Florence keeps Carolinas at risk

More than 30 people have died and thousands have been rescued from floodwaters in the Carolinas that have isolated towns and disrupted medical services.

“Catastrophic flooding and tornadoes are still claiming lives” in the wake of Hurricane Florence, North Carolina Gov. Roy Cooper said Monday. Of the 31 known deaths Monday evening since the massive storm made landfall Friday as a Category 1 hurricane, 24 occurred in North Carolina, six in South Carolina and one in Virginia.

Downgraded to a tropical depression, Florence settled over the Carolinas and dropped more than 30 inches of rain in some areas — swelling rivers, felling trees and creating conditions for long-term environmental damage.

Mr. Cooper said about 2,600 people and more than 300 animals in North Carolina have been rescued by emergency responders amid ongoing operations, and he pleaded with people to stay off roads, noting that a few inches of water are enough to sweep cars away.

“Please don’t make yourself someone who needs to be rescued. Again, stay off the roads in much of the state. Many roads in our state are still at risk of floods,” the governor said.

More than 484,000 people in North Carolina don’t have electricity, and emergency responders drove 23 truckloads of food and supplies Monday morning into Wilmington, a city of more than 117,000 that has been cut off from ground transportation except for one road.

At least 14,000 evacuees are in 110 shelter locations across the state.

Capt. Mick Cote, the federal health coordinating official for hurricane response, said the Department of Health and Human Services is supporting the local government as it operates medical shelters that are treating elderly patients with chronic conditions — “anything from nursing home patients to folks that typically receive different levels of care in their own home.”

Capt. Cote said additional flooding was expected over the next 24 to 48 hours.

“At least the health care infrastructure has survived relatively intact. We know we’re not out of the woods yet. There’s a lot of work to do, and there could be more work to do over the next few days,” he said.

A mobile medical truck was dispatched from Charlotte, North Carolina, to Pender County, just north of Wilmington, to assist residents affected by Florence after the local hospital, Pender Memorial, was flooded and evacuated.

Dr. David Calloway, an emergency physician, said patients started asking for help at the mobile unit, called Carolinas MED-1 and operated by Atrium Health. Within two hours of setting up, they had treated at least five patients with issues ranging from an asthma attack to diabetic ketoacidosis, which can be life-threatening if left untreated, he said.

“People are piling in right now,” Dr. Calloway said Monday evening.

The mobile unit, which carried more than 30 medical personnel, is the only facility within a 50-mile radius for the community, which is as isolated as neighboring Wilmington, he said.

Meanwhile, cresting rivers and rising floodwaters are threatening overflowing manure lagoons and toxin-filled coal-ash landfills, said environmentalists monitoring hog and poultry farms and power plants along the coast.

“Unfortunately and predictably, we are hearing impacts to both coal-ash impoundments and some of these waste lagoons at these industrial hog operations,” said Will Hendrick, manager of North and South Carolina operations for the nonprofit environmental watchdog Waterkeeper Alliance.

Mr. Hendrick said his team is monitoring five coal-ash plants within a half-mile of rivers, lakes or streams, and more than 60 hog and poultry manure pits, the majority of which are concentrated in the coastal plain and generate in excess of 200 million gallons of untreated waste.

“There we’re concerned about some of the bacteria impacts and the public health and aquatic life impacts that results when their contents are introduced into the rivers, lakes and streams nearby,” he said.

Coal ash contains high concentrations of toxins and heavy metals, according to the alliance, including arsenic, chromium and mercury.

Last week, the Centers for Disease Control and Prevention launched an Emergency Operations Center to monitor the risk of infectious diseases posed by contaminated floodwater, mold prevention treatment and help controlling mosquito populations that thrive in standing water.

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For people who have lost loved ones, rescued from rising floodwaters and those with damage to their property or homes, the psychological effects of Hurricane Florence can have an immediate impact.

Christian Burgess, director of the Disaster Distress Hotline, a national call center operated by the Department of Health and Human Services, said they received a 56 percent increase in call volume since news of Florence started to take form.

This included survivors of past floods and hurricanes like Hurricane Harvey, Mr. Burgess said, but about 30 percent of calls over the past few days are coming from North Carolina, with residents experiencing distress over lost property or not being able to get back home.

“In the immediate aftermath of disaster, because of the distress most people experience, they just need reminders of what helps them get through tough times and who is available that they can turn to,” he said. “We’re also providing resource referrals that they can follow up with to get the information they need in order to feel calmer or more control in the situation.”

As floodwaters recede, mental health effects are likely to linger and can even worsen. Researchers from the University of Texas following survivors four months after Hurricane Harvey last year found that more than half suffered mental health stress, with an estimated 18 percent reporting serious psychological distress.

“If you talk to somebody about what’s on your mind, it can go a long way in helping you to feel that you’re not alone,” Mr. Burgess said, “that what you’re feeling is normal in the aftermath of a disaster and that recovery is possible and that you will get through this.”

The Disaster Distress Helpline is available at 1-800-985-5900 or you can text TalkWithUs to 66746. Counselors are available 24 hours a day, 365 days. It is operated by the Substance Abuse and Mental Health Services Administration of the Department of Health and Human Services.