The Perfect Storm: Shelter-Based Surveillance in the Aftermath of Hurricane Sandy — New Jersey, 2012

BACKGROUND:  Hurricane Sandy made landfall in New Jersey on October 29, 2012, causing widespread infrastructure damage and power outages and prompting one of the largest American Red Cross disaster responses to date. Approximately 7,000 residents were relocated to at least thirty Red Cross shelters. CDC and New Jersey Department of Health conducted shelter-based surveillance to track morbidity, and designed and implemented sustainable methods for shelter staff to report morbidity data remotely.

METHODS: Red Cross staff recorded demographic data, primary complaint(s), disposition, and referral data for each client health visit. Aggregate morbidity tallies of individual interactions for each 24-hour period were compiled, reported to CDC daily, and shared with local health departments for potential follow-up. At each shelter, CDC developed a sustainable method for daily reporting based on available technology, which included reporting by e-mail, text message, or fax.

RESULTS:  During November 5–21, we collected aggregate morbidity data in the 21 shelters housing >30 residents overnight. Shelters reported 5,189 health services visits, which address7,101 health needs. Fifty-two percent of health needs involved acute illness, 32% follow-up care (e.g., wound care, blood pressure or blood glucose checks, and medication refills), 13% chronic illness exacerbations, and 3% injury. Within 1 week, 100% of shelters transitioned to remote reporting, with all but two using smartphones to text or e-mail pictures of forms.

CONCLUSIONS:  Acute care was the most common need; chronic illness exacerbations and follow-up care were also substantial. We successfully demonstrated timely capture of standardized morbidity data by using a unique reporting method. As a result of this response, expanding and institutionalizing smartphone technology for reporting shelter surveillance data is being considered.