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That came on Monday morning, when the health district called for a collective“ huddle” to assess damages.
There was significant water damage [ to the Laboratorio de Salud in San Juan ]. Instruments were still covered in plastic. It was a complete mess. They couldn’ t operate anything. There was evidence of mold in many of the labs; you could see it and you could smell it. It wasn’ t a place you wanted to be.”
Fortunately, laboratory impacts were minimal. A back door was blown open, admitting water and debris. The entire facility— all on the ground floor— was flooded with water, but“ not more than an inch deep.” And, of greater consequence, while city power was out, a back-up generator was flooded and out of commission for 3-4 hours.
Said Requenez,“ Some of our refrigerators and freezers are on monitoring systems, so we could tell if they were ever out of the correct temperature range.” All reagents and supplies of questionable integrity— plus the destroyed select agents— had to be replaced. And, because the local FedEx route goes through Houston, the lab’ s bulk reorders were delayed until that city“ dried out.”( Select agents arrived sooner, coming via the state public health laboratory in Austin and a person-to-person handoff at a midway point between Austin and Corpus Christi.)
Dr. Martina McGarvey surveys conditions at a Puerto Rican public health laboratory during APHL’ s laboratory assessment deployment in October 2017
On Tuesday morning, the laboratory reopened for business, with an immediate focus on water testing. The one posthurricane change to the lab’ s continuity of operations( COOP) plan: double-bolt all laboratory exterior doors.
Recovery from Square One
As bad as Harvey was, Maria may have been worse.
Described as“ apocalyptic,” the storm made a direct hit on Puerto Rico September 20, 2017, as a nearly Category 5 hurricane. Over the next 30 + hours, it ravaged the island without mercy. Four months later, a third of this US territory still had no power, and so many residents had quit the island that academics described it as an“ exodus.” As reported by the Los Angeles Times, one San Juan area resident predicted,“ Puerto Rico isn’ t going to be the same. It’ s going to be before Maria and after Maria.”
The indiscriminate destruction did not spare the main island’ s 11 discrete PHLs. In early October, CDC and APHL( at the request of CDC) sent teams of laboratorians to appraise the damage.
Christine Bean, PhD, MT( ASCP), head of the New Hampshire Public Health Laboratory and a member of the APHL team, said,“ There was significant water damage [ to the Laboratorio de Salud in San Juan ]. Instruments were still covered in plastic. It was a complete mess. They couldn’ t operate anything. There was evidence of mold in many of the labs; you could see it and you could smell it. It wasn’ t a place you wanted to be.”
Eddie O’ Neill La Luz, PhD, MS, MPH, a CDC deputy senior advisor for laboratory science and a member of the CDC assessment team, cited three immediate problems:“ The island power grid was severely disrupted. Infrastructure damage created water leaks that compromised equipment, reagents, supplies. Because there’ s no power, you cannot control the temperature, so things just cook inside.”
In addition to all these problems, some of the laboratories had been broken into and robbed of basic provisions, such as cleaning supplies.
Although CDC defers to other federal entities on facility repairs, the agency did contribute several uninterruptible power supplies to island laboratories. Working with the Puerto Rico Department of Health, CDC also arranged for highpriority specimens needing testing for tuberculosis, influenza, rabies, salmonellosis or leptospirosis to be shipped to the continental US for analysis at CDC and state PHLs in Georgia, Virginia and Florida.
“ In the long term,” said La Luz,“ our involvement has been to help reestablish their testing at the Puerto Rico Department of Health.” As of mid-March, Puerto Rico’ s PHLs had restored about 50 % of their testing menus, comprising about 80 % of total test volume. The rabies laboratory is fully operational, and the HIV-STD-hepatitis laboratory is back to full capacity for HIV and STD testing.
A Different Kind of Flood
Yet, even while mega-storms are a grave and growing threat, Bean points out that they are not the only source of laboratory flooding. In 2012, over the Martin Luther King, Jr., holiday weekend, an improbable series of events left the New Hampshire PHL inoperable for about two weeks.
12 LAB MATTERS Spring 2018
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