Lessons Learned in Sandy Applied to Juno Response

It’s been a brutal couple of weeks in the northeast; they’re running out of places to put all of the snow. While New York City escaped the worst of the snowstorms and the northeast is proving to be extremely resilient, Rx Response moved to alert status the last week in January to ensure that there were no major challenges to pharmaceutical supply.

Before the storm, the warnings that came from NOAA and TV weathermen were convincing, warning the 28 million people in 7 states that potentially historic levels of snowfall could be coming. Compare that to the messaging prior to Hurricane Sandy, which hyped the storm but did not give the potential storm surge damage the same weight.

Since we often see the same kinds of problems arise following a disaster for our members, I thought it would be interesting to take a look at New York City’s preparation prior to Hurricane Sandy and compare it to activities undertaken just a couple of weeks ago. As access and credentialing into restricted areas remains one of our top challenges I thought it would prove an interesting comparison to see how the city has worked to become more prepared and proactive in the face of a natural disaster.

Hurricane Sandy

In 2012, Governor Cuomo declared a state of emergency on October 26th in anticipation of the hurricane’s arrival. On October 27th, the governor began planning to shut down the subway, bus and commuter rail lines. Discussions on closing roads occurred, but the 28th only brought orders for speed restrictions and warning that bridges may be closed.

The tropical storm, downgraded from a hurricane made landfall in the NYC area on October 29th, 2012. Bridges were closed at 7:00PM and oversized vehicles were prohibited from traveling in some areas. By the next day the president had issued a disaster declaration and the storm had caused devastating impact throughout the area. Bridges were re-opened but only to emergency personnel; and since no formal transportation restrictions were put in place, programs like CEAS that are created to assist access for the private sector during disasters were not activated to assist. The Governor’s declaration included a vague definition of emergency personnel, “medical personnel which include doctors, nurses, etc.”, and as we have often seen in past disasters, delivery vehicles and drivers for pharmaceuticals to supply those doctors and nurses were often excluded from that exemption until we were able to obtain a letter granting them status from the State Health Department, and in a few cases to arrange police escorts

The bridges began to open on the 31st with a rule that only allowed cars with at least three passengers into the area. This was intended to reduce the traffic impact created by the closure of much of NYC’s mass transit system, but again, deliveries were hindered for 3rd Party Logistics providers making deliveries of critical medicines. Because these 3rd Party Logistics providers often deliver in courier vans and don’t advertise what type of cargo they carry, local law/traffic enforcement had a difficult time understanding the critical need to give them access

Despite the massive damages caused by the storm, the pharmaceutical supply system was quick to recover and continue to make deliveries into the affect areas, although many pharmacies were damaged or closed due to the storm and unable to serve their patients. Transportation and fueling issues remained the most challenging concerns.

Winter Storm Juno

Flash forward to 2015 and the threat of winter storm Juno. The storm only glanced over NYC, but officials implemented a number of tools to try and anticipate potential impacts from the storm. The day the storm hit NYC Mayor de Blasio ordered city streets closed to traffic beginning at 11:00PM. The order included a much clearer exception for “vehicles used to deliver food, medical supplies or fuel”. The CEAS program activated and members of Rx Response were added to NYC’s exceptions list to allow unhindered deliveries into the restricted areas. In nearly every instance, deliveries of critical medicines were successful, even if they arrived a littler than usual due to the snowy roads.

While it is always easy to play Monday morning quarterback after a disaster, I think it’s important to reflect that we have learned real lessons from the disasters and disruptions that we have experienced. And as Rx Response grew out of a lesson learned from Katrina that the pharmaceutical supply system needs to work together with Emergency Management and Public Health response, New York City deserves kudos for understanding the needs of the private sector and working to ensure that medicines were able to get into the city and into the hands of patients.

       Email contactus@rxresponse.org with comments, questions or blog ideas.