Bodies Found in New Orleans Hospital; Other Health Effects of Hurricane Examined

The bodies of more than 40 patients were found Sunday at the flooded New Orleans-based Memorial Medical Center, owned by Tenet Healthcare, the AP/Washington Times reports.

Dave Goodson, assistant administrator of the hospital, said the patients -- mostly elderly -- died while waiting for four days to be evacuated after Hurricane Katrina hit and "were not abandoned" (Martel, AP/Washington Times, 9/13). The exact number of bodies found, as well as causes of deaths, remains unclear (Nossiter, AP/Philadelphia Inquirer, 9/13).

Two medical professionals inside the hospital said "conditions began to turn desperate shortly after the floodwaters cut off roads," the Washington Post reports. The doctors said drinking water and medical supplies became scarce and IVs had to be rationed (Struck, Washington Post, 9/13). In addition, temperatures at the hospital reached 106 degrees.

Goodson said, "I would suggest that [the heat] had a lot to do with" the deaths.

Tenet spokesperson Steven Campanini said none of the deaths resulted from lack of food, water or electricity to power medical equipment, adding that some of the patients had died before the hurricane hit. In addition, he said many of the patients at the hospital were seriously ill before the hurricane struck (AP/Philadelphia Inquirer, 9/13).

Campanini said Tenet did not know how many of the deaths were patients and how many were patients from other hospitals or residents seeking shelter at the hospital. He said the hospital had been stockpiling food and supplies and transferring patients to other hospitals before the hurricane, but 115 patients remained at the facility when the levees broke and the city was flooded.

Louisiana Department of Health and Hospitals spokesperson Bob Johannessen said the department could not confirm Campanini's statements but added that the deaths were under investigation (Johnson, New York Times, 9/13).

Sally Foreman, a spokesperson for New Orleans Mayor Ray Nagin, said the city knew patients had remained in hospitals, but the first priority had been to evacuate patients in critical care units (Washington Times, 9/13).

Federal officials, drug companies and AIDS organizations are working to provide care to the nearly 8,000 HIV-positive people displaced by the hurricane, the AP/Miami Herald reports.

In the aftermath of the hurricane, health providers in Florida, Tennessee, Alabama, Mississippi, Georgia and other states are reporting that displaced HIV/AIDS patients are arriving at their clinics seeking new prescriptions and medical care. In response to the need, several AIDS service organizations from the affected area have partnered with clinics in other cities to provide temporary housing and medication for HIV-positive patients.

According to Nicholos Bellos, president of the Dallas-based Southwestern Infectious Disease Associates, HIV/AIDS patients have complex medical histories that are often well-documented at their clinics. "Not many of these people had a chance to go by and pick up their medical records on the way out of town," he said, adding, "One of our biggest problems, right off the bat, is just documenting their HIV-positive status." In addition, HIV-positive patients can develop drug resistance if they miss doses of their medication, making the virus more difficult to treat.

Federal officials have said they are working to streamline care to HIV-positive patients after the hurricane destroyed the Biloxi, Miss., and New Orleans service centers of the Health Resources and Services Administration -- an HHS agency that provides health care for people living with HIV -- and left the centers in Hattiesburg, Miss., and Mobile, Ala., flooded and without power. Several drug companies also have offered to provide medication to patients at no cost (Mendoza, AP/Miami Herald, 9/12).

Meanwhile, a number of organizations are working to help evacuees with chronic illnesses who are facing potentially life-threatening interruptions in care, the Philadelphia Inquirer reports. For many such patients, the storm "severed their links to doctors, prescription medications and medical care," and now they are seeking care in unfamiliar locations, according to the Inquirer.

The American Diabetes Association has established a Katrina message board on its Web site where survivors can post requests for referrals, treatments and supplies. For cancer patients, the American Society of Clinical Oncology also has established a Katrina message board where displaced patients can look for their doctors and doctors treating the relocated patients can try to get information on their new patients (Vrazo, Philadelphia Inquirer, 9/13).

According to USA Today, some of the 150 evacuated cancer patients currently being treated at Houston's M.D. Anderson Cancer Center are too "shell-shocked" to provide basic information about their condition or treatment, so providers have been using ASCO's message board to find information.

Meanwhile, Joseph Mirro, chief medical officer at St. Jude Children's Research Hospital in Memphis, Tenn., said many cancer patients who were relocated from New Orleans hospitals have been able to resume chemotherapy treatments, but daily radiation treatments are more challenging. He added that it is unclear how interrupting cancer treatments will affect patients (Szabo, USA Today, 9/13).

