How Rural Areas Like Florida’s Panhandle Can Become More Hurricane-Ready

By Eren Erman Ozguven
When Hurricane Michael roared onto northwest Florida's Gulf Coast in October 2018, its 160 mile-per-hour winds made it the strongest storm ever to hit the region. It was only the fourth Category 5 storm on record to make landfall in the U.S.
Thousands of residents, from the coast to 100 miles inland, were left without housing, power, food or water. Schools, stores, businesses and many government buildings shut down for weeks. Hospitals had to temporarily stop services.
Months later, many locals were still trying to survive in battered, tarp-covered homes or living in tents, relying on local food banks for survival. Lacking customers, some business owners shuttered their doors and left town.
In Michael's aftermath, it gradually became apparent that Florida's Panhandle experienced more severe damage than many urban areas around the state that are relatively better prepared for behemoth storms. I have seen firsthand how this was due to lack of preparedness and infrastructure that was aging, limited and substandard.
I have studied hurricane resilience for the past 13 years and know that better preparation can help make communities more resilient in the face of major disasters. As the high-risk months approach, I and other Florida State University scholars from many different fields are working with local communities to help them get ready and improve their response plans.
Lost Homes and Livelihoods
After Hurricane Michael passed through, I drove to Panama City — one of the hardest-hit areas — with fellow FAMU-FSU College of Engineering professors Juyeong Choi and Tarek Abichou. We made the trip to observe infrastructure and community damage and meet with local emergency management officials as part of a project supported by the federally funded Natural Hazards Center, which works to reduce harm from natural disasters.
To get there from Tallahassee, we drove west on State Road 20, an inland route that took us through ravaged rural areas. We returned along U.S. Highway 98, a scenic road that hugs the Gulf of Mexico, stopping at Mexico Beach — a small coastal tourist town that was nearly wiped away by Hurricane Michael's winds and storm surge.
The damage we saw was beyond anything we had imagined. There were hundreds of thousands of downed trees and hundreds of blocked roadways. Numerous houses and farms were completely destroyed, along with extensive timber plantations — the region's big money-producing crop.
FSU planner-in-residence Dennis Smith, who has worked for decades in emergency management in the public and private sectors, was just as stunned. "The damage, both the magnitude and the geographic extent and intensity, was some of the worst I had ever seen," he told me. "There are extensive housing losses (far inland) and the damage to woodlands is like nothing I've ever seen."
The social impacts were equally daunting. "We were especially not prepared for the numbers of homeless," said Ellen Piekalkiewicz, who directs a center focusing on the needs of communities, families and children at FSU's College of Social Work. In the schools, she said, "there have been a number of kids having psychological problems."
Planning for the Next Big Storm
It is extremely challenging to prepare for very fast Category 5 hurricanes like Hurricane Michael. Storms of this size generate extreme winds and storm surge that knock out communications — including cellphone towers — and transportation routes. But proactive planning and community-level decision making can ensure that no one is left without assistance.
One essential step is identifying critical escape and emergency response routes, which are at high risk of disruption during these disasters. Pinpointing these routes in advance provides time to improve roadway infrastructure and develop alternative public evacuation plans in case primary routes are blocked.
It also is important to assess which demographic and socioeconomic groups will be most affected by damage to power lines and roadways — for example, aging populations. Studying power outages and roadway closures during hurricanes, together with a region's physical features, reveals vulnerable locations that will be at high risk in future events.
My engineering colleagues and I also are studying how uncertainty about storm tracks affects evacuation planning and how wind damage to buildings varies with different types of terrain. These are crucial questions for storm preparedness.
#HurricaneMichael just hours away from a catastrophic, unprecedented #Florida Panhandle, Big Bend Cat. 4 landfall.… https://t.co/97B6EcuMLe— The Weather Channel (@The Weather Channel)1539164645.0
Another high priority is identifying and supporting at-risk populations. Especially in rural areas like Florida's Panhandle, planners need good information on population size, location and composition. The most effective way to collect it is by working with nonprofit agencies, volunteer groups, faith-based organizations, community-based centers, neighborhood-level groups, hospitals and governmental organizations.
