Literature Review

Los Angeles wildfires leave older patients vulnerable Direct Relief - California Wildfires; by Talya Meyers; 1/22/25 The radio announcer said nursing home residents were being evacuated to the Pasadena Convention Center, so Dr. Laura Mosqueda headed over. Older adults were arriving at the evacuation shelter with hair and hospital gowns covered in ash. People urgently needed to be on oxygen — in a large convention hall with few electrical outlets — or their catheters were getting full but responders didn’t have gloves. ... Some patients were in hospice and end-of-life care, and getting them placed more comfortably was an urgent priority. ... The wildfires that ripped across Southern California communities this month will hurt the health of millions — causing everything from short-term respiratory symptoms to long-term adverse outcomes from chronic disease — but older adults will likely be among the most vulnerable. ... [And with that,] Dr. Mosqueda cautioned that while older adults may be more likely to be medically fragile, many aren’t. Many have perspectives that help them navigate frightening, uncertain situations like the wildfires. “Older adults…were among the most calm and circumspect people I spoke with,” she recalled. “They just had a lot of wisdom and life experience, and they weren’t getting freaked out. They had so many internal resources.”

Which health facilities have been impacted by L.A.-area fires? AI may paint a clearer picture DirectRelief; by Andrew Schroeder; 1/14/25 Geospatial AI and remote sensing advance health system impact analysis shows where facilities have been damaged or destroyed -- and where medical needs may be greatest. One of the most important factors for humanitarian responders in these types of large-scale disaster situations is to understand the effects on the formal health system, upon which most people — and vulnerable communities in particular — rely upon in their neighborhoods. Evaluation of the impact of disasters ... is traditionally a relatively slow and manually arduous process, involving extensive ground truth visitation by teams of assessment professionals. Speeding up this process without losing accuracy, while potentially improving the safety and efficiency of assessment teams, is among the more important analytical efforts Direct Relief can undertake for response and recovery efforts.

An Eaton Fire First Responder recalls patients fleeing the fast-growing blaze Direct Relief; by Talya Meyers; 1/15/25 Eaton Fire evacuees, fleeing their homes for the safety of the Pasadena Convention Center, were arriving in numbers. For Fernando Fierro, vice president of nursing services at the community health center AltaMed, and the first of his response team to arrive, it was “chaotic.” “There wasn’t any infrastructure in place,” he recalled. More than 550 people sheltering at the convention center, in five event halls converted to dormitories, needed medical assessments. People had fled too urgently to bring their medications, or they needed canes and walkers, or they needed more intensive care than AltaMed’s response team could provide in a shelter setting. Complicating the situation were the close quarters and the presence of animals: People had brought their dogs, cats, and birds. Fierro, a U.S. Army combat veteran with extensive disaster response experience, knew the crowded shelter and animals would increase the likelihood of infectious diseases like norovirus and avian flu.

How to help people impacted by the California firesNBC News - Today Show; by Becca Wood; 1/8/24, updated 1/12/24

Meals on Wheels volunteers deliver extra food ahead of winter storm Fox 4 KDFW, Dallas, TX; by Alex Boyer; 1/8/25 Volunteers are doing their best to help some of North Texas’ most vulnerable people prepare for the winter storm. ... Meals on Wheels in Dallas County is a service provided by the Visiting Nurses Association. Currently, the organization serves about 5,200 homebound seniors and disabled adults throughout the county each weekday. That’s in addition to those in hospice care.

