As health departments in Texas try to assist people with immediate medical needs following Hurricane Harvey, they're also looking to ensure those affected can get the prescription drugs they need and stay as safe as possible.
"Our best advice is always to avoid floodwater as much as you can," says Chris Van Deusen, a spokesman for the Texas Department of State Health Services. "Of course, people have had to be in the water — they haven't had a choice."
The state has already begun filling requests for tetanus vaccinations and is sending supplies of the vaccine to the affected areas. The Centers for Disease Control and Prevention recommends adults get a tetanus booster every 10 years; the bacteria can enter the body through breaks in the skin and can cause serious illness. The CDC also has specific recommendations for children on their website.
Van Deusen says water contamination from household chemicals and possibly industrial chemicals could be a problem, although as of midday Monday, he had yet to hear of a major industrial facility being flooded.
Dr. Phil Huang, medical director and health authority for Austin Public Health in the state capital, urges people to clean wounds with soap and water. "Certainly, there can be contamination with high levels of water — fecal contamination, things like that."
He also warns that well water could be contaminated as a result of flooding. He says it's important that people boil water for at least a minute before using it, or get bottled water.
Huang says in the days ahead, safety concerns could include carbon monoxide poisoning in households using generators; the consumption of contaminated food stored without refrigeration; and injuries suffered when people try to get back to their homes. Longer term, he says, mold will be an issue.
Huang says one of Austin's community health centers has set up mobile clinics to help people in shelters there who need prescription drugs, either by filling existing prescriptions or writing new ones as necessary.
The state has also contracted with the grocery chain H-E-B to work with patients on filling prescriptions as long as there is some way to verify the prescription, Van Deusen says.
A total of 14 hospitals have been evacuated in the affected region since Friday, he says, noting that two emergency departments have since reopened.
This morning, MD Anderson Cancer Center, one of country's top cancer hospitals, tweeted that it was closed for all patient appointments today and tomorrow. Since yesterday, the hospital has been surrounded by water, and roads have been impassable. Staff in the hospital continue to care for inpatients.
"Our patients are safe," tweeted Dr. Karen Lu, Chair of Gynecologic Oncology at MD Anderson, on Sunday.
Starting last week, the Texas Health and Human Services Commission has been contacting long-term care facilities in the state to ask about evacuation and shelter plans, according to commission spokeswoman Carrie Williams.
As of mid-afternoon Monday, 39 nursing facilities and 19 assisted living facilities housing more than 2,280 residents had been evacuated, according to Williams.
"[We] will continue to contact providers to assess unmet needs," she wrote in an email. "If we spot an emergency situation, we refer that to the State Operations Center and/or law enforcement as warranted."
On Sunday, a photo of elderly residents surrounded by high water inside their nursing home went viral on social media, generating huge concern and some outrage. Hours later, emergency personnel evacuated 15 senior citizens from the home, La Vita Bella in Dickinson, Texas, Dickinson's emergency management coordinator David Popoff told The Daily News.