"Involving these entities in hurricane training exercises is also important to build trust," FSU public administration professor Richard Feiock told me. "That makes communities stronger and more durable when a hurricane hits."
One promising strategy we have identified through focusing on the needs of vulnerable groups is repurposing existing hurricane shelters to serve evacuees with pets or other special needs. Experience has shown that some people will remain in harm's way instead of evacuating if they think leaving means abandoning their pets.
National Guard members distribute food and water in Miller County, Georgia, Oct. 12, 2018, during Hurricane Michael relief efforts.
U.S. Air National Guard / Tech. Sgt. Amber Williams / CC BY 4.0
Getting the Word Out
Communities also need to develop systems for alerting residents about hurricane risks and getting accurate information to them as quickly as possible when a storm threatens. Such networks can include radio, TV, phone and even door-to-door notification. In rural areas it is especially important to design strong community training programs, and to foster strong social networks that draw on neighbor-to-neighbor ties and other personal connections.
Hurricane warning information should include locations and types of shelters, along with dates, times and locations for pickups if transportation is available, and should explain what people can bring with them. Our research indicates that with these improvements, Panhandle communities and others like them can develop better emergency plans that reduce the stress of evacuations, provide safe shelter and ultimately save lives.
Reposted with permission from our media associate The Conversation.
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A Healthy Microbiome Builds a Strong Immune System That Could Help Defeat COVID-19
By Ana Maldonado-Contreras
Takeaways
- Your gut is home to trillions of bacteria that are vital for keeping you healthy.
- Some of these microbes help to regulate the immune system.
- New research, which has not yet been peer-reviewed, shows the presence of certain bacteria in the gut may reveal which people are more vulnerable to a more severe case of COVID-19.
You may not know it, but you have an army of microbes living inside of you that are essential for fighting off threats, including the virus that causes COVID-19.
How Do Resident Bacteria Keep You Healthy?
<p>Our immune defense is part of a complex biological response against harmful pathogens, such as viruses or bacteria. However, because our bodies are inhabited by trillions of mostly beneficial bacteria, virus and fungi, activation of our immune response is tightly regulated to distinguish between harmful and helpful microbes.</p><p>Our bacteria are spectacular companions diligently helping prime our immune system defenses to combat infections. A seminal study found that mice treated with antibiotics that eliminate bacteria in the gut exhibited an impaired immune response. These animals had low counts of virus-fighting white blood cells, weak antibody responses and poor production of a protein that is vital for <a href="https://doi.org/10.1073/pnas.1019378108" target="_blank">combating viral infection and modulating the immune response</a>.</p><p><a href="https://doi.org/10.1371/journal.pone.0184976" target="_blank" rel="noopener noreferrer">In another study</a>, mice were fed <em>Lactobacillus</em> bacteria, commonly used as probiotic in fermented food. These microbes reduced the severity of influenza infection. The <em>Lactobacillus</em>-treated mice did not lose weight and had only mild lung damage compared with untreated mice. Similarly, others have found that treatment of mice with <em>Lactobacillus</em> protects against different <a href="https://doi.org/10.1038/srep04638" target="_blank" rel="noopener noreferrer">subtypes of</a> <a href="https://doi.org/10.1038/s41598-017-17487-8" target="_blank" rel="noopener noreferrer">influenza</a> <a href="https://doi.org/10.1371/journal.ppat.1008072" target="_blank" rel="noopener noreferrer">virus</a> and human respiratory syncytial virus – the <a href="https://doi.org/10.1038/s41598-019-39602-7" target="_blank" rel="noopener noreferrer">major cause of viral bronchiolitis and pneumonia in children</a>.</p>Chronic Disease and Microbes
