Abstract

The main objective of this work was to characterize the prevalence of acute medical needs by examining emergency department (ED) and outpatient wound care clinic (WCC) visits before, during, and after the 2017 Hurricanes Irma and Maria, in St. Thomas, United States (U.S.) Virgin Islands. Descriptive statistics and logistic regression were used to assess associations between the occurrence of the storms and visits due to injuries and chronic conditions presented to the ED and WCC from September 1, 2016 to May 31, 2018. ED visits increased and the rate of injury care was higher during the storms (12 patient visits per day) than before or after the storms (9 patient visits per day). WCC visits increased during (12%) and after the storms (45%), and were associated with patients 60 years and older. The odds of ED and WCC visits due to injury during the storms were significantly higher (odds ratio [OR]: 1.28, 95% confidence interval [CI]: 1.17, 1.40) than prior to the storms. The odds for visits due to injuries were 1.19 (95% CI: 1.12, 1.28) times higher after the storms. Increases occurred in ED and WCC visits for injury care during the storms and in WCC visits after the storms. Public health preparedness mandates understanding how major hurricanes impact the prevalence of acute medical needs, and the factors that influence decisions to seek medical care, in their wake.

Highlights

  • Hurricanes Irma and Maria, 2 of the most powerful storms of the 2017 Atlantic hurricane season, struck the United States (U.S.) Virgin Islands as category 5 storms on September 6, 2017, and on September 20, 2017, respectively.[1,2,3] Hurricane Irma caused catastrophic damage to St

  • An examination of the 3 time periods shows the proportion of visits among patients aged 40 years and older was greatest during the storms, whereas the percentage of visits for patients aged 39 years and younger declined during and after the storms

  • There was not a statistically significant difference by sex, before and after the storms, but a higher proportion of emergency department (ED) visits was associated with male patients during the storms (51.0%) than with females (49.0%); and the daily volume of self-pay patient visits was slightly higher after the storms than before and during the storms

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Summary

Introduction

Hurricanes Irma and Maria, 2 of the most powerful storms of the 2017 Atlantic hurricane season, struck the United States (U.S.) Virgin Islands as category 5 storms on September 6, 2017, and on September 20, 2017, respectively.[1,2,3] Hurricane Irma caused catastrophic damage to St. Thomas and St. John and devastated St. Croix.[1,3] Hurricane Maria arrived 2 weeks later, devastating St. Croix and exacerbating the damage inflicted by Hurricane Irma on the 3 islands.[2,3]

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