Category: 2022

Mitigation aims to alleviate the long-term consequences and impacts of a disaster event. Julia Winer highlights the importance of community resilience when lessening the risks involved in a disaster. Community-based disaster risk reduction (CBDRR) and Community-based disaster management (CBDM) are two approaches that reduce disaster risks through community participation. The approaches encourage the citizens to advocate for their own preparedness as a way to decrease dependency on external aid and resources.  The main goals of CBDRR and CBDM are to reduce vulnerabilities within the community by empowering people and local institutions, reduce the impact of structures that increase inequality and underdevelopment, and preserve infrastructure, the environment, and other resources. As an example of this, Julia encourages individual measures that prevent the environmental impacts of climate change by encouraging citizens to do their part. 

Click here to read the student’s full exemplar. 

On April 20, 2010, an explosion at the Deepwater Horizon oil rig off the coast of Louisiana killed 11 workers, injured 17, and leaked 210 million gallons of oil into the Gulf of Mexico. It took four days to understand the scale of the explosion and to identify the leak, and it took about a month for the leak to be sealed following many unsuccessful attempts by BP. While the well was declared “effectively dead” at the time, reports conducted in 2012 found the well active and still leaking two years later. This event led to over 100 civil and criminal lawsuits against BP and other defendants responsible for the incident, which ended in more than $65 billion in costs for cleanup, charges, and penalties. 

Rebecca Payne goes into great detail discussing this case from a public health standpoint. In this case study, Payne explains the epidemiological aspects of the case with a specific focus on the human health implications. Following the spill, the oil rig workers reported physical symptoms ranging from throat irritation to rectal bleeding to miscarriages as well as mental health symptoms including depression and Post Traumatic Stress Disorder (PTSD). Payne also discusses the management surrounding the clean-up of the Deepwater Horizon Oil Spill (DHOS) which proved to not only be expensive but also controversial. The use of dispersants to contain the spread failed while simultaneously resulting in major destruction to the marine wildlife and underwater ecosystem. These efforts appear to also have been mishandled by BP who failed to provide proper Personal Protective Equipment (PPE) and safety training for the clean-up crew, despite orders from Occupational Safety and Health Administration (OSHA). 

Overall, as Payne explains, communication was poor and inefficient as both BP and the federal government under President Obama’s leadership failed to act in a timely manner, confirming that there are many lessons to be learned from this case. Payne explains that so long as the world continues to rely on petroleum, there will continue to be oil spills. However, the DHOS can serve as a cautionary tale and pave the way for improvement in public health policy, response time, clean-up efforts, and PPE while mitigating the effects on the surrounding biological environment. 

Download the case study here.

On the night of November 7, 2018, 28-year-old Marine Corps veteran Ian David Long opened fire on the 259 patrons and employees of the Borderline Bar and Grill in Thousand Oaks, California with the sole purpose of targeting as many college students as possible. Over the course of 20 minutes, Long issued multiple attacks on the establishment using a .45-caliber handgun illegally fitted with a high capacity magazine, ending in the fatal shooting of 12 people before Long committed suicide. 

In this case study, author Maryam Razzaq discusses the epidemiological aspects and management of this fatal event as well as the communication involved between local law enforcement, the media, and the public. While an extensive epidemiological study has not been conducted, Razzaq discusses the details of a 2021 report released by the Ventura County Sheriff’s Office which describes Long’s potential motive, risk factors including his mental health, and eye-witness testimony. During the event, on-site command posts and off-site information centers were effective in coordinating operations and managing the influx of media and concerned family members safely. However, the first choice of placement of the command post was not appropriate and may have hindered early assessment of the scene and rapid deployment of resources. 

Razzaq also explains the utilization of social media before, during, and after the shooting as a conduit of real-time information while also describing the criticism faced by the Ventura County Sheriff’s office on their lack of transparency with the public during such a confusing and stressful situation. Overall, Razzaq stresses the importance of gun legislation reform as well the need to strengthen the public’s education and accessibility of the law as a preventative measure. 

Download the case study here. 

Wenqi Lu presents the facts of the 2004 Indian Ocean Tsunami in this case study.  In the morning of Dec 26th, 2004, a 9.1 magnitude earthquake shook the Indian Ocean, causing an 800 miles rupture in the ocean.  Within 20 minutes Indonesia was the first country to be impacted, and eventually, the resulting damages spanned 14 countries. The total death count reached 227,898 people, with 1,740,000 people displaced, costing countries $15 billion to rebuild and recover.

From an epidemiological aspect, 3 countries (Indonesia, Sri Lanka, and India) suffered the greatest losses in lives.  Females had a significantly higher documented mortality rate than males, with twenty-year-old males having the lowest rates.  The association between distance from the coast, gender, and mortality rates was described by Wenqi Lu.  The data used in this case study was aggregated by the Synthesis Report, and documented by the survey “Mortality, The Family and the Indian Ocean Tsunami”.

The global response to this disaster was unprecedented; in just a few hours food supplies, financial aid, and resources were rapidly deployed as well as long-term assistance to rebuild and reconstruct the affected areas.  While almost half of the health clinics were damaged, the global community was able to set up mobile field hospitals and provided the necessary relief services.

From the event, lessons learned included the gaps in the warning systems and other mitigation plans, which have been adopted during the 2012 Japan earthquake and tsunami.

Read Wenqi Lu’s case study here

Community-based disaster risk reduction and community-based disaster management are emphasized in Alnsour’s exemplar on mitigation and community resilience.  Sabaa points out that the top-down approach employed by government institutions has been ineffective, or even harmful at times. Examples of such include the industrial efforts of large countries such as the United States and China; they are major emitters of pollution and contribute to the global impacts of climate-related disasters. Sabaa emphasizes the impacts of an empowered community when describing the efforts at the individual level which can be effective in disaster response and recovery.  The example of Central Luzon’s earthquake is used by the author as an example of the success that can be achieved from an involved and empowered community.  

Read Sabaa Alnsour’s exemplar here

An independent and well-equipped community can respond to and recover from disasters when aid is not available. Maryam Razzaq emphasizes how vulnerability increases when communities are overly dependent on external help and resources. Therefore, by establishing mitigation strategies beforehand, communities are better-suited for post-disaster rehabilitation. Such efforts are also helpful because they bring a sense of hope and security to the individuals in a community to be able to withstand disasters, collaborate with support agencies, and follow mitigation guidelines.

Click here to read her work. 

Cheryl Liang distinguishes between community-based disaster risk reduction and community-based disaster management and describes the shared goal of community resilience and the role of individuals in building resilience. In order to achieve that goal more successfully, residents of the community play an important role in bearing the responsibility and committing to it alongside local authorities and community leaders. Cheryl describes three components of resilience, the reflectiveness of communities to learn from their past, the social connectedness to be able to communicate, and the presence of tools such as early warning systems to mitigate the impacts. Additionally, the higher authorities are responsible for building effective risk perceptions and capacities to manage future disasters, these are fundamental in building community resilience.

Read Cheryl Liang’s exemplar here

Michelle Bandel provides an analysis of the 2012 Hurricane Sandy’s epidemiological, management, and communication factors. She described the extensive infrastructural damages that resulted from the most expensive hurricane since Katrina. Hurricane Sandy caused $62 billion in damages in the US and $315 million in the Caribbean, Michelle describes the costly impact on the destruction of infrastructures such as roads and tunnels.

The total reported death toll from multiple countries was 285, with 125 deaths in the United States alone, of those 57.3% were direct deaths caused by environmental and structural forces, and 38% were indirect deaths caused by unsafe conditions. For many of the post-disaster management efforts such as the supply and distribution of medical supplies, water, and food, healthcare coalitions and multi-lateral partnerships were harnessed. Agencies like the Red Cross, the Department of Health and Human Services (HHS), FEMA, CDC, and others shared resources and knowledge to streamline operations. Additionally, FEMA  approved $600 million in direct assistance, the Senate passed a $50.5 billion Hurricane Sandy relief bill, and President Barack Obama passed an executive order to establish a task force to rebuild and recover from the hurricane.

Deployed nurses in major NYC hospitals faced challenges practicing in unfamiliar environments, Michelle described the responder’s psychosocial challenges stemming from the ongoing evacuation plans and increasing uncertainty of the future. With the exception of some unprepared hospitals during the acute phase, the response efforts were relatively effective. Throughout the case study, Michelle highlights that hospital evacuation, rescue & recovery efforts, workplace disruption and instability, and communication are all plans that need to be optimized for future occurrences. 

Read Michelle Bandel’s case study here

This case study is on the recent floods in Henan Province, China that occurred from July 16th to 21st, 2021. The floods were due to a series of extreme rainstorms over the city of Zhengzhou and the surrounding region, achieving its average annual rainfall of 25.2 inches in just one day on July 20th.  The heavy rainfall affected 14,786,000 people in the Henan province with 398 people dead or missing.  In managing the event, the Henan Provincial Flood Control headquarters issued a warning on July 16th and the Meteorological Bureau launched a level III emergency response, which was upgraded to a level I on July 21st.  Multi-lateral coordination efforts included the Ministry of Emergency Management dispatching fire and rescue workers to provide emergency relief, troops, and fire brigades were sent to assist in flooding response and prevention efforts, the local governments purchased security insurance for their residents, and hotels were used to house the displaced communities.  However, despite early warning alerts, local governments did not take measures to protect their residents and infrastructure, believing that the storm would not cause severe flooding.  The lag in suspending school and transportation and escalating the warning to a level I emergency was detrimental to the response efforts. Additionally, the rainfall affected communication capabilities, and the exchange of information was momentarily halted before drone technology was deployed.

Read Zhiyuan Chen’s case study here

In 1984, the community of The Dalles, Oregon experienced a large-scale outbreak of Salmonella Typhimurium. This foodborne disease outbreak, which infected a total of 751 people, was eventually traced back to the salad bar of a local restaurant. However, as investigators continued to pursue this case to further understand the primary food source and gather more information on the pathogen, the investigation continued to turn up with inconsistent information due to the sporadic nature of the outbreak. Following an inconclusive environmental study, a criminal investigation was conducted to find that the Salmonella outbreak was an intentional act of terrorism conducted by the members of the Rajneeshpuram religious association to affect the voter turnout of an upcoming election.

In her case study, Khadija Akther discusses the epidemiological events that made up this case along with the management of the outbreak and communication of information between health officials and the public. The 751 patients were identified through passive surveillance and examination of stool samples for the sample pathogen, which helped investigators categorize the cases into three cohorts: case employees, case customers, and secondary cases. As Akther explains, many different agencies were involved in this case due to the inconsistencies in the identification of the outbreak source. Healthcare workers first reached out to the CDC to aid in the investigation but the case was eventually passed over to law enforcement.

While the Rajneeshpuram organization was identified as the culprit, the overall handling of the case faced many limitations and inefficiencies due to lack of proper management. Akther reports lack of communication and cooperative collaboration amongst the agencies involved leading to disorganization and delays in closing the case.

You can read more about the investigation and it’s implications on the future of foodborne outbreak surveillance in Akther’s case study found here.