29 September 2005

To: Supervisors of Commissioned Corps Officers

From: United States Surgeon General

Subject: Update on Hurricanes Katrina and Rita Response

Thank you very much for your support of the Commissioned Officers under your command who have, or will be, deployed under this unprecedented response to Hurricanes Katrina and Rita. They have deployed to the front lines in the devastated region, as well as to the Secretary's Operation Center and other local Washington, D.C., centers to assist with deployment and outreach. We appreciate the sacrifices made by you and their colleagues, now with an added workload, who have remained in the office.

As you know, Secretary Leavitt activated the Commissioned Corps on August 28th and asked OPDIV and Staff Div heads to support the Department's response to Hurricane Katrina. Senior leaders within the Department, and within other departments where officers are assigned, were notified of the critical nature of this effort and all universally pledged their support. In addition, each officer deployed was directed to contact their supervisor, prior to deployment, to alert the supervisors as to their status. Many officers continue to maintain contact with their office as they undertake this mission in the Gulf Region.

We can all be proud of the achievements of our Corps. Here are just a few of their most recent actions.

In Texas, we have 37 officers staffing a Secretary's Emergency Response Team

(SERT) as part of the Joint Field Operations. Led by RADM Mary Pat Couig from FDA this group, in concert with the Dr. Eduardo Sanchez, Texas Commissioner of Health, is overseeing field operations in Dallas, Houston, San Antonio, and College Station. Some excerpts from their daily reports

include:

A 127 PHS Commissioned Corps team is deployed to College Station, TX with a 500 bed Federal Medical Shelter (FMS). Housed on campus at Texas A&M University, these officers cared for 235 patients - 25 were burn patients, 26 Intensive Care, 45 Surgical Ward, and 124 nursing home patients. In addition, the team was tasked with providing medical care to two other shelters in the immediate area. These officers are being deployed to another area to provide critical health care and aid in recovery.

A small team of 6 PHS Commissioned Corps officers plus five civilian CDC and SAMHSA staff accomplished a difficult mission in San Antonio. They worked tirelessly all night long at the airport to ensure more than 16,000 Hurricane Rita evacuees, including 580 special needs patients, were triaged upon arrival in San Antonio.

A small team of 10 PHS Commissioned Corps officers, including 4 Inactive Reserve Corps officers, is supporting special needs shelters for Hurricane

Rita evacuees in Houston. A Federal Medical Shelter is expected in the

Houston area today to relieve the local health care infrastructure. As the assessment of Hurricane Rita continues, more evacuees are expected in the Houston area and they will receive care through supplemented Community Health Centers.

In Louisiana, RADM Craig Vanderwagen from IHS is leading several teams that have a combined 22 missions (and increasing). Currently, 234 PHS Commissioned Corps officers, 71 civilian federalized employees (unpaid, temporary federal employees) and contingents from CDC and FDA are in the area. A total of seven medical strike teams of physicians, nurses, and pharmacists are addressing the medical and public health needs in special needs shelters across southern Louisiana. Other missions include:

LSU Special Needs (SN) Shelter (Field House) continues to operate with PHS Commissioned Corps officers and an Oklahoma Medical Reserve Corps (MRC) unit.

Alexandria SN Shelter has PHS Commissioned Corps officers and 20 MRC volunteers providing clinical care to evacuees.

Lafayette SN Shelter has PHS Commissioned Corps officers and state volunteers from the Mayo clinic providing clinical care to evacuees at the Heyman Memorial Center. As a result of Rita, these patients are being evacuated to Alexandria.

Lake Charles SN Shelter has PHS Commissioned Corps officers and 17 volunteers (MRC plus LPN's) are providing clinical care to evacuees at McNeese University.

Rescue Worker Occupational Health is ongoing with Corps officers providing occupational health care to police, rescue workers, and firefighters from New Orleans that were rotating through the Belmont Hotel in Baton Rouge. PHS officers also providing mental health services to this same group who are now living on the cruise ships in New Orleans.

Pet Shelters are supported by PHS veterinary officers - at LSU and the Lamar Dixon site in Gonzales in conjunction with a VMAT team and many walk-on volunteers. They are handling thousands of animals from mice to horses. They rescued 30 monkeys from a primate lab in New Orleans. PHS medical providers are providing clinical care for the veterinarians and pet handlers. A mental health worker has supplemented the teams on occasion for grieving pet owners.

Disaster Mortuary Operations Response Teams have Corps officers embedded with them, signifying our respect for the dignity of these activities. Approximately 11 chaplains who have been federalized, some are working with the human remains recovery teams, at the morgue, and others are working at the family call-in center.

Family Call/Assistance Centers are State operations for those who are looking for family members they suspect perished. PHS officers are assisting as available. OSG and OPHEP assisted the state in organizing the walk-in family assistance center and in handling the backlog of interviews (more than 2000 now reduced to zero) over the phone.

In Mississippi, RADM Brenda Holman from FDA is leading 119 Commissioned Corps officers and 24 volunteer staff supporting the Nevada 1 Clinic in Gulfport, a community dental mission, a pharmacy mission, and providing primary care on board a cruise ship housing evacuees. There is also ongoing assessment of shelter needs and staff rotation for the Biloxi Community Health Center.

Environmental health and engineer officers have performed assessments on several hundred shelters, schools, and water, waste-water, sewer systems across both Mississippi and Louisiana. Likewise, public health teams, composed mostly of CDC officers, have performed health system assessments, collected epidemiological data, made vector control recommendations, and provided appropriate health information to the medical community, governmental decision makers, and private citizens. Other teams, composed mostly of FDA officers, conducted food safety inspections.

Beyond the clinical, environmental, and preventive medicine contributions, many officers are involved in the administrative and logistical support, as well as the leadership, of running a multi-state response that is responsible for the public health of tens of thousands of Americans.

There are many other stories of our officers making a real difference in the lives, the health, and the safety of our neighbors in the Gulf Region. We look forward to sharing these with you in the future. You may also visit the Commissioned Corps Management Information System (CCMIS) website http://dcp.psc.gov for updates on Corps activities.

There will be many more requests for PHS support in the storm-damaged areas. We will increasingly try to incorporate Medical Reserve Corps and other unpaid, temporary federal employees into appropriate deployments as time goes on, but the Corps will continue to be integral to the response. Your continued support is essential to our efforts to protect the public health of the people in Texas, Louisiana, and Mississippi.

I thank you again for your total support of our Commissioned Corps officers. For those of you who have remained at your normal posts, you have supported the efforts of those who are on the front lines, you've helped cover their "normal" job functions while they are gone, you stand ready to support the team when called. As we thank and commend our public health "troops" in the field, know that I appreciate your service and commitment as well. We remain sensitive to the needs of the OPDIVS, StaffDivs, and agencies involved and know full well that other public health missions must be maintained as we concentrate efforts in the Gulf Region.

We would not be successful without you; and I salute your patriotism, your patience, and your generosity as we all help those affected recover from this natural catastrophe. Thank you for helping us accomplish our mission of protecting, promoting, and advancing the health and safety of the people of this great Nation.

Richard H. Carmona, M.D., M.P.H., F.A.C.S.

VADM, USPHS