Diagnostic Testing Strategies for Health Care Delivery During the Great Bangkok Flood and Other Weather Disasters

Abstract

Objectives Our objectives were (a) to define resiliency strategies for catastrophic floods; (b) to report how these strategies that evolved during the Great Bangkok Flood; (c) to anticipate crisis care during weather disasters and mitigate risk for victims, patients, residents, and professionals; (d) to offer leadership approaches for disaster laboratory medicine, modeled after the Bangkok Medical Center and National Health System Laboratory response to Thai government requests for help; and (e) to identify point-of-care (POC) and laboratory diagnostic requirements during weather disasters, including infectious disease outbreaks summarized historically. Methods Great Bangkok Flood data were gathered by 2 members (G.J.K., C.V.) of the response Working Group established at the request of the Division of Medical Sciences, Ministry of Public Health. We also conducted follow-up interviews of medical professionals and surveyed the National Health System, which provided emergency diagnostic services. Results The historical record proves the impact of infectious diseases in weather disasters. Problems encountered during the Bangkok Flood included leptospirosis, presumed cholera at very low penetration, and fungal infections. Widespread prolonged inundation interrupted supply chains motivating future preparedness. Conclusions Feasibility of POC testing was demonstrated in previous flood episodes (eg, Hurricane Katrina) and again during the Great Bangkok Flood, although on a limited basis. Preparation, training, mobility, and deployment were challenges. In addition, some medical problems require sophisticated analytical methods not yet amenable to testing directly at the site of need. Unmet needs ensure a bright future for innovators who develop new POC solutions and increase the mobility of diagnostic services for weather disasters.