Updated

The floodwaters from Tropical Storm Harvey will disappear over time, but for millions of people in East Texas and along the Gulf Coast of Louisiana, the psychological and physical effects of this historic storm will last a lifetime.

These are some of the conditions that Harvey’s victims – and the health practitioners who treat them – are confronting now and will be dealing with for years, even decades, to come.

Psychological effects

Studies have confirmed that the psychological impact of floods is significant. As the floodwaters rise, so do the fear, anxiety and post-traumatic stress linked to feelings of being trapped. Even if you haven’t been in the direct path of the storm and aren’t suffering the effects of flooding in your home or neighborhood, these feelings can still overwhelm you. Empathic news watchers have vivid memories of Hurricane Katrina in 2005, as well as other floods that ravaged the American landscape before and after.

What to do? 

Reach out to family and friends and community to share reassurances and positive emotions. Sleep, exercise and proper diet can interrupt a cycle of worry caused by flood fears. If the problems or anxieties continue, seek professional help.

Physical effects

The physical effects of flooding extend far beyond drowning. Health concerns include contaminated floodwaters that spread bacterial, viral and fungal infections, and running out of food, water and medications. People may be wounded or killed by unseen objects, such as carbon monoxide from emergency generators, or from eating contaminated food or drinking unsafe water. Hard surfaces and furniture that come in contact with floodwater may harbor dangerous bacteria, including salmonella, shigella, typhoid and tetanus, and viruses such as hepatitis A.

Skin infections and conjunctivitis are common, and open wounds and rashes can become easily infected. Mosquitoes will proliferate in standing water and may lead to outbreaks of West Nile virus, Zika and dengue fever. Mold that exacerbates allergies and asthma will appear.

The effects of the storm can even be felt by people hundreds or thousands of miles away. Harvey has flooded the streets surrounding MD Anderson Cancer Center, which is struggling to maintain care to people from all over the country.

What to do? 

Secretary of Health and Human Services Dr. Tom Price has declared a public health emergency, which is very helpful. More than 53,000 pounds of medical equipment and supplies have been sent to the area, and more than 500 emergency responders have been deployed. The focus, according to Price, is on transporting patients and making sure that people have access to their medications. More than 2,000 pharmacies remain open, and they are being restocked. Mobile clinics will be sent out from community health centers.

To counter the risk of contagion, surfaces in homes that have come in contact with floodwaters need to be disinfected carefully, and workers need to wear rubber boots and gloves. According to the Centers for Disease Control and Protection, “Walls, hard-surfaced floors, and many other household surfaces should be cleaned with soap and water and disinfected with a solution of one cup of bleach to five gallons of water.”

Contaminated fabric, including pillows, clothing, carpeting, mattresses and furniture, should be destroyed. The potable water supply must be maintained, especially because infectious diarrhea can lead to life-threatening dehydration. Floodwater must be avoided as much as possible, and a tetanus booster should be given to anyone in the area who hasn’t received one in the past 10 years.

If tap water has been compromised or isn’t available, bottled water or water that has been boiled should be used for drinking, brushing teeth and bathing. Even canned food surfaces can become contaminated and should be boiled first. Any food that has come in contact with floodwater, even if it is wrapped in plastic, should be discarded.

To prevent carbon monoxide poisoning, generators should be placed at least 20 feet away from windows, doors and vents.

As with any large-scale disaster, cooperation and community mindedness are the keys to health safety. Several hospitals have had to be evacuated. The healthy and young have worked together to help save the sick and elderly. Social media has been utilized when 911 has failed. 

Most important of all is the need to remain calm. Worry may seem appropriate when your home and health are on the line, but people who are afraid take fewer precautions. And when you are distracted by worry, injury and infection are more likely to occur.