| Perspectives on Texas

While there is no question that Hurricane Katrina’s effect on the people of Louisiana was devastating and will be long-lasting, the people of Texas should look back and be proud of how they were good neighbors.

But given the well-documented decreases in funding and staffing at state and local health departments in the years since, are we prepared to be as hospitable in the future?

About 500,000 Louisianans evacuated to Texas over Labor Day weekend in 2005. Half stayed with friends or relatives or in hotels. The others were accommodated in shelters throughout the state, starting with Houston and Harris County, where they were provided services for several weeks.

So how was it that those shelters were opened, equipped and staffed?

The state of Texas and its communities had spent the years following 9/11 and the 2001 anthrax attacks preparing and practicing for a bioterrorism event.

Funds were appropriated to bring together public health, medical care and emergency response personnel, and help them develop “playbooks” to respond to the deployment of deadly agents.

County medical societies, local health departments and emergency medical units met in communities across the state, where they updated response plans and took them for test drives.

At the state level, the newly-created Preparedness Coordinating Council brought together groups like the Texas Medical Association, the Texas Nurses Association, the American Civil Liberties Union and the Texas Hospital Association to help revise the state’s emergency response plan.

Although there were no bioterrorism events in Texas between 2001 and Labor Day 2005, naturally occurring events like Tropical Storm Allison, which caused massive floods, forced local and state agencies to implement disaster plans and improve them based on what worked and what didn’t.

In August 2005, the Texas Department of State Health Services undertook what was at the time the largest “strategic national stockpile” exercise in the country in a multi-county region in North Texas. The exercise, overseen by the U.S. Departments of Health and Human Services and Homeland Security and conducted weeks before Hurricane Katrina, was to respond to a simulated mass deployment of aerosolized plague, and Texas scored well.

Several weeks before that, Hurricane Emily made landfall in South Texas. The state health department activated its emergency response center and managed the emergency. The agency learned from both experiences and revised its emergency response operating procedures.

As a result of all of these trials, by late summer 2005, Texas and its communities were better prepared for a large bioterrorism event than they had been at any time in the five preceding years. That meant Texas was ready when the wrath of Hurricane Katrina spared us but made landfall one state to the east, leaving hundreds of thousands of our neighbors in need of shelter, medical care and public health services.

We had practiced, we had made improvements and we performed.

Ten years later, we can look back and be proud of our compassion as a state and our competence as a system. But in the shadows of Texas’ recent Ebola outbreak, and amid the persistent threat of communicable disease, hurricanes and other weather-related events, we must ask ourselves and our policymakers if we are as prepared to respond today as we could and should be.

The federal government, which provides the bulk of the funding for emergency preparedness, has cut the purse strings – and Texas is taking the biggest cut. The U.S. Centers for Disease Control and Prevention program that supports frontline state and local public health professionals has been cut by 16 percent over the last four years after adjusting for inflation. This year alone, Texas saw a $3 million drop in that federal funding – 7.1 percent, the largest percentage cut in the country.

Renewed funding, renewed partnerships and renewed practice is what it will take. We did it in 2005. Could we do it again in 2015?