Thinking of our members, colleagues, patients, loved ones, and first responders affected by the SoCal firesCoalition for Compassionate Care of California, Sacramento, CA; by Jennifer Moore Ballentine; 1/8/25, 6:23 pm ET The staff of CCCC are watching as the Palisades, Eaton, Hurst, and other fires ravage Southern California. Our hearts and thoughts are with all affected. Here are a few tangible ways you can help, even at this early stage.Donate to:

Chaos and devastation: How the mountain fire erupted Ventura County Star, Ventura, CA; by Cheri Carlson and Tom Kisken; 11/17/24 ... The mountain fire that ignited 3 miles away was sweeping across Somis in a sprint accelerated by 80 mph Santa Ana winds that rattled the small ranches on their Ridgecrest Lane cul-de-sac. The fire soon leaped to the hills above Camarillo where it fed on more homes. It destroyed some 243 structures and threatened thousands more. In its first hours, the assault triggered roadside rescues, firefighters racing to get ahead of the flames and people scrambling to escape. ... It was lunch time at Bernadette’s, the residential care and hospice home at the bottom of Marissa Lane in Camarillo Heights. Four elderly residents, all in beds, had just started eating chicken nuggets and noodles. Sheriff’s deputies pounded on the door. Though smoke already filled the sky, a darker patch was coming. The home two lots away from the care center would soon burn to the ground. “It was like the apocalypse,” said Bernadette Abiera, the home's administrator. Deputies lifted the residents out of their beds and into wheelchairs. They rolled them down a hill to waiting squad cars. ...  The deputies ran back in to find two caregivers tending to a resident who was still eating his lunch. He wouldn’t stop. “I had to take the food out of his hands and carry him to the wheelchair,” said Deputy Justin Lopez. ... [Click on the title's link to continue reading.] 

Palm Harbor family suffers flood after Milton, less than month after mother dies from breast cancer ABC WFTS Tampa Bay, FL; by Jessica De Leon; 10/26/24 One Palm Harbor family is gutting the first floor of their home, destroyed by flood waters after Hurricane Milton. Cali Gignac’s childhood home is not in a flood zone or near any large bodies of water, yet more than two feet of water entered her parents' townhome and destroyed everything just a month after her mother died. “We haven’t had a chance to sort her mementos. We haven’t had a chance to grieve her or anything. And now it’s like... everything is garbage.” Now, they are trying to save what they can, sometimes stopping to take a snapshot of notes or photos that they find. But as tears come, they quickly move on, knowing they have so much to do.“Our photo albums are just, like, melting.”Editor's note: Click here for a public service educational video, "Community Crisis and Grief," with a significant section devoted to coping with "normal" bereavement in the midst of a community crisis. Disclosure, provided by Composing Life Out of Loss, a sponsor of this newsletter.

As IV shortage continues after hurricane, U.S. invokes wartime power to speed recovery CBS News; by Alexander Tin; 10/15/24 The Biden administration says it has invoked the wartime powers of the Defense Production Act to speed rebuilding of a major American factory of intravenous fluids that was wrecked by Hurricane Helene last month. Damage to the plant in North Carolina has worsened a nationwide shortage of IV fluids, and hospitals say they are still postponing some surgeries and other procedures as a result. Some 60% of the nation's IV supplies had relied on production from the plant, run by medical supplier Baxter, before it was damaged by the storm. "Ensuring people have medical supplies they need is a top priority of the Administration. It's exactly why we are working closely with Baxter to support cleanup and restoration of the facility, including invoking the Defense Production Act to help production resume as quickly as possible," an official with the Department of Health and Human Services told CBS News on Tuesday.

CMS grants temporary relief for home health, hospice agencies affected by hurricane McKnights Home Care; by Adam Healy; 10/15/24 The Centers for Medicare & Medicaid Services has issued several temporary flexibilities intended to help hospices and home health agencies affected by Hurricane Helene continue to provide care amid the emergency. During the emergency period, home health providers may take advantage of extended deadlines for quality reporting and patient assessment requirements, according to CMS. The agency communicated last week that it would permit delayed Outcome and Assessment Information Set submissions, and it also extended the five-day completion requirement for patients’ comprehensive assessments to 30 days. These patients assessments may also be conducted remotely or by record view — a departure from the typical in-person requirement — during the temporary emergency period. CMS said that this change will allow patients to be cared for in the environment of their choice, reduce impacts on acute care and long-term care facilities, and maximize clinicians’ ability to care for patients with the greatest acuity.