<p>Patients with chronic illnesses including Type 2 diabetes, obesity and cardiovascular disease exhibit a hyperactive immune system that fails to recognize a harmless stimulus and is linked to an altered gut microbiome.</p><p>In these chronic diseases, the gut microbiome lacks bacteria that activate <a href="https://doi.org/10.1126/science.1198469" target="_blank" rel="noopener noreferrer">immune cells</a> that block the response against harmless bacteria in our guts. Such alteration of the gut microbiome is also observed in <a href="https://doi.org/10.1073/pnas.1002601107" target="_blank" rel="noopener noreferrer">babies delivered by cesarean section</a>, individuals consuming a poor <a href="https://doi.org/10.1038/nature12820" target="_blank" rel="noopener noreferrer">diet</a> and the <a href="https://doi.org/10.1038/nature11053" target="_blank" rel="noopener noreferrer">elderly</a>.</p><p>In the U.S., 117 million individuals – about half the adult population – <a href="https://health.gov/our-work/food-nutrition/2015-2020-dietary-guidelines/guidelines/" target="_blank" rel="noopener noreferrer">suffer from Type 2 diabetes, obesity, cardiovascular disease or a combination of them</a>. That suggests that half of American adults carry a faulty microbiome army.</p><p>Research in my laboratory focuses on identifying gut bacteria that are critical for creating a balanced immune system, which fights life-threatening bacterial and viral infections, while tolerating the beneficial bacteria in and on us.</p><p>Given that diet affects the diversity of bacteria in the gut, <a href="https://www.umassmed.edu/nutrition/melody-trial-info/" target="_blank" rel="noopener noreferrer">my lab studies show how diet can be used</a> as a therapy for chronic diseases. Using different foods, people can shift their gut microbiome to one that boosts a healthy immune response.</p><p>A fraction of patients infected with SARS-CoV-2, the virus that causes COVID-19 disease, develop severe complications that require hospitalization in intensive care units. What do many of those patients have in common? <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e2.htm" target="_blank" rel="noopener noreferrer">Old age</a> and chronic diet-related diseases like obesity, Type 2 diabetes and cardiovascular disease.</p><p><a href="http://doi.org/10.1016/j.jada.2008.12.019" target="_blank" rel="noopener noreferrer">Black and Latinx people are disproportionately affected by obesity, Type 2 diabetes and cardiovascular disease</a>, all of which are linked to poor nutrition. Thus, it is not a coincidence that <a href="https://www.cdc.gov/mmwr/volumes/69/wr/mm6933e1.htm" target="_blank" rel="noopener noreferrer">these groups have suffered more deaths from COVID-19</a> compared with whites. This is the case not only in the U.S. but also <a href="https://www.washingtonpost.com/world/europe/blacks-in-britain-are-four-times-as-likely-to-die-of-coronavirus-as-whites-data-show/2020/05/07/2dc76710-9067-11ea-9322-a29e75effc93_story.html" target="_blank" rel="noopener noreferrer">in Britain</a>.</p>Discovering Microbes That Predict COVID-19 Severity
<p>The COVID-19 pandemic has inspired me to shift my research and explore the role of the gut microbiome in the overly aggressive immune response against SARS-CoV-2 infection.</p><p>My colleagues and I have hypothesized that critically ill SARS-CoV-2 patients with conditions like obesity, Type 2 diabetes and cardiovascular disease exhibit an altered gut microbiome that aggravates <a href="https://theconversation.com/exercise-may-help-reduce-risk-of-deadly-covid-19-complication-ards-136922" target="_blank" rel="noopener noreferrer">acute respiratory distress syndrome</a>.</p><p>Acute respiratory distress syndrome, a life-threatening lung injury, in SARS-CoV-2 patients is thought to develop from a <a href="http://doi.org/10.1016/j.cytogfr.2020.05.003" target="_blank" rel="noopener noreferrer">fatal overreaction of the immune response</a> called a <a href="https://theconversation.com/blocking-the-deadly-cytokine-storm-is-a-vital-weapon-for-treating-covid-19-137690" target="_blank" rel="noopener noreferrer">cytokine storm</a> <a href="http://doi.org/10.1016/S2213-2600(20)30216-2" target="_blank" rel="noopener noreferrer">that causes an uncontrolled flood</a> <a href="http://doi.org/10.1016/S2213-2600(20)30216-2" target="_blank" rel="noopener noreferrer">of immune cells into the lungs</a>. In these patients, their own uncontrolled inflammatory immune response, rather than the virus itself, causes the <a href="http://doi.org/10.1007/s00134-020-05991-x" target="_blank" rel="noopener noreferrer">severe lung injury and multiorgan failures</a> that lead to death.