Hawaii could burn again. How can the government prepare?

“President Joe Biden’s disaster declaration came within hours of the wildfires that tore through Lāhainā, Maui, last week, where the death toll is at least 111 and a thousand people may still be missing. The disaster declaration helped unlock federal aid for Maui, adding to Hawaii’s emergency stores another 50,000 meals, 10,000 blankets, and $700 cash for survivors in the immediate aftermath.
But questions around the response at every level of government continue to mount. Many of the disaster’s survivors have said the assistance was slow to arrive, wondering days later why distribution centers were so disorderly, and missing persons numbers still so high.”

“At the same time, some decisions made locally also contributed to the chaos. “As reports have come out, the alarm systems weren’t initiated the way that community members would expect,” Ing added. “Even the evacuation process seemed unclear. Some community members were feeling that there was more deference and priority given to the hotels.””

“If you think about disaster response, that’s like a body responding to an injury. You’ve got arteries and capillaries, and those are not the same thing; they serve very different purposes. So I think when people critique FEMA and the federal government, it’s sort of misplaced because you can’t assume that a national, huge apparatus is going to know who the right people are on the ground to reach into the community.

What we need to do is make sure those local capillaries are very strong and as well-circulating as possible. The artery function that FEMA is meant to do are the big volumes of aid coming in. If you don’t have FEMA working with those local capillaries and supplying aid in the right spaces, then you get delay and confusion. That has to be organized at the local level so that when they show up, they’re immediately directed by the state and local level to the most effective channels.”

https://www.vox.com/climate/2023/8/18/23836054/hawaii-maui-wildfires-government-response-expert

Where Did Puerto Rico’s Disaster Relief Go?

“Billions of dollars were allocated by the federal government to rebuild Puerto Rico following Hurricane Maria and recovery efforts are projected to cost U.S. taxpayers another $50 billion, according to Federal Emergency Management Agency (FEMA) estimates. But corruption by FEMA officials in Puerto Rico has slowed down progress dramatically. Back in 2019, FEMA’s deputy regional administrator in charge of Maria recovery was indicted as part of a $1.8 billion bribery scheme involving an Oklahoma-based electric company. Officials on the island were also indicted for allegedly steering $15 million in federal rebuilding contracts to preferred contractors. And the Jones Act shares some of the blame since its restrictions on shipping to U.S. territories like Puerto Rico drive up costs for imported products significantly and delay the arrival of necessary supplies during emergency situations.
Congress has begun to ask questions about how exactly that money has been spent over the last five years.”

Trump Slowly Enlisting More Agencies in ‘Whole of Government’ Response to Virus

““We need the federal government to play its role,” Gov. Andrew M. Cuomo of New York said Monday. “The federal government has tremendous capacity.”

Much of that capacity is untapped. Hospital ships are at port. The Department of Veterans Affairs, legally designated as the backup health care system in national emergencies, awaits requests for help. The veterans department has a surplus of beds in many of its 172 hospital centers and a robust number of special rooms for patients with breathing disorders.

The sprawling system of emergency doctors and nurses ready to be deployed by the Department of Health and Human Services — known as the National Disaster Medical System — is also still waiting for orders, other than to staff locations where passengers offloaded from cruise ships are being quarantined.

And the Defense Department, home to 1.3 million active-duty troops and a civilian and military infrastructure that has made planning for national emergencies almost an art form, has yet to be deployed to its fullest capabilities. Senior Pentagon officials say they are ready to assist in any way that is ordered, but they also caution that much of the military’s emergency medical care is designed for combat trauma or natural disasters, and not mass quarantine for infections.

The last time a big infectious disease epidemic emerged, President Barack Obama dispatched nearly 3,000 American troops to Liberia to build hospitals and treatment centers to help fight Ebola. The Pentagon opened a joint command operation at a hotel in Liberia’s capital, Monrovia, to coordinate the international effort to combat the disease, and the American military provided engineers to help construct additional treatment facilities and sent people to train health care workers in West Africa to deal with the crisis.”

“Defense Secretary Mark T. Esper said on Tuesday that the Pentagon will make available to the Department of Health and Human Services up to 5 million N95 masks, which can be used to help protect health workers and vulnerable people against the virus. The first 1 million, he said, would be available immediately.

The Pentagon is also making available 2,000 ventilators for hospitals, a number that would likely fall far short of the expected need. “When you look at how many people who may need it”

“Field hospitals and the hospital ships Comfort and Mercy are designed for trauma wounds, not viruses, and doctors would have to be assigned from elsewhere to staff them. The ships, each with a 1,000-bed capacity, have helped in natural disasters like tsunamis, hurricanes and earthquakes, not quarantines.

Defense Department officials said that one possibility for the Comfort would be to station in New York Harbor and absorb non-coronavirus patients in New York, which could free up hospital beds in Manhattan to attend to infectious cases.”

“Oregon sent a letter to Vice President Mike Pence on March 3 asking for 400,000 N95 masks. For days, it got no response, and only by March 14 received its first shipment, of 36,800 masks. But there was a problem. Most of the equipment they got was well past the expiration date and so “wouldn’t be suitable for surgical settings,” the state said.

New York City also put in a request for more than 2 million masks and only received 76,000; all were expired, said Deanne Criswell, New York City’s emergency management commissioner. The city is also requesting additional beds for intensive care units and medical teams to staff a convention center that may be turned into a temporary medical facility.”

“FEMA officials said the Department of Health and Human Services remains in charge of the federal response, and it too is waiting for orders from the agency before it moves to ramp up assistance.”

“In previous national emergencies, FEMA would be responsible for finding out where to obtain masks, ventilators, hospital beds and tents from either the military or the private sector and ensuring the supplies are delivered to states, according to Michael Chertoff, the secretary of homeland security under President George W. Bush who oversaw the response to Hurricane Katrina.

“They have relationships and know where to look for things,’ Mr. Chertoff said. “Without that it’s not clear to me who would be doing the coordination and facilitation function.””