There’s little worse than the vast flooding Hurricane Matthew has unleashed in North Carolina. Dirty water has breached homes, storefronts, nursing homes. People have been trapped in cars stalled in rushing water. Death tolls are rising.
But as people of this coastal state know too well, the trouble will not fade when Matthew’s floodwaters recede.
A rising crest of health threats is also on its way, public health experts say, including some unexpected risks. Families already battered by flood damage need to take steps to protect themselves all over again.
“People get very concerned about dirty water, that fuel oil might have leaked or sometimes their septic tanks. In reality, most of that doesn’t pose much of a health risk,” said Dr. Julie Casani, head of the state public health division’s Public Health Preparedness and Response branch.
“I worry more about people getting injured during the cleanup.”
Floyd, Fran and friends
Experience from previous storms backs that up. After a flood, homes that normally are shelters become altered environments hosting all sorts of hazards, contributing to an expected post-flooding uptick in emergency department visits.
This story comes from North Carolina Health News.
For six weeks after Hurricane Floyd struck in 1999, incidence of bone and tissue injuries, respiratory problems, gastrointestinal trouble and heart disease were higher at 20 hospitals in 18 counties than they were over the same period the previous year.
Suicide attempts, dog bites, fevers, skin problems, and people seeking help with basic medical needs such as oxygen and medication refills, dialysis and vaccines all were more common during the six weeks after Floyd. So were spider bites, diarrhea, asthma attacks and injuries from assault, gunshot wounds and rape.
People can take steps to protect themselves. To begin with, people should stay clear any water that is slow to drain, said John Morrow, PItt County, N.C., public health director. Its depth can be deceptive and may pose a drowning risk, the most common cause of death from floods.
“Just stay out of the water, period. Particularly children,” Morrow said. “They are too likely to say I’m just going to swim out there and get my ball.”
Casani agrees. “You can’t see what you can’t see. While plodding through water you may not be able to see something that is submerged. People can get cut. Or they trip and fall or sprain an ankle.”
Air it out
During a flood cleanup, people sometimes bring petroleum-powered devices — generators and power washers included — inside their homes or garages. That should never occur, Morrow said, because the carbon monoxide emissions can be deadly.
“Exhaust collects. Before you know it, you get dizzy and can’t get to fresh air or turn the thing off in time,” he said.
Ten cases of carbon monoxide poisoning were reported in weeks after Hurricane Floyd, compared with none during a comparable period in the previous year.
There is plenty to do indoors. And while water laced with chemicals or sewage is not the biggest threat people will encounter while cleaning up their homes, that remains a potential risk. So cleaning with protective gloves and boots is recommended.
“You don’t want flood water to come in contact with your face or mouth. The risk of sickness is low. But pathogens can pass through cuts and scrapes,” said Tim Kelley, the director of the environmental health program at East Carolina University.
The North Carolina State University Extension offers detailed guidance on how to proceed with cleanups at home after a flood. A priority is to shovel out mud or silt before it dries and to wash down flooded walls and floors with hoses and then get them dry.
Drywall acts like a sponge, extension materials warn, and it might be necessary to remove wall board above the flood line. Wet insulation also must go. Sometimes holes must be drilled into the siding to fully dry walls, a process that can take months.
Much of that effort is required because of mold growing inside a home. Mold isn’t a health risk to everyone, but it can be a serious risk to people with asthma and allergies, or people with suppressed immune systems due to HIV infection, cancer treatments or other health conditions.
“One of the things about eastern North Carolina is that we’re surrounded by mold. You can’t avoid it, it is so damp and musty. There are thousands of species,” said Paul Barry, from the Department of Public Health at ECU.
The state Department of Public Safety recommends people treat every item touched by floodwaters as contaminated and disinfect those items with household cleaning products. It also recommended that people stay clear of any flood-damaged material that may contain asbestos. Discard mattresses, upholstered furniture, carpets and padding, and books and paper products touched by floodwaters, department officials urge.
Then there’s food and drinking water safety to attend to.
State Health Director Randall Williams on Tuesday urged people in multiple counties to boil their water.
When it comes to food, be conservative, health officials say. Discard any food touched by floodwaters, including edibles in cans, bottles or jars. Food that was in a refrigerator or freezer that reached more than 40 degrees should be thrown away, the N.C. State University Extension materials recommend.
If all the above isn’t enough, there are also disease-carrying insects to worry about. Mosquitoes lay their eggs in water and multiply more quickly after big rains and floods. State health officials recommend people wear insect repellent and empty any standing water in birdbaths, tires, flowerpots and other containers.
Casini, who lost a home to damage from Hurricane Isabel in Maryland in 2003, stressed that natural disasters, and all the challenges that follow, put a strain on anyone’s mental health.
She encourages people to slow down and not try to put everything back together at once, indoors or out.
“This isn’t your standard fall cleanup. This is happening in treacherous conditions,” Casini said.
Instead, do only what is feasible to tackle safely, she said. Try to get your family on what feels like a normal schedule. And reach out to other people in the same boat.
“Maybe they were never your friends,” Casini said. “But something like this becomes a collective experience.”