Global & Disaster Medicine

Archive for the ‘FEMA’ Category

After Maria, FEMA awarded Tiffany Brown, an Atlanta entrepreneur with no experience in large-scale disaster relief and at least five canceled government contracts in her past, $156 million for 30 million meals for Puerto Ricans. 50,000 were delivered.

NY Times

“…..In November, The Associated Press found that after Hurricane Maria, FEMA awarded more than $30 million in contracts for emergency tarps and plastic sheeting to a company that never delivered the needed supplies…..”

 


America’s Survival Food King: 300 calorie, Mylar-packed meals like Savory Stroganoff cost less than $1 and can last for decades, with 90% of nutrients intact.

Bloomberg

“…..FEMA was running low on food rations. In the previous four weeks, the agency had supplied millions of meals to the Texans and South Floridians displaced by hurricanes Harvey and Irma. Maria had created a third disaster zone with more complex logistics, having knocked out Puerto Rico’s electricity, gutted its roads, and destroyed its markets and ports. Restoring food security on the island could take months. Lee had to procure millions of servings of just-add-water meals to sustain the victims. Could Jackson provide at least 2 million and begin deliveries immediately?….”

  • Mylar pouches of freeze-dried meals such as Savory Stroganoff and Loaded Baked Potato Casserole
  • Designed to remain edible on shelves for a quarter century.

Wise Company


FEMA: 3,000 residents of Puerto Rico still living in shelters to be sheltered in New York and Florida

NY Times

“…..The Federal Emergency Management Agency said that it was finalizing extraordinary plans to fly about 3,000 residents of Puerto Rico still living in shelters to New York and Florida.

“Transportation assistance is something that I don’t think we have done previously,” Will Booher, a FEMA spokesman, said. “But this is unique to what’s going on in Puerto Rico.” The agency said the relief effort was being undertaken at the request of Gov. Ricardo Rosselló.

FEMA regularly finds housing for hurricane victims, often at hotels or motels nearby. But because there is so little available lodging on the island, and no easy way to get people from shelters to safe housing, the agency is arranging charter flights for residents, beginning with those still in shelters…..”


Texas & Florida: Still waiting for FEMA

NY Times

“…..one of the busiest hurricane seasons in years has overwhelmed federal disaster officials. As a result, the government’s response in the two biggest affected states — Texas and Florida — has been scattershot: effective in dealing with immediate needs, but unreliable and at times inadequate in handling the aftermath, as thousands of people face unusually long delays in getting basic disaster assistance…..One of the most significant problems FEMA has had in Texas and Florida is the backlog in getting damaged properties inspected. Contract inspectors paid by the agency must first inspect and verify the damage in order for residents to be approved for thousands of dollars in aid. FEMA does not have enough inspectors to reduce the backlog, and the average wait for an inspection is 45 days in Texas and about a month in Florida, agency officials said…….”


Today’s FEMA SitRep on Puerto Rico and USVI after the hurricanes

FEMA Sit Rep

Puerto Rico

• Shelters: 92 shelters open with 4,154 (-102) occupants
• Disaster Assistance Registrations: 792k Power Outages / Restoration
• 21.6% (+5%) of customers with power restored
• 25.4% of transmission lines energized; 36.5% substations energized
• Generator failure reported in Centro Medico; emergency generators to be installed
• PREPA estimating 95% to be restored by December 15
Communications:
• 85% (+24) of population live in areas where wireless coverage is available for voice and text messages
Health & Medical
• 61 (-2) of 67 hospitals open
• 2 Federal Medical Stations operational Water Restoration
• 72% of PRASA customers have potable water service
• 65 water filter plants are operating
Guajataca Dam
• Water has stopped flowing over spillway; reservoir pool is 4 feet below spillway; there is no longer any seepage noted under spillway slabs
U.S. Virgin Islands
• Shelters: 5 shelters open with 290 (-17) occupants
• Disaster Assistance Registrations: 14.9k
Power Outages / Restoration
Customers receiving power from grid: St. Thomas: 29% St. Croix: 1.6%; St. John: no grid power, restoration expected in 2-3 weeks Communications:
• 88% of population lives in area where wireless coverage is available for voice and text
Health & Medical
St. Thomas: Schneider Medical Center sustained damage; established mobile medical facility
• St. Croix: Charles Harwood Facility closed; Governor Juan Luis Hospital partially open despite damage
FEMA Response
• NRCC: Modified Level III (day shift, 8:00 am – 6:00 pm EDT)
National IMAT East-1 & 2, & Region III IMAT deployed to PR
• FEMA Region II & X IMATs: deployed to USVI • MERS teams deployed to both USVI & PR

Puerto Rico and U.S. Virgin Islands Need Urgent Aid Now to Avert Public Health Crises

ISDA

“…..Infectious disease risks in the wake of these hurricanes include exposures to waterborne pathogens, the spread of infections in crowded shelters, food-borne illnesses, mosquito-borne infections and mold-related illnesses. Reliable access to medicines for patients with HIV and tuberculosis is also critical to preventing treatment disruptions that increase patients’ risks of serious illness, disease progression, and to avoid the emergence of drug-resistance or transmission of these infections.  Health workers in the affected areas struggle with shortages of antibiotics and hydration solutions, and they are bracing for potential infectious disease outbreaks.  Ensuring that basic needs are met including access to clean water, safe food and sanitation as essential for infection control. …..”

Pinpointing Where the Lights Went Out in Puerto Rico

The images above show lighting around San Juan, capital of the commonwealth; the images below show the entire island. One image in each pair shows a typical night before Maria made landfall, based upon cloud-free and low moonlight conditions; the second image is a composite that shows light detected by VIIRS on the nights of September 27 and 28, 2017. By compositing two nights, the image has fewer clouds blocking the view. (Note: some clouds still blocked light emissions during the two nights, especially across southeastern and western Puerto Rico.) The images above show widespread outages around San Juan, including key hospital and transportation infrastructure.

 

 


EPA is continuing to coordinate with local governments in Puerto Rico and the USVI to assess the conditions of drinking water.

EPA

EPA Hurricane Maria Update for Wednesday, October 11th

10/11/2017
Contact Information: 

WASHINGTON (October 11, 2017) — The U.S. Environmental Protection Agency (EPA) continues to coordinate closely with federal, commonwealth, territory, and local partners as the Agency responds to the impact of Hurricane Maria. EPA is focused on environmental impacts and potential threats to human health as well as the safety of those in the affected areas.  EPA is continuing to coordinate with local governments in Puerto Rico and the USVI to assess the conditions of drinking water, which includes sampling, analysis and lab support, and getting wastewater treatment systems up and running. EPA’s missions also include oil and chemical spill response, oil and chemical facility assessments and debris management.

There are reports of residents obtaining, or trying to obtain, drinking water from wells at hazardous waste “Superfund” sites in Puerto Rico.  EPA advises against tampering with sealed and locked wells or drinking from these wells, as it may be dangerous to people’s health.

EPA has collaborated with FEMA and the Department of Defense on a video documenting our drinking water assessment teams’ work. The video shows EPA teams at sites in Caguas and Yabucoa, Puerto Rico that are without power and need generators to get up and running. EPA is working with FEMA and local municipalities to get the drinking water wells functioning.

EPA and partners assessing non-PRASA drinking water system, Cañabón, Puerto Rico. EPA and partners assessing non-PRASA drinking water system, Cañabón, Puerto Rico. Photo courtesy of EPA.

EPA Administrator Scott Pruitt, at the request of Puerto Rico Governor Ricardo Rosselló and in consultation with U.S. Department of Energy Secretary Rick Perry, today waived certain parts of the Clean Air Act to allow for the continued use of heating oil and marine fuel designated for use in Emission Control Areas that exceed the 15 parts per million sulfur standard for mobile non-road generators and pumps used for emergency purposes in Puerto Rico. This waiver is effective immediately and will continue through October 30, 2017. Any non-ultra low sulfur diesel fuel authorized under this waiver and remaining in a mobile non-road generator or pump after October 30, 2017, may continue to be used until the fuel has been consumed

Personnel
EPA continues to deploy personnel to Puerto Rico and the U.S. Virgin Islands as conditions allow. As of October 10, 2017:

  • About 236 personnel are currently involved in hurricane response efforts.
  • About 48 personnel are on the ground in USVI to assist with response efforts.
  • About 89 personnel are on the ground in Puerto Rico to assist with response efforts.

Debris Management
EPA continues to work with FEMA, the U.S. Army Corps of Engineers and the Puerto Rico and USVI governments on debris management. EPA will assist with the handling and disposal of orphan containers, household hazardous waste, medical waste and e-waste. EPA plans to conduct air monitoring at collection areas and during all hazardous materials operations.

Marine Operations
EPA is working with the US Coast Guard on marine operations to assess sunken vessels on the eastern coast of Puerto Rico and USVI. Teams will locate and evaluate the condition of sunken vessels and assist with the disposal of recovered oil and hazardous materials.

Assessment of Superfund Sites, Oil Sites and Regulated Facilities
EPA continues to re-assess Superfund sites, oil sites, and chemical facilities in both Puerto Rico and the USVI to determine if the sites were affected by Hurricane Maria and if there is a potential for contamination to cause off-site impacts.

Drinking Water and Wastewater Management
In USVI, EPA continues to coordinate drinking water sampling with the U.S. Virgin Islands Department of Natural Resources. In Puerto Rico, the EPA continues to focus on assessing both drinking water and wastewater systems and continues to work closely with the government of Puerto Rico.

Water Safety
Raw sewage continues to be released into waterways and is expected to continue until repairs can be made and power is restored. Water contaminated with livestock waste, human sewage, chemicals, and other contaminants can lead to illness when used for drinking, bathing, and other hygiene activities. According to the Centers for Disease Control and Prevention (CDC), people should not use the water from rivers, streams and coastal water to drink, bathe, wash, or to cook with unless first boiling this water for a minimum of one minute. If boiling the water is not possible, water may be disinfected with bleach. To learn more about making water safe in an emergency, go to CDC’s Making Water Safe in an Emergency web page.

For information and updates, visit: https://www.epa.gov/hurricane-maria.


FEMA SitRep: California Wildfires (10/12/17)

FEMA

Current Situation 18 large fires burning (FMAGs issued for 10) across 150k acres of state and private land.

Impacts: • 24 confirmed fatalities (CalOES law enforcement) • Approximately 106k people under Mandatory Evacuations • 36,513 (+3,100) homes threatened; 94 (+44) damaged / 1,313 (+168) destroyed •

Within existing fire perimeters: Population 26,270, 2 mobile home parks, 12 schools, 10 emergency medical services, 10 fire stations, 5 NSS shelters, 13 nursing homes, 3 cell towers •

50k customers without power and 36k without gas

(FEMA Reg IX) State/Local Response: • Governor declared a state of emergency in Napa, Sonoma, Butte, Lake, Solano, Mendocino, Nevada, Orange, and Yuba counties • CA EOC at Partial Activation • 59 Red Cross and independent shelters open with 5,117 (+2.8k) occupants (ESF-6 as of 3:30 a.m. EDT) FEMA Response: • DR-4344-CA and 10 FMAGs approved • Region IX IMAT-1 & LNO deployed to CA EOC • Staging Area established at Travis AFB


FEMA SitRep for Puerto Rico and USVI: 10/12/17

FEMA

Hurricane Update – Caribbean Current Situation Life safety and life sustainment efforts in PR and USVI ongoing.

Passing showers possible for eastern PR and USVI.

Flash Flood Watch remains in effect for PR through this evening.

Impacts Population: • Shelters: 107 (-1) open with 5,602 (-140) occupants in PR; 5 open with 339 occupants in USVI •

Disaster Assistance Registrations: 370k in PR; 9k in USVI

Communications: • PR: 22% of cell towers operational; 64% of the Puerto Rico population live in areas where wireless coverage is available for voice and text messages • USVI: 45% of cell towers operational (St. Thomas: 50%; St. John: no cell sites operational; St. Croix: 48%); St. John being serviced by temporary Wi-Fi hot spots and personal MiFi devices

Power: • Restoration: PR: 10.6% have electricity; PREPA is reporting that the failure of tie line that caused the generation plant to go down October 10 has been repaired; USVI: 14.4% St. Thomas; 0% St. John; 12% St. Croix on power grid; 90% of the USVI to be restored by late December

Generators: PR: 70 installed; 135 available; 365 en route; USVI: 55 generators installed, 50 available; 39 en route

Health and Medical: • PR: 65 out of 67 hospitals open; 36 hospitals connected to power grid, 29 on generator power; USNS Comfort is en route to Arecibo and is subsequently scheduled to move to Aguadilla • USVI: USVI Department of Health (DOH) is without power; public health clinic co-located at the DOH is closed and vaccine supply located at the facility affected; ESF-8 working with DOH to assess damage to vaccine supply. St. Croix: Charles Harwood Hospital and Governor Juan Luis Hospital damaged; partially open; St. Thomas: Schneider Medical Center damaged; established mobile medical facility

FEMA Response • NRCC: Level I (day shift), Enhanced Watch (night shift) • National IMAT East-2: Deployed to PR • FEMA Region II & X IMATs: Deployed to USVI • FEMA Region III IMAT: Deployed to PR • MERS teams deployed to both USVI & PR


Hurricane Maria: Federal Response Timeline

Sunday, September 17 – Pre-Landfall •	FEMA’s National Response Coordination Center (NRCC) remains fully activated with all emergency support functions operational, including Department of Defense (DoD) liaisons.  FEMA holds daily video-teleconference with leadership across various departments and agencies.•	FEMA has a Federal Coordinating Officer (FCO) and Incident Management Assistance Team (IMAT) co-located with the Governor on St. Croix, as well as liaisons on St. John and St. Thomas that will remain in place throughout the storm’s potential landfall.•	FEMA has an FCO and Incident Management Assistance Team co-located with key staff from the Caribbean Area Division at the FEMA Distribution Center in Puerto Rico, who will remain in place throughout the storm’s potential landfall.•	DoD Civil Authority Information Support Element (CAISE) assisting with communication and outreach support to communities in the U.S. Virgin Islands.•	The U.S. Army Area Support Medical Company and the U.S. Air Force Ground Surgical Team operating in St. Thomas are sheltering aboard the amphibious ship USS Kearsarge and will return to U.S. Virgin Islands after Hurricane Maria passes.•	The Department of Transportation, through the Federal Aviation Administration (FAA), is working on the relocation and protection of the mobile air traffic control tower at St. Thomas airport ahead of the storm. •	The U.S. Geological Survey (USGS) is prepositioning assets in Puerto Rico, including storm surge and rapid deployment gauges, to support water-level measurements and flood forecasting.•	FEMA temporarily repositions the remainder of the federal employees in the U.S. Virgin Islands in order to resume operations as quickly as possible, while also freeing shelter resources for island residents.  •	DoD, including U.S. Army Corps of Engineers (USACE), personnel deployed to support Hurricane Irma response efforts will ride out the storm on the USS Kearsarge just off the coast of the islands. They will be ready to continue existing operations as soon as the storm passes.Monday, September 18 – Pre-Landfall•	FEMA’s NRCC is fully activated with all emergency support functions operational.  FEMA holds daily video-teleconference with leadership across various departments and agencies.•	President Donald J. Trump issues federal emergency declarations for the Territory of the U.S. Virgin Islands and the Commonwealth of Puerto Rico in advance of Hurricane Maria’s landfall.•	FEMA and federal personnel remain co-located with the Governor on St. Croix, as well as liaisons on St. John and St. Thomas that will remain in place.  FEMA and federal personnel also remain in place and in close coordination with the Governor of Puerto Rico.  •	Two Type 1 FEMA Urban Search and Rescue (US&R) teams, two canine teams, one logistics package, and one Type 4 US&R team in Puerto Rico.•	FEMA’s efforts in the U.S. Virgin Islands include an increased push of commodities over the last several days to Virgin Islands Territorial Emergency Management Agency (VITEMA) points of distribution to ensure residents have extra food, water, and supplies ahead of the storm. •	U.S. Virgin Islands has six open shelters, with additional shelters scheduled to open prior to the storm’s potential landfall.Tuesday, September 19 – Storm Approaches Landfall in U.S. Virgin Islands•	FEMA’s NRCC is fully activated with all emergency support functions operational.  FEMA holds daily video-teleconference with leadership across various departments and agencies.•	FEMA and federal personnel remain co-located with the Governor on St. Croix, as well as liaisons on St. John and St. Thomas that will remain in place.  FEMA and federal personnel also remain in place and in close coordination with the Governor of Puerto Rico.  •	One Type 4 FEMA US&R team and one canine team to arrive in Puerto Rico.•	The Department of Health and Human Services (HHS) deploys one Disaster Medical Assistance Team to Puerto Rico.Wednesday, September 20 – Storm Makes Landfall in Puerto Rico•	FEMA’s NRCC is fully activated with all emergency support functions operational.  FEMA holds daily video-teleconference with leadership across various departments and agencies.•	President Donald J. Trump issues major disaster declarations for the U.S. Virgin Islands and the Commonwealth of Puerto Rico.•	FEMA and federal personnel remain co-located with the Governor on St. Croix, as well as liaisons on St. John and St. Thomas that will remain in place.  FEMA and federal personnel also remain in place and in close coordination with the Governor of Puerto Rico.  •	HHS activates National Disaster Medical System Definitive Care Reimbursement Program, which reimