient from external factors during a response.

So let me tell a story about that. So hurricane Harvey affected the Houston area. And historically hurricanes have frequently affected Houston to the extent that the infrastructure owners and operators there have gone to remarkable lengths to mitigate the effects of hurricanes on their infrastructure. So you can say they are well hardened against disasters against flooding and wind.

And that's a good thing. But we had some examples in Harvey of some tense moments, not based on the resilience of that infrastructure, but based on their reliance on external partners for supplies that could have caused the entire system to have to evacuate. So what we experienced was facilities that, you know, made decisions not to evacuate, did their own risk assessment and determined that they felt they were resilient against the rain and wind and flooding that was anticipated. So maybe a couple days into the extreme rainfall and flooding, an example from one of our partners that we saw was their supplies were starting to run short and they were not sure how they would get the supplies in.

So normally in a flooding event this partner would have utilized fixed-wing or helicopters on air transportation to get supplies in. But because in the weather system that was hurricane Harvey the rain was continual for several days, rain and wind, they could not use that those air transport systems. They couldn't use trucking systems because of the flooding and so late one night we got some emails from our partners saying we may have to evacuate because we can't figure out how to get supplies in. Which is a bigger problem, because at that point that infrastructure is surrounded by water and evacuating patients in a situation where you can't get supplies in is not going to be very easy.

Luckily this partner was able to think on their feet and found duck boats that they were able to bring down to the area that could drive as far as they could with supplies and then become boats when needed to get the supplies to the facility.

So that was some quick and creative thinking on their part. But I know that in a lot of instances when we recover from disasters, we're building back better and we're building back more resilient. And I want to make sure that this doesn't create a false sense of resilience when you rely on external partners for anything like supplies, or linens, waste removal, anything like that.

When you're making plans or decisions about whether to evacuate a facility you need to not only consider how resilient your facility is but the resiliency of the partners that you rely on.

ME: As the the nation or the world deals with, you know kind of issues, related to extreme weather: what are some ways that you think that those in the Healthcare and Public Health Sector can help maybe not prepare necessarily for that, but respond better to that those kind of risks?

LW: I think a key does reside in our partnership so obviously in the Houston area there's a lot of experience with extreme weather but as climate change pushes more extreme events to places where they may not have felt it before, I think that ability to share information and have consultations across the partnership during a response may support that creativity.

I think we're going to be seeing more infrastructure planning for more extreme events and in the construction of those facilities, I think our partners can help each other and provide guidance and advice. And certainly we can work with our partners to develop those best practices and circulate those through the communities. So I see this, the challenge of climate change and extreme weather being something we'll have to face in the future.

I do want to flag one of our government partners from the National Institute of Environmental Health Sciences is Dr. John Balbus. And he worked very closely on the Resilient Communities Toolkit for the healthcare community in thinking about climate change. And so we should have him on one of the future podcasts to talk about that.

ME: Absolutely, but I think that's another great example of another partner who's trying to think - use that, and this is a term you used when you're speaking at a conference - I believe it was the idea of “extreme creativity” of trying to solve problems.

Because sometimes there are so many things that you can plan for but they're just some contingencies that just can't be accounted for. So you have to account for that in some way in that you can't account for it but you have to be able to be flexible and pivot in your kind of problem solving.

LW: So that's right. I mean most people think of duck boats as family entertainment when touring a city. But I think this is a great idea. I wonder if they use the little kazoos when they brought the stuff in?

ME: They might have, they might have! So I think that's our episode for the lesson learned from Hurricane Harvey. And we'll be back with our next episode with a lesson learned on Hurricane Irma and then Maria to close out this kind of miniseries here.

So thanks for listening everyone. As always if you have any questions about anything you heard on the podcast, you have questions about the HPH Sector Partnership or about the ASPR CIP Division, email us at [email protected]. And if you have any feedback on the podcast we'd love to hear it - or requests for future topics, you know, we're certainly open to that. Thank you Dr. Wolf, as always.

LW: Thank you, Mike!

ME: Thank you for listening everyone and we’ll see you next time!

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