It is time to put hurricane preparedness on the radar for individuals living with spinal cord injury

Abstract

Hurricane Dorian's devastating trajectory over the Northwest Bahamas was the most recent Atlantic storm to call attention to the catastrophic impact of climate change. Although disasters create adversities for all members of the affected population, people with disabilities and special medical needs are disproportionately challenged by such events and are more vulnerable to the conditions they create. This point-counterpoint series highlights the hardships faced by individuals living with spinal cord injury (SCI) when disasters strike. This commentary focuses on the time-urgent need to improve storm readiness among at-risk individuals living with SCI before the start of the upcoming hurricane season. We review the evidence indicating that tropical cyclones are becoming increasingly destructive in the era of climate change and consider how this trend may magnify the difficulties that those with SCI may experience before, during, and in the aftermath of a hurricane. We then review the ways in which health professionals caring for individuals with SCI can help them better prepare for hurricanes while also enhancing their own readiness to provide care during and after an extreme storm.

Climate Change and Physiatry: A Call to Proportional and Prospective Action

“…Natural disasters such as hurricanes, wildfires, and floods are becoming more frequent and more intense because of climate change 1 . People with disabilities face life-threatening obstacles to evacuation and care during disasters, including power outages, flooding, debris, care disruption, limited access to medications and supplies, property damage, displacement, and psychological trauma 3,12 . More than 150,000 people with physical, visual, or learning disabilities were found to be disproportionately impacted by Hurricane Katrina 33 …”

“…1 People with disabilities face life-threatening obstacles to evacuation and care during disasters, including power outages, flooding, debris, care disruption, limited access to medications and supplies, property damage, displacement, and psychological trauma. 3,12 More than 150,000 people with physical, visual, or learning disabilities were found to be disproportionately impacted by Hurricane Katrina. 33 In 2020, Shapiro et al 12 painted a striking picture of the challenges that SCI patients face in the wake of a natural disaster: "Patients living in high-rise buildings may become trapped if elevators are not operating.…”

“…Not only are people with disabilities more vulnerable to the health effects of climate change, they are also less resilient 4 . Indeed, in July of 2019, the United Nations Human Rights Council adopted a resolution on climate change and the rights of people with disabilities “recognizing that persons with disabilities are among the most adversely affected in an emergency, sustaining disproportionately higher rates of morbidity and mortality, and at the same time being among those least able to have access to emergency support.” 5 The ways in which climate change negatively impacts the health of people with disabilities are varied and include an increased risk of heat-related injury due to rising ambient temperatures, cardiopulmonary disease from wildfire smoke and air pollution, and harm from natural disasters due to decreased mobility and dependence on technology and caregiver support 3,6–12 . The indirect effects of climate change include the emergence and changing landscape of infectious disease, which are associated with increased symptom severity in people with disability due to underlying medical conditions and barriers to accessing care 13,14 …”

“…5 The ways in which climate change negatively impacts the health of people with disabilities are varied and include an increased risk of heatrelated injury due to rising ambient temperatures, cardiopulmonary disease from wildfire smoke and air pollution, and harm from natural disasters due to decreased mobility and dependence on technology and caregiver support. 3,[6][7][8][9][10][11][12] The indirect effects of climate change include the emergence and changing landscape of infectious disease, which are associated with increased symptom severity in people with disability due to underlying medical conditions and barriers to accessing care. 13,14 In addition to the direct costs to human health, the economic costs of the health effects of climate change are estimated at more than $800 billion annually in the United States (US) and will only increase with time.…”

Rehabilitación en época de pandemia, un desafío a largo plazo

“…En la actualidad se están determinando los efectos de las catástrofes naturales (terremotos, huracanes, entre otros) en las personas en situa-ción de discapacidad y, por supuesto, una pandemia sin precedentes como la que estamos viviendo se configura como una catástrofe más 3,4,5 . Con alta probabilidad, este tipo de eventos va a ser cada vez más frecuente en las próximas décadas a consecuencia de los efectos imparables del cambio climático, época que los científicos han dado en llamar antropoceno 6 ; además, la posibilidad de nuevas epidemias va a ser cada vez más alta, lo que acarreará distintos grados de letalidad y de efectos sobre la capacidad funcional, el bienestar y la calidad de vida de millones de personas.…”