By Robert I. Field, Ph.D., J.D., M.P.H.
Some predictions are eerily prescient.
Back in 1994, a physicist looked far into the future and predicted that the first signs of climate change would look like this:
“[T]he slow rise in sea level will start to affect cities like New York during big storms. One year, high waves will wash up on the roads bordering the harbor, forcing the police to close them for a day or two. As time passes, this will get to be a more common phenomenon, and the strength of the storm needed to trigger it will become less.” (See James Trefil, A Scientist in the City, Anchor Books, 1994, p.247-248)
Then, we’ll get the big wake-up call:
"[P]erhaps during one of those hurricanes that occasionally make their way up the East Coast, a big storm surge will send water into the streets of lower Manhattan. It will be a big news item, of course, but it will take some time before people realize that there’s a problem to be dealt with.”
As we try to cope: ”Large (and very expensive) dikes will be built to keep the rising waters away from the city.”
I recalled that last prediction when I noticed this in today’s news:
“New York Gov. Andrew Cuomo and New York City Mayor Michael Bloomberg on Wednesday pushed for new and better protection of the nation’s biggest city that could include sea walls and levees to ward off what Cuomo fears is an emerging pattern of violent storms.”
Maybe it’s time to admit that the scientists are onto something. Had we paid attention 18 years ago, we might not have been so surprised by Sandy’s ferocity this week.
Among many major effects, environmental changes have large and immediate consequences for the health care system. On Monday and Tuesday, two large New York hospitals had to evacuate patients when power went out and back-up generators failed. NYU Langone Medical Center transferred 215 patients to other facilities, and Bellevue Hospital transferred 300.
At the same time, major storms and flooding cause injuries and illnesses that force many people to seek emergency care at the facilities still in operation.
Where does the health care system turn to relieve the stress? Help comes from many sources. Hospitals pitch in by taking evacuated patients from sister institutions. Charities like the American Red Cross supply food and shelter. State and local governments provide police, fire, and other emergency services.
But who coordinates the web of responders? For that, the health care system turns to the backbone of the disaster response system – the federal government.
Two agencies are especially crucial. The Federal Emergency Management Agency (FEMA) makes sure that essential supplies, including food and water, are distributed. The Agency has undergone a major restructuring since its dismal performance in 2005 after Hurricane Katrina.
The Department of Health and Human Services sends in medical supplies and personnel. This week, it moved 2,100 workers to New York and created six temporary treatment sites containing 1,500 beds in Brooklyn and Long Island.
The federal capacity for public health preparedness has improved significantly since the Sept. 11 terrorist attacks. However, recent budget cuts at all levels of government have threatened some of those gains.
Somewhat surprisingly, the need for a federal role in disaster response is the subject of debate. Some, including Mitt Romney, believe that most federal responsibilities should be moved to the states and the private sector.
How much more evidence than Hurricane Sandy do we need of the vital support the federal government provides in disaster protection?
Eighteen years ago, a scientist warned with eerie precision of the way climate change would play out. The federal government is the only entity with the resources and national perspective needed both to try to control it and to respond to its effects.
In the long-run, federal disaster protection will be a lot cheaper and more effective than those sea walls.