</p><p>Several studies <a href="https://doi.org/10.1016/j.trsl.2020.08.004" target="_blank" rel="noopener noreferrer">described in one recent review</a> have identified an altered gut microbiome in patients with COVID-19. However, identification of specific bacteria within the microbiome that could predict COVID-19 severity is lacking.</p><p>To address this question, my colleagues and I recruited COVID-19 hospitalized patients with severe and moderate symptoms. We collected stool and saliva samples to determine whether bacteria within the gut and oral microbiome could predict COVID-19 severity. The identification of microbiome markers that can predict the clinical outcomes of COVID-19 disease is key to help prioritize patients needing urgent treatment.</p><p><a href="https://doi.org/10.1101/2021.01.05.20249061" target="_blank" rel="noopener noreferrer">We demonstrated</a>, in a paper which has not yet been peer reviewed, that the composition of the gut microbiome is the strongest predictor of COVID-19 severity compared to patient's clinical characteristics commonly used to do so. Specifically, we identified that the presence of a bacterium in the stool – called <em>Enterococcus faecalis</em>– was a robust predictor of COVID-19 severity. Not surprisingly, <em>Enterococcus faecalis</em> has been associated with <a href="https://doi.org/10.1053/j.gastro.2011.05.035" target="_blank" rel="noopener noreferrer">chronic</a> <a href="https://doi.org/10.1016/S0002-9440(10)61172-8" target="_blank" rel="noopener noreferrer">inflammation</a>.</p><p><em>Enterococcus faecalis</em> collected from feces can be grown outside of the body in clinical laboratories. Thus, an <em>E. faecalis</em> test might be a cost-effective, rapid and relatively easy way to identify patients who are likely to require more supportive care and therapeutic interventions to improve their chances of survival.</p><p>But it is not yet clear from our research what is the contribution of the altered microbiome in the immune response to SARS-CoV-2 infection. A recent study has shown that <a href="https://doi.org/10.1101/2020.12.11.416180" target="_blank" rel="noopener noreferrer">SARS-CoV-2 infection triggers an imbalance in immune cells</a> called <a href="https://doi.org/10.1111/imr.12170" target="_blank" rel="noopener noreferrer">T regulatory cells that are critical to immune balance</a>.</p><p>Bacteria from the gut microbiome are responsible for the <a href="https://doi.org/10.7554/eLife.30916.001" target="_blank" rel="noopener noreferrer">proper activation</a> <a href="https://doi.org/10.1126/science.1198469" target="_blank" rel="noopener noreferrer">of those T-regulatory</a> <a href="https://doi.org/10.1038/nri.2016.36" target="_blank" rel="noopener noreferrer">cells</a>. Thus, researchers like me need to take repeated patient stool, saliva and blood samples over a longer time frame to learn how the altered microbiome observed in COVID-19 patients can modulate COVID-19 disease severity, perhaps by altering the development of the T-regulatory cells.</p><p>As a Latina scientist investigating interactions between diet, microbiome and immunity, I must stress the importance of better policies to improve access to healthy foods, which lead to a healthier microbiome. It is also important to design culturally sensitive dietary interventions for Black and Latinx communities. While a good-quality diet might not prevent SARS-CoV-2 infection, it can treat the underlying conditions related to its severity.</p><p><em><a href="https://theconversation.com/profiles/ana-maldonado-contreras-1152969" target="_blank">Ana Maldonado-Contreras</a> is an assistant professor of Microbiology and Physiological Systems at the University of Massachusetts Medical School.</em></p><p><em>Disclosure statement: Ana Maldonado-Contreras receives funding from The Helmsley Charitable Trust and her work has been supported by the American Gastroenterological Association. She received The Charles A. King Trust Postdoctoral Research Fellowship. She is also member of the Diversity Committee of the American Gastroenterological Association.</em></p><p><em style="">Reposted with permission from <a href="https://theconversation.com/a-healthy-microbiome-builds-a-strong-immune-system-that-could-help-defeat-covid-19-145668" target="_blank" rel="noopener noreferrer" style="">The Conversation</a>. </em></p>By Jeff Masters, Ph.D.
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