Opinion - It's hurricane season again, and public health hangs in the balance
June marks the beginning of the 2025 Atlantic hurricane season, and forecasters are warning of above-average activity.
More than half of U.S. coastal areas should plan to face a major hurricane of Category 3, 4, or 5. If our 2024 experience is a reliable predictor, we can anticipate more than $100 billion in damage, more than 100 fatalities and an increasingly problematic, if overlooked, element of these disasters: the threat to public health.
Hurricanes and other water-centric events, like flooding, are creating ideal environments for the transmission of infectious diseases, from mold exposure to flesh-eating diseases to mosquito-borne viruses.
Clusters of a potentially fatal infection caused by Vibrio bacteria, which can cause severe diarrhea and necrotizing skin lesions, hit Florida after Hurricane Ian in 2023. Cases in 2024 exceeded that total, with high burdens in Florida counties that experienced the worst flooding from Hurricane Helene.
In Texas last summer, health officials warned the public of the risk of contracting West Nile virus post-Hurricane Beryl.
Mosquito-borne illness is possible wherever there are mosquitoes. Florida, California and Texas all experienced locally acquired cases of dengue fever in 2024.
Chikungunya, which can result in lifelong physical debilitation, is also present in the United States, with travel-associated and locally acquired cases being documented in Gulf states as recently as 2019.
Several deaths from Eastern equine encephalitis occurred last year in northeastern states, with several towns instituting curfews to curb the mosquito-borne threat.
Rises in mosquito populations are a well-documented hazard after hydrologic disasters like hurricanes, tsunamis and floods. These events can compromise sewage pipes, contaminate drinking water and result in diffuse areas of standing water that become breeding grounds for mosquitoes.
Emergency preparedness professionals have long understood the risk. What's changing is the frequency of billion-dollar disasters — and with them, we suspect, greater damage, flooding, and disease risk.
The good news is that we can leverage past experience, predictive models and tools like state and regional medical stockpiles to mitigate some of the worst health impacts. By strategically positioning medical supplies and countermeasures closer to the point of need, health authorities can significantly reduce response time, minimize logistical challenges and save lives.
A number of states already have medical stockpiles for basic medications and personal protective equipment; others are creating or updating legislative authorities for them.
These stockpiles generally lack federal support and medical countermeasures for high-consequence threats. The utility of state or regional caches could be expanded to include emerging needs like vaccines, treatments and diagnostics for vector-borne infections.
Congress authorized the Department of Health and Human Services to conduct a pilot program matched by local funds for state stockpiling of medical countermeasures and other supplies for public health emergencies. The Biden administration did not request funding for state stockpiles and Congress has not appropriated funds for the program, however, stagnating the initiative.
Funding is the number one type of support that jurisdictions say they need to help them establish and maintain stockpiles.
Investing in state or regional stockpiles is a cost-effective approach to emergency preparedness. It minimizes the need for last-minute, high-cost procurements during crises, places more autonomy in the hands of states and helps maintain health care system resilience.
President Trump's executive order on preparedness recognizes ownership of preparedness at the state and local level, and calls on federal policy to help empower state and local jurisdictions to make smart infrastructure choices. This same ethos can extend to public health preparedness.
Last year's final report of the congressional Select Subcommittee on the Coronavirus Pandemic concluded that state stockpiles can provide a tailored local complement to the federal Strategic National Stockpile.
As natural disasters increase in frequency and intensity, the federal government can support local decision-makers in meeting their communities' unique public health readiness needs.
During COVID-19, many local officials did not know what was in the federal stockpile. Drawing stockpiles closer to the communities that will need them, tied to input from local, state or regional medical advisory groups, would increase awareness of stockpile contents and enable tailored input to support assets these communities need.
Redundancies built into state or regional caches could allow local health care providers access to critical supplies that allow them to meet medical standards of practice even in a crisis.
State stockpiles could facilitate greater efficacy of vendor-managed inventories and improve the quality and efficiency of supply rotations. Especially for countermeasures that have cold chain requirements or other complicated logistics, the federal role can be to provide the training and best practices to allow jurisdictions to successfully store and distribute these assets when needed.
COVID-19 revealed a national unpreparedness to increase production rationally based on identifiable gaps pre-disaster. For example, better local input on necessary ventilator functionalities would have improved the production of quality devices as demand surged, rather than devices produced by auto manufacturers that were failures.
State and regional stockpiles can reverse this underpreparedness and empower local communities.
Congress should show its federal support by extending the authorized timeline for the state stockpile program and, critically, funding it commensurately in the coming appropriations cycle.
By strategically positioning medical supplies and countermeasures closer to the point of need, a federal-regional-state partnership can significantly reduce response time, minimize logistical challenges and save lives before future hurricane seasons and other regional disasters occur.
Craig Vanderwagen is a former assistant secretary for preparedness and response in the Department of Health and Human Services and the founder and general manager of East West Protection, LLC, which provided private and public sector disaster preparedness support.
Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
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