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That came on Monday morning , when the health district called for a collective “ huddle ” to assess damages .
There was significant water damage [ to the Laboratorio de Salud in San Juan ]. Instruments were still covered in plastic . It was a complete mess . They couldn ’ t operate anything . There was evidence of mold in many of the labs ; you could see it and you could smell it . It wasn ’ t a place you wanted to be .”
Fortunately , laboratory impacts were minimal . A back door was blown open , admitting water and debris . The entire facility — all on the ground floor — was flooded with water , but “ not more than an inch deep .” And , of greater consequence , while city power was out , a back-up generator was flooded and out of commission for 3-4 hours .
Said Requenez , “ Some of our refrigerators and freezers are on monitoring systems , so we could tell if they were ever out of the correct temperature range .” All reagents and supplies of questionable integrity — plus the destroyed select agents — had to be replaced . And , because the local FedEx route goes through Houston , the lab ’ s bulk reorders were delayed until that city “ dried out .” ( Select agents arrived sooner , coming via the state public health laboratory in Austin and a person-to-person handoff at a midway point between Austin and Corpus Christi .)
Dr . Martina McGarvey surveys conditions at a Puerto Rican public health laboratory during APHL ’ s laboratory assessment deployment in October 2017
On Tuesday morning , the laboratory reopened for business , with an immediate focus on water testing . The one posthurricane change to the lab ’ s continuity of operations ( COOP ) plan : double-bolt all laboratory exterior doors .
Recovery from Square One
As bad as Harvey was , Maria may have been worse .
Described as “ apocalyptic ,” the storm made a direct hit on Puerto Rico September 20 , 2017 , as a nearly Category 5 hurricane . Over the next 30 + hours , it ravaged the island without mercy . Four months later , a third of this US territory still had no power , and so many residents had quit the island that academics described it as an “ exodus .” As reported by the Los Angeles Times , one San Juan area resident predicted , “ Puerto Rico isn ’ t going to be the same . It ’ s going to be before Maria and after Maria .”
The indiscriminate destruction did not spare the main island ’ s 11 discrete PHLs . In early October , CDC and APHL ( at the request of CDC ) sent teams of laboratorians to appraise the damage .
Christine Bean , PhD , MT ( ASCP ), head of the New Hampshire Public Health Laboratory and a member of the APHL team , said , “ There was significant water damage [ to the Laboratorio de Salud in San Juan ]. Instruments were still covered in plastic . It was a complete mess . They couldn ’ t operate anything . There was evidence of mold in many of the labs ; you could see it and you could smell it . It wasn ’ t a place you wanted to be .”
Eddie O ’ Neill La Luz , PhD , MS , MPH , a CDC deputy senior advisor for laboratory science and a member of the CDC assessment team , cited three immediate problems : “ The island power grid was severely disrupted . Infrastructure damage created water leaks that compromised equipment , reagents , supplies . Because there ’ s no power , you cannot control the temperature , so things just cook inside .”
In addition to all these problems , some of the laboratories had been broken into and robbed of basic provisions , such as cleaning supplies .
Although CDC defers to other federal entities on facility repairs , the agency did contribute several uninterruptible power supplies to island laboratories . Working with the Puerto Rico Department of Health , CDC also arranged for highpriority specimens needing testing for tuberculosis , influenza , rabies , salmonellosis or leptospirosis to be shipped to the continental US for analysis at CDC and state PHLs in Georgia , Virginia and Florida .
“ In the long term ,” said La Luz , “ our involvement has been to help reestablish their testing at the Puerto Rico Department of Health .” As of mid-March , Puerto Rico ’ s PHLs had restored about 50 % of their testing menus , comprising about 80 % of total test volume . The rabies laboratory is fully operational , and the HIV-STD-hepatitis laboratory is back to full capacity for HIV and STD testing .
A Different Kind of Flood
Yet , even while mega-storms are a grave and growing threat , Bean points out that they are not the only source of laboratory flooding . In 2012 , over the Martin Luther King , Jr ., holiday weekend , an improbable series of events left the New Hampshire PHL inoperable for about two weeks .
12 LAB MATTERS Spring 2018
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