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Questions about one of the greatest American public health disasters in the last 100 years
by Donald B. Louria, MD
(November 2005)

The American people are now being asked to believe that Katrina was of such dimensions and ferocity that nothing and nobody could have stopped its devastation. We are being asked not to point fingers and instead focus on the future, on rebuilding one of America’s great cities (presumably this also applies to the other communities in Louisiana, Mississippi, Alabama, and Texas, large and small, devastated by the hurricanes). The political focus is primarily on response, acknowledging that initial response was incompetent and appalling, but asserting that government now has it “right” and will put massive resources behind the rebuilding. Of course, no acceptance of responsibility can compensate for the human misery and the deaths caused by tardy, inept, bureaucracy-laden, and thoroughly bungled response to a disaster that was predictable - and they knew was coming. The federal government bears the bulk of the responsibility, in particular, the Federal Emergency Management Agency (FEMA) - stacked with inexperienced political appointees, underfunded, downgraded, and demoralized by the resignation of experienced emergency experts.

A primary focus in the wake of this catastrophe should be, as with any public health disaster, on whether it could have been prevented and how we can prevent similar cataclysms in the future. No matter how effective a response is in terms of rebuilding or aiding the traumatized refugees, it does only limited and temporary good if next year, or the year after, similar events occur. That raises two questions:

1. Was the strength of Katrina created in part by global warming? It is fully established that one of the consequences of global warming will be more severe weather events. Storms, hurricanes, and typhoons will be of greater intensity. Category 3 hurricanes will turn into category 4 or 5. Did this happen with Katrina? Nobody will ever know for sure. An article in Science notes the increasing severity of hurricanes over the last decades and hypothesizes that global warming may be playing a role. Politicians, especially the Bush administration, will probably treat the idea dismissively, most likely using the same rationalizations they used to deny the consequences of or even the existence of global warming (they do now admit it is real, but they apparently will not do anything about it). This issue is really not whether the severity of Katrina was related, in part, to global warming. The issue is the certainty as global warming gets worse (as it will in the absence of worldwide actions), that future hurricanes will become devastating category 4 and 5 as a consequence of that warming.

It is simple. Hurricane Katrina is a harbinger, an omen. If we do not do something about global warming, we can expect more Katrinas - a lot more.

2. Could the severity of Katrina have been lessened, could New Orleans have been saved, if the levees had been attended to and the marshes and wetlands that surround New Orleans had been protected so they could serve as a buffer against the storm surges? The answer is an unequivocal yes, though such actions would not have protected other communities in Louisiana, Mississippi, and Alabama. Here, there is plenty of blame at various levels, but it is hard not to put the major responsibility on the federal government - on the Army Corps of Engineers, FEMA, and the Congress. One could argue that any attempts starting in the last decade would not have been completed in time to avoid this catastrophe; we will never know because, in essence, nothing was done.

If those are the overriding public health prevention issues , what are the potential solutions?

1. Commit the United States to a very active anti-global warming program. For those who will argue any action by the United States would be very expensive and hurt business, I would say look at the costs of Katrina. Do you want the costs of one or two or ten more Katrinas? We should do the following:

a) Ratify and follow the Kyoto Accord and, by so doing, once again become a constructive member of the world community. Then, like other nations, we will have to take specific steps to reduce our carbon dioxide emissions. Some will say that carbon dioxide levels in the environment are primarily due to natural causes, not humans But, it does not matter whether humans are responsible for 10 percent or 25 percent or 50 percent or 90 percent. Carbon dioxide is the major greenhouse gas and we spew huge amounts of it into the air from our uses of fossil fuels. If we want to lessen the extent of global warming, we must reduce the amount of carbon dioxide we create and that means phasing out fossil fuels or, alternatively, developing technologies that allow us to use the fuels without polluting the atmosphere with carbon dioxide.

Although controlling carbon dioxide emissions is a must, it is no panacea. The global warming that has already occurred guarantees additional category 4 and 5 storms over the next decade or two. Presumably, reduction in carbon dioxide emissions will reduce the frequency of such catastrophic storms and, hopefully, some new technologies will eventually be able to remove greenhouse gases from the environment.

b) Start a massive program to support alternative and environmentally friendly energy technologies - wind, solar, wave, hydrogen, fusion, hydro, biomass, biodiesel, nanotechnology, etc. So far, there has been a lot of rhetoric accompanied by grossly inadequate funding.

c) Stop the stupidity and insouciance and mandate rapid increases in gasoline mileage requirements for cars and trucks.

2. Immediately provide whatever funding and resources needed to create levees or gates that can withstand a category 5 hurricane. This must be accompanied by an emergent, fully funded effort to restore marshes and coastal wetlands in New Orleans and, where appropriate, in other coastal areas of the United States.

3. Thoroughly investigate other areas, such as building code revisions, with the expectation that, no matter what we do, there will be more Katrinas.

Our government failed us miserably. It would be further dereliction of duty if the response is primarily restoration, resettlement, and rebuilding without an equal focus on prevention. Thus far, the President and Congressional leaders have been virtually silent on the global warming aspects of Category 4 and 5 hurricanes, and there has been similar silence on environmentally friendly alternatives to fossil fuels and on fuel conservation by mandating gasoline mileage increases. Instead, we have heard plaintiff pleas to save gasoline by driving less; that is a reasonable suggestion, but, as a way of avoiding the critical issues, it is unacceptable.

Unfortunately, here is the likely scenario:

- A lot of talk and some action on levees, but without the necessary urgency or adequate funding or firm time lines.

- Talk about marshes and wetlands surrounding New Orleans, but little urgent action, and no action in regard to other coastal areas.

- Maybe some actions on building codes, but confined to New Orleans.

- A continued focus on more drilling for oil and gas, building new refineries, and undercutting clean air laws and regulations thereby worsening global warming. Given the current mentality in Washington DC, I think you can be pretty sure of this.

- Virtually no meaningful actions on global warming, alternative fuels, or conservation. Have you heard any recent even semi-intelligent discussions, concerns, or ideas about global warming from the White House, the Bush Administration, or the Congress? No meaningful action in those three areas is tantamount to criminal negligence.

I hope the response will not be that limited and feeble; if it is, our Government will, once again, fail us miserably and will have guaranteed more catastrophic weather events in the future - probably the near future.