How’s the Weather? Severe Weather Classifications in Syndromic Surveillance

ObjectiveTo report the results of the application of New Jersey’s SevereWeather Classifier in New Jersey’s syndromic surveillance systemduring two extreme weather events.IntroductionHurricane ‘Superstorm’ Sandy struck New Jersey on October 29,2012, causing harm to the health of New Jersey residents and billionsof dollars of damage to businesses, transportation, and infrastructure.Monitoring health outcomes for increased illness and injury due toa severe weather event is important in measuring the severity ofconditions and the efficacy of state response, as well as in emergencyresponse preparations for future severe weather events. Followingthe experience with Hurricane Sandy, NJDOH initiated a projectto develop a suite of 19 indicators, known as the Severe WeatherClassifier (SWC) in EpiCenter, an online system which collectsemergency department chief complaint data in real-time, to performsyndromic surveillance of extreme weather–related conditions.NJDOH has since used these classifiers in more recent events tomonitor for weather-related visits to storm-affected area emergencydepartments (ED’s).In June, 2015, a squall line of damaging thunderstorms, known asa “bow echo,” caused downed wires and multi-day power outagesin Camden and Gloucester counties in southern New Jersey. Almostexactly seven months later, in January, 2016, Winter Storm Jonasdropped more than a foot of snow over New Jersey. These eventsprovided an opportunity to assess the indicators within SWC.MethodsThe impact of these storms on ED visits was assessed in EpiCenterby using the SWC sub-classifications for disrupted outpatientmedical care (dialysis and oxygen needs, and medication refills).Rates per 1,000 ED visits were calculated on two weeks of EDvisits by classification for each storm. For the June 2015 bow echostorm, this assessment focused on Gloucester and Camden counties,the two hardest hit by the storm. For Winter Storm Jonas, rates per1,000 ED visits were calculated statewide since all counties wereimpacted.ResultsAfter the June, 2015 bow echo storm, both Camden and Gloucestercounty ED’s experienced increases in disrupted medical care, themost notable being for oxygen needs (Figures 1 and 2). Duringand after Winter Storm Jonas, ED visits for oxygen assistance andmedicine refills were the most impacted (Figure 3). It is speculatedthat ED visits for dialysis were not noticeably higher since the stormoccurred over a weekend when, generally, treatments take placeduring weekdays.ConclusionsWhile not every classification in the suite that makes up theSWC would be relevant in every extreme weather event, having the19 various elements available provides tools for state and local usersto monitor storm impacts both locally and at the state level