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Vol. LVII, No. 20
October 7, 2005
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NIH-Funded Research Post-Katrina
Losses to Gulf Area Scientists Are Longer Term, Harder to Quantify

On the front page...

There was little if any dramatic footage of storm and flood damage to research facilities after Hurricane Katrina. Everyone was rightly concerned with addressing emergency and immediate needs. Now, though, as clean-up and recovery continue, stories about losses to science and NIH-funded research interests in the Gulf area are beginning to emerge. Although physical damage to buildings and other structures was less than at first feared, affected-area research projects in general and the requirements for conducting them suffered a tremendous hit.

Continued...

"We are not asking for charity," said NIH grantee Dr. Seth Pincus, via email, "but those of us with NIH funding know how competitive the process of obtaining NIH support is, and that it looks to be even worse in the years ahead. Realistically, given the hurdles we face, it will be extraordinarily difficult to remain competitive. Although I would hardly call New Orleans a research powerhouse, the support provided by NIH plays an important role in the local economy, and this will be important in the city's recovery."

Pincus, director of the Research Institute for Children at Children's

New vs. Old Response to Disaster

Back on 9/11, a disaster medical assistance team (PHS-1 DMAT comprised mostly of PHS Commissioned Corps officers) headed by NIH's Capt. Van Hubbard helped provide medical support for workers at Ground Zero in New York City. The team, a part of the National Disaster Medical System (NDMS), was trained, outfitted and ready to go within hours of the attacks on the World Trade Center. Forty-five members of the team (including a number of NIH PHS commissioned officers and civilian staff) spent nearly 2 weeks at the World Trade Center site and additional members served in other capacities.

There have been many changes that have taken place in preparing for disaster response since 9/11. Today, the Office of Force Readiness and Deployment manages the PHS commissioned corps response at the request of the Secretary of HHS. Thus, although the PHS-1 DMAT did not respond as a team, the overall corps response to Katrina has been intact with many of our team members providing leadership roles, Hubbard said. However, the needs identified in the aftermath of recent hurricanes has raised the question of whether a PHS team with supplies and equipment to be self-sufficient for 72 hours would be a beneficial addition to the current response capabilities.

Hospital, professor and vice chair of the department of pediatrics and professor in the department of microbiology at Louisiana State University Health Sciences Center in New Orleans, has been conducting research funded in the last decade by NCI and is currently principal investigator on two NIAID grants.

Pincus also pointed out that "unique reagents necessary for research projects have been lost, many irretrievably. For my own grant-funded research, I have fewer tools with which to work than when I applied for the grants. I imagine it will take up to a year of work to reconstitute many of these materials. Some will never be able to be replaced (unique monoclonal antibodies, etc.). And we are much better off than many, since we were able to store some samples in liquid nitrogen and fill the dewars before we evacuated. Similarly, animal colonies have been lost."

Compounding efforts to get labs up and running again will be the loss of skilled staff, he said. "Many people have already decided not to return to New Orleans," Pincus noted. "For example, 2 of my technicians (out of a total lab of 5) have already indicated that since they lost everything and have to start over from scratch, they aren't planning on coming back to New Orleans. The others are up in the air. It will be the most skilled and talented who are able to find jobs elsewhere. Ironically, finding host labs will accelerate this process, since people will settle in new cities and be more likely to be offered jobs there. A similar process is happening already among faculty (as I contemplate the future, the idea of leaving has certainly crossed my own mind). And where will we recruit skilled personnel to replace those who leave?"

The Tulane National Primate Research Center, located in Covington, La., about 42 miles north of New Orleans and just north of Lake Pontchartrain, reported that its personnel and animals survived Hurricane Katrina without injuries.

'Team Gumby' Learns to Be Flexible
By Rich McManus

If disasters have one lesson to teach responders, it's that you better keep your improvisational chops honed and your bags packed.

Charles McGarvey, a Clinical Center physical therapist who was part of a 38-person PHS team dispatched to Baton Rouge, got a call from Admiral John Babb the day before Hurricane Katrina hit New Orleans.

"Do you have your bags packed?" asked the admiral in a Sunday morning phone call. By 5 p.m., McGarvey was at a special tarmac at Dulles Airport, boarding a jet to Jackson, Miss.

Team Alpha was originally scheduled to fly into Meridian, Miss., then go to the Superdome in New Orleans. But in the space of a few hours, they were redirected to Jackson, where their mission was "field hospital augmentation."

Jackson turned out to be a mere layover, a place to rent 18 minivans at midnight for the drive further south to Baton Rouge, where the team reported to the Pete Maravich Assembly Center (PMAC), a basketball arena on the campus of Louisiana State University.

Team Alpha helped the Louisiana state health department erect a 200-bed field hospital on the gym floor. Laboring alongside LSU undergrads, town volunteers and trained responders from Illinois and New Mexico, the PHS team had a full-fledged pharmacy up in only 4 hours, and organized a small hospital on the fly.

"Things would change before you could complete a sentence," said PHS officer Dr. Sarah Linde-Feucht of FDA, a family physician on Team Alpha. "It was a pretty taxing experience...we learned that personality is sometimes more important than skills."