Some mental health professionals have raised concerns that cultural, social and racial barriers could affect their efforts to counsel evacuees who were displaced and disoriented by the hurricane, USA Today reports. Most of the evacuees are black, but blacks make up less than 5% of mental health professionals in most specialties.

According to Raymond Crowel of the not-for-profit National Mental Health Association, mental health professionals might misinterpret some responses from evacuees as indications of mental illness.

Robert Atwell, president of the Association of Black Psychologists, said, "These are people who come from different racial backgrounds and different social classes. They are going to have to work really hard to bridge that gap." The group plans to post "cultural competency" recommendations online this week.

According to Charles Curie, head of the federal Substance Abuse and Mental Health Services Administration, most mental health professionals are aware of cultural issues. "While it is critical to have people of their own culture treating people of the same culture, all professionals are geared toward being aware of those cultures," Curie said (Jayson, USA Today, 9/13).

The Baltimore Sun on Tuesday examined how the "diaspora" from the hurricane has "created challenges in communities ... where taxed addiction counselors already have full caseloads and, in some cases, all staffed treatment beds are full."

According to the Sun, some evacuees with substance abuse problems have sought to obtain OxyContin prescriptions at shelters, and others have told shelter staff that they require methadone to continue treatment regimens. In addition, some evacuees with substance abuse problems "are given away" by symptoms of withdrawal, such as body tremors, sweating, diarrhea and vomiting, the Sun reports.

The effect that the evacuation of New Orleans will have on the "availability of drug treatment and the patterns of illegal drug trade over time isn't clear," but some substance abuse treatment centers have added beds to admit patients and accommodate displaced addiction counselors, according to the Sun.

Leon Evans, executive director for the Center for Health Care Services in Texas, said that some evacuees with substance abuse problems did not receive an adequate supply of methadone to last throughout the evacuation. "You've got people who left before the storm, but they didn't dream they'd need that much" methadone, he said, adding, "You've got others who left with just the clothes on their back. After two weeks, they're all in the same boat. Everyone's out of resources" (Bell/Hay Brown, Baltimore Sun, 9/13).

The Washington Post health section on Tuesday published three articles on the effect of Hurricane Katrina on health care. Summaries appear below.

• "At Risk Before the Storm Struck: Prior Health Disparities Due to Race, Poverty Multiply Death, Disease": The article examines how evacuees who are black, have low incomes, lack access to health care and have chronic diseases face "greater peril than those with better health and access to care." Many of the areas affected by the hurricane have high rates of chronic diseases, such as diabetes and hypertension, and health officials "expect many of the storm-related deaths to result not from trauma or drowning, but from lack of medicine and treatment for people with chronic illnesses," the Post reports. Winston Price, immediate past president of the National Medical Association, said that the hurricane should demonstrate how health care disparities can lead to serious health problems among minority groups (Payne, Washington Post, 9/13).
  


• "Next Threat: Illness: Experts Anxious To Contain Disease Outbreaks, Rumors": The article examines efforts by health officials to control outbreaks of infectious diseases -- such as gastrointestinal viruses, flu, chicken pox, MMR, and hepatitis A -- and "quell unfounded rumors about others" in the aftermath of the hurricane. The article includes a series of questions to and answers from health officials and infectious disease experts about the "biggest communicable disease concerns facing hurricane survivors" (Agnvall, Washington Post, 9/13).
  


• "Uncharted Territory: Mental Health Experts Struggle To Forecast Katrina's Psychological Impacts -- and Best Treatments": The article examines how mental health experts predict that the psychological effects of the hurricane, "a catastrophe without parallel in modern American history, are likely to be far greater" than those of the Sept. 11, 2001, terrorist attacks because of the large number of individuals affected and the extent to which they are affected. Individuals affected by the hurricane might have increased risk for post-traumatic stress disorder and likely will experience acute stress reactions over the first month. The Center for the Study of Traumatic Stress at the Uniformed Services University has begun to distribute a handout on behaviors and treatment strategies to help mental health workers treat individuals affected by the hurricane (Boodman, Washington Post, 9/13).
  

PBS' "NewsHour with Jim Lehrer": The segment reports on public health issues in the Gulf states. The segment includes comments from Carol Rubin, chief of CDC's National Center for Environmental Health, and physicians assisting in the relief efforts (Dentzer, "NewsHour with Jim Lehrer," PBS, 9/12). The complete segment is available online in RealPlayer.