Katrina 'war room' in gear
By Steve Sternberg, USA TODAY
WASHINGTON — Sometime Friday, a brand-new, 100-bed hospital will open its doors to patients on a parking lot next to the shuttered Mardi Gras Party Shop in hurricane-battered Gulfport, Miss.
The hospital is made of vinyl fabric stitched into a series of Quonset hut-shaped tents. It has air conditioning and plumbing. It has an emergency room, intensive-care unit and operating suite for minor surgery. It can handle 12,000 patients a week.
It is one of a half-dozen portable medical centers slapped together on Mississippi's Gulf coast in the aftermath of Hurricane Katrina. Nearly 1,000 miles away, here in the Secretary's Operations Center at the Department of Health and Human Services in Washington, D.C., Brian Kamoie has taken a personal interest in each one.
Kamoie's focus is the federal government's response to the crisis on Mississippi's Gulf coast. He is one of dozens of staffers working 12-hour shifts in the Op Center, acting as Secretary of Health Michael Leavitt's eyes on the crisis and helping to coordinate the agency's activities.
Manned 24-7, the Op Center was completed in 2002, in response to 9/11 and the anthrax attacks that followed. During Katrina, Op Center staff and volunteers have spilled out of the center into two conference rooms with 50 computers each on other floors.
Katrina so far represents the toughest test of the Op Center's capabilities, marked during the first week by the information blackout that plagued the Gulf coast. Although HHS has escaped the scathing criticism leveled at the Federal Emergency Management Administration, Leavitt drew some fire early on for a two-day delay in declaring a public health crisis.
Gerald Parker, the Op Center's director and deputy assistant secretary of health, says the problem wasn't a loss of communications, because his staffers had satellite phone contact throughout the crisis. Rather, so many people were stranded that no one knew the extent of the damage. And it took two days for technicians to obtain satellite photos of the disaster for the Op Center's 10-screen video wall.
"Situation awareness was bad for everybody," he says. His deputy, Robert Blitzer, puts it down to "the fog of war."
Even before the hurricane, Parker says, HHS began moving disaster relief experts into the region. Afterward, Op Center staff began shifting more than 1,000 U.S. Public Health Service officers and tons of supplies into the affected region, making the response to Katrina the largest public health relief operation in U.S. history.
Kamoie, a professor of public health law at George Washington University who has been on loan to the federal government since 2004, helped coordinate the delivery of medical supplies to Mississippi, including medical teams and a half-dozen portable hospitals, which serve as triage centers, primary-care clinics and emergency rooms.
Rear Adm. Brenda Holman, ordinarily administrator of the Food and Drug Administration's 700-employee regional office in Oakland, has been relaying requests from state officials throughout Mississippi.
"As late as yesterday, I was prepared not to set this hospital up," Holman says of the temporary hospital in Gulfport. "Last night, (state officials) persuaded me that it was necessary."
Jim Craig, head of Mississippi's medical disaster response, says federal officials have been responsive to almost every request, and he says the extra beds will come in handy in this coastal town of 72,000 whose nine hospitals were crippled — three of them shut down — by Hurricane Katrina.
No detail is too small for Op Center staff to handle. Kamoie even agreed to reimburse North Carolina about $200 to fix a flat tire that temporarily halted a convoy transporting another mobile hospital to Gulfport from the University of North Carolina at Chapel Hill. Called Carolinas One, it has taken over for Gulfport's drowned Hancock Medical Center, which will be out of commission for the next month.
"We told them that if for any reason reimbursement doesn't come through, we would cover their cost," he says. "When they got a flat tire, they sent us the bill. We'll pay it."
Holman's counterpart in Louisiana, Adm. Craig Vanderwagon, of the Indian Health Service, is faced with precisely the opposite problem, trying to keep surviving New Orleans hospitals alive by not siphoning off paying patients to military medical facilities.
"In Jefferson Parish, the hospitals are functioning fine, but half a million patients have left the market," he says. "The more patients we send out, the fewer that'll be available for local hospitals."
The problem became so acute that Leavitt himself met with hospital CEOs during a visit to the region and assured them he would do his best to keep their hospitals open. Vanderwagon has had tough assignments before; he was the director of primary care and public health for the health ministry in Iraq and had to restore a health system for 26 million people.
In New Orleans, Vanderwagon oversaw one of many remarkable feats of the hurricane recovery effort: a Navy ship being used to pump water out of the city's storied, 650-bed Charity Hospital, founded in 1736.
"Medics with the 82nd Airborne had done their training at Charity," Vanderwagon says. "They discovered a Navy vessel that could pump water out at 12,000 gallons a minute. They were able to dry the hospital out. It's now dry enough that we can look at electrical and engineering issues."
http://www.usatoday.com/news/nation/2005-09-14-katrina-war-room_x.htm
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