Katrina: It Could Have Been Worse, U.S. Report Says

But the number of people needing mental-health care will likely increase, experts contend

THURSDAY, Jan. 19, 2006 (HealthDay News) -- Although Hurricane Katrina devastated New Orleans and other Gulf Coast areas on Aug. 29, the destruction and loss of life could have been worse if it hadn't been for warnings and evacuations, a new federal report contends.

But the emotional devastation has yet to be fully tallied, the report adds.

The findings are contained in five new studies on public health responses in Louisiana in the two months after Katrina struck. They appear in the Jan. 20 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

A second report by the CDC, due in March, will focus on a wider swath of the stricken Gulf Coast area and the broader impact of the worst hurricane in U.S. history.

Preliminary mortality rates revealed approximately 1,000 deaths in Louisiana, 200 in Mississippi, and 20 in Florida, Alabama and Georgia. The majority of the deaths were caused by storm surges along the Mississippi and Louisiana coastlines and flooding in the New Orleans area, the report said. In addition, more than 200,000 people were stranded in evacuation centers.

Almost two months after Katrina hit, 20.2 percent of houses still had no water, 24.5 percent had no electricity, and 43.2 percent had no telephone service.

And 49.8 percent of the adults exhibited levels of emotional distress indicating a potential need for mental health services.

"We found that residents have a variety of environmental, medical and mental health needs," said Dr. Randolph Daley, a veterinary epidemiologist with the CDC. "The impact of the hurricane was great and some of those needs have already been addressed, but there are many needs that will continue."

"The need for mental health services is going to continue for a good amount of time," Daley added.

The CDC findings were released Thursday, one step behind news reports that said more than 3,200 people still are unaccounted for in the four states hit hardest by Katrina. The official death toll now stands at 1,302; estimates say more than a million people were displaced, and damage tallies range between $70 billion and $130 billion.

According to the CDC report, it's possible some of the missing were washed into nearby Lake Pontchartrain, and other bodies may still be buried in the rubble of the city. In recent weeks, at least one family returning to a wrecked home found the remains of a relative inside, the Associated Press reported.

Another report in the MMWR focused on emergency-department visits after Katrina struck, to see what impact the storm had on the types of visits.

"From September 8 through 25, we had over 17,000 emergency department visits occurring at participating facilities," said report author Sukhminder Sandhu, an epidemic intelligence officer at the CDC.

"The proportion of relief workers with acute respiratory events and unintentional injuries was higher compared with residents," she added. "In comparison, residents had a higher number of motor-vehicle crashes than rescue workers as residents returned to the city."

Most emergency department visits were for non-hurricane-related medical problems, Sandhu said. "The majority were for illness," she said.

And while there were no outbreaks of cholera -- as had been feared -- related to either hurricane Katrina or hurricane Rita, which blasted ashore on Sept. 24, a system established to monitor health conditions in evacuation centers found that influenza-like illness and rash were the most commonly reported communicable disease syndromes.

But most of these cases were attributed to "over-reporting," according to the CDC report.

"For example, after telephone investigation, a skin infestation cluster of 60 cases was determined to be four confirmed cases of scabies, with the remainder being evacuation center residents treated prophylactically," the report said.

Chronic medical conditions made up 31 percent of the medical problems in the centers. In addition, mental health troubles -- either previously diagnosed, such a depression, or newly recognized, such as anxiety -- made up 9 percent of patient problems, the CDC reported.

A final CDC report highlighted the need for New Orleans residents to protect themselves from mold as they rebuild their city, pointing out that an environmental assessment had found 46 percent of the homes surveyed had visible mold growth at or above levels associated with health problems.

Yet, residents and workers have not consistently used appropriate respiratory protection, the report noted.

To deal with this problem, the CDC is calling for more public education about the danger of mold and how people can protect themselves.

One expert thinks the situation could have been much worse.

"It's rather remarkable that we didn't see more injuries, more infectious diseases," said John C. Pine, director of disaster science and management at Louisiana State University. "The nature of this storm had alerted the public health community. All of us were thinking that such a disaster could have catastrophic results."

But Pine is concerned about the long-term mental health effects on people who lost their homes and jobs.

"There is enormous mental health strain, even today," Pine said. "We tend to measure things we can count, like the number of dead. But the numbers needing mental-health care will likely go up."

More information

The U.S. Environmental Protection Agency can tell you more about Katrina's aftermath.

SOURCES: Randolph Daley, expert veterinary epidemiologist, D.V.M., M.P.H., U.S. Centers for Disease Control and Prevention, Atlanta; Sukhminder Sandhu, Ph.D., epidemic intelligence officer, CDC, Atlanta; John C. Pine, Ph.D., director of disaster science and management, Louisiana State University, Baton Rouge; Jan. 20, 2006, CDC's Morbidity and Mortality Weekly Report
Consumer News