​​​​Winter 2018​

​APHL conducts laboratory assessment in Puerto Rico to help​​ restore public health testing after Hurricane Maria

Photo: Dr. Martina McGarvey surveys conditions at a Puerto Rican public health laboratory during APHL's laboratory assessment deployment in October, 2017

​On September 20, 2017, Hurricane Maria made landfall on the island of Puerto Rico. The Category 5 hurricane with gusting winds in excess of 100 miles per hour dumped over 40 inches of rain in less than two days and inflicted roughly $100 million in damages on the devastated island. By storm's end, more than 90 percent of the population had no access to power or cellular phone coverage, and more than 50 percent were without safe drinking water. It was the worst natural disaster in Puerto Rico's history.

APHL responded to the storm even before it hit. Following established procedures, the association activated its Incident Command Structure and began hosting calls with members and partners to prepare hurricane response plans.

In October, the US Centers for Disease Control and Prevention (CDC)​ asked APHL to send a team of experts to assess damage to six Puerto Rican laboratories located across the island. These laboratories deliver essential public health testing services: evaluating the quality of water and milk, detecting pathogens causing contagious diseases and supporting reference microbiology. Puerto Rico needed them back in operation as quickly as possible.

Within three weeks of the initial request for support, APHL assembled and deployed an assessment team of laboratory leaders. The team – Dr. Christine Bean, New Hampshire Public Health Laboratories; Dr. Andrew Cannons, Florida Department of Health Bureau of Public Health Laboratories, Tampa Branch; Dr. Martina McGarvey, Pennsylvania Department of Environmental Protection; and Tyler Wolford of APHL – arrived at their hotel in San Juan to find a darkened lobby. The property's generator had died, and the only recourse was to find alternate lodging in a damaged city crowded with first responders. Fortunately, lodging was secured within hours and the APHL team was ready to begin laboratory assessments the next day.

Once on the road, the team found building damage and a lack of consistent power to be the two most common problems at laboratory facilities. Power outages resulted in equipment downtime and a loss of refrigerated reagents while infrastructure damage led to moldy walls, leaking ceilings and inoperable communication systems. Supply deliveries could be slow. The Central Public Health Laboratory waited three weeks to receive a generator that did not function properly when it arrived.

After the assessments, the APHL team collaborated with Puerto Rico Department of Health​ and CDC staff to create plans for restoring testing services. As a first step, they developed itemized lists of reagents and equipment to be replaced while repairs were underway at laboratory facilities. 

More than four months after the hurricane, the partners continue to work to restore Puerto Rico's full public health testing capabilities using systems developed during the October assessment to identify and execute priorities.