26 September 2005

To: All Commissioned Corps Officers

From: United States Surgeon General

Subject: Update on Hurricanes Katrina and Rita Response

We continue to be stunned and saddened by the devastation brought by Hurricanes Katrina and Rita. I know you have been following the media reports regarding the response by federal, state, local agencies and thousands of volunteers. Their efforts have been heroic and commendable. With so many groups in action, the media coverage provided to the Commissioned Corps has been limited. Be assured we are there - in Texas, Louisiana, and Mississippi. Your colleagues are fully engaged, carrying out our mission, demonstrating each day an enthusiastic public health competence tempered with empathy and compassion for the people of the Gulf Region.

We are proud of the achievements of our Corps. Here are just a few of their latest 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, this group, in concert with 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-member 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 are caring for 235 patients; 25 are burn patients, 26 Intensive Care, 45 Surgical Ward, and 124 nursing home patients. In addition, the team is tasked with providing medical care to two other shelters in the immediate area.

A small team of six PHS Commissioned Corps officers plus five civilian CDC and SAMHSA staff has been accomplishing a heroic mission in San Antonio. They worked tirelessly at the airport to ensure that more than 16,000 Hurricane Rita evacuees, including 580 special needs patients, were triaged upon arrival in San Antonio. Signifying the close ties between the PHS and the city, CAPT Henry Lopez has been appointed acting Deputy Health Commissioner of Greater Metropolitan 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. The majority of Hurricane Katrina evacuees have been relocated to Fort Chaffee, Arkansas. Further, a Federal Medical Shelter is expected in the Houston area today, and will be staffed by Veterans Administration volunteers. 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 is leading several teams that have a combined total of 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 will be arriving over the next two days to address the growing number of missions and provide rest and respite for those who have been on the front lines for three weeks or more. A few of the missions include:

LSU Special Needs (SN) Shelter (Field House) continues to operate with PHS Commissioned Corps officers and an Oklahoma Medical Reserve Corps unit. The census is expected to increase with incoming evacuees from Hurricane Rita.

Alexandria SN Shelter has PHS Commissioned Corps officers and 20 Medical Reserve Corps (MRC) volunteers providing clinical care to evacuees. The shelter census has increased due to taking the Thibedaux SNS patients. A surge in the census is expected as a result of Hurricane Rita.

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 are 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. (For more insight as to the importance of these activities, please refer to OFRD Core Curriculum Module 113.)

Disaster Mortuary Operations Response Teams have Corps officers embedded with them to signify the importance of the activity and to provide

dignity. Approximately 11 chaplains 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 is leading 119 Commissioned Corps officers and 24 volunteer staff supporting the Nevada 1 Clinic in Gulfport. There is ongoing assessment of shelter needs and staff rotation for the Biloxi Community Health Center and a cruise ship clinic.

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.

Many of you have not yet deployed. 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. Now more than ever, we need you to be ready to go to the field when called - especially those with clinical skills.

And we need to assure that every officer is Basic Qualified, for your own protection, and for those we serve! If you have not yet achieved this status, I direct you to do so immediately, pending immunization limitations. As the events of the past few weeks have shown us, we simply can't wait for a disaster to occur, or a public health need to be identified, before becoming prepared to respond.

Our mission is underway, it is not yet complete. Join with us today as we provide relief, public health services, and medical care to the people of the Gulf Region.

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

VADM, USPHS