Although many trees were downed in the storm and there was some damage to structures, the animal facility remained intact and the center has an ample supply of food for the animals. Funded by the National Center for Research Resources, the primate center supports NIH extramural investigators conducting gene therapy research and studies of infectious diseases, including AIDS, Lyme disease, microsporidiosis and malaria.

With help from the NIH Office of Research Facilities, NCRR staff located, purchased and shipped a large generator to the center. NCRR also organized emergency shipments of fuel from multiple sources to power the generator, providing lighting and necessary air circulation in the animal facility. Tulane staff have also indicated they will need to replace nine animal corrals and some fencing destroyed by the hurricane, at an estimated cost of nearly $2 million.

NIEHS's Capt. Bill Stokes, chief veterinary officer for PHS, is heading a team of PHS veterinarians assisting with zoonotic public health issues in Louisiana. Team members are assisting with carcass disposal at biomedical facilities and are treating thousands of rescued animals. As a precaution against outbreaks of zoonotic diseases, the team is vaccinating and treating rescued animals as they are brought to shelters, said NIEHS.

The Squirrel Monkey Breeding and Research Resource, supported by NCRR at the University of South Alabama in Mobile, and Chimp Haven — a sanctuary for chimpanzees no longer needed in research — near Shreveport, La., survived the storm without injuries or major damage, according to reports days after the storm.

According to a Sept. 8 email sent on behalf of Dr. Chip Price, president of the American Association for Laboratory Animal Science, a group of volunteers from the association's Texas branch, from LSU's main campus and from Tulane University's animal care staff made their way through to Tulane's main campus and "found many animals alive. [The volunteers] removed 175 boxes of transgenic mice and 5 boxes from this facility to the Tulane Primate Center. Rest of animals euthanized. Staff all accounted for; some may have lost homes. No report yet as to when campus will reopen."

"Even those scientists who have immediately found temporary labs to work in face months when no real work will be done in labs," Pincus explained. "We have personal lives to get back together, closed and damaged buildings, etc.

'NEI Grantee Helps Hurricane Evacuees

Oklahoma's Northeastern State University College of Optometry — recipient of an NEI grant to conduct vision screenings for children as part of the Vision in Preschoolers (VIP) Study, a multicenter clinical trial — has been providing eye exams and eyeglasses to evacuees from Hurricane Katrina.

 
  Dr. George Foster, dean of Oklahoma's Northeastern State University College of Optometry, examines a Katrina evacuee's eyes.
The college sent the VIP study van and a team of 40 to 50 volunteers to Camp Gruber in Braggs, Okla., where 1,600 Katrina evacuees had arrived from the Superdome in New Orleans. Camp Gruber, originally a World War II military base, is now a National Guard training center.

The van team, consisting of doctors, students and technicians, conducted more than 300 comprehensive eye exams, at a rate of about 80 per day, according to Dr. George Foster, dean of the College of Optometry. In addition, the team has provided over 270 pairs of eyeglasses, worth about $45,000, thanks to optical companies that have donated frames and lenses.

"It has been very gratifying to be able to help these people who have lost so much," Foster said. "In most cases, they had no prescriptions for eyeglasses and just had the clothes they were wearing. Some were legally blind without glasses. Now, they are finding places to live. We are blessed to have the van, and will continue to provide eye health care a day or two a week until the need has been met."

Our institute was undamaged, so we can get going almost immediately when New Orleans becomes habitable. But I still estimate that there will be a 3- to 4-month loss of work time, even for those already in other labs."

As the Record went to press, Pincus reported that he and his associates were "planning to reopen on Oct. 1, barring more problems from [Hurricane] Rita."

Another NIH'er on the team, social worker Jeasmine Aizvera, noted that the responders themselves, not to mention evacuees, were often in need of mental health counseling.

Six members of Team Alpha told their stories at a Lipsett Amphitheater debriefing on Sept. 19. The crux of their reports — and the reason they dubbed themselves "Team Gumby" — is that, in an emergency, you do what the situation requires, not what your resumé touts.

The PMAC team triaged 15,000 patients before closing on Sept. 7. Six thousand patients were admitted in 9 days. "About 2,000 patients arrived each day, by helicopter, ambulance and bus," said Linde-Feucht. A nearby field house was also pressed into service as a temporary hospital.

NIDDK's Dr. Jeffrey Kopp, a kidney specialist and commissioned officer, also spoke at the Sept. 19 debriefing. Since Louisiana is deep within the "kidney disease belt," an epidemiological pocket known for its high incidence of ESRD (end-stage renal disease), he and colleagues rapidly evaluated how many hospitals were left standing to accommodate patients needing dialysis.

Some 45 dialysis clinics serving more than 2,400 patients had been shut down by the hurricane, he reported. Fifty evacuees per day were in need of dialysis.

Flying by helicopter around the Crescent City metro area over the course of 3 days, Kopp visited 34 hospitals and obtained information on four more. His census showed 26 of them open, and a dozen shuttered. "We were not there to take charge," he explained, "but to augment."

Team Alpha returned to their respective HHS agencies on Sept. 9. In the aftermath of their deployment, they have assembled a host of lessons, chief among them: "Flexibility required due to constant evolution of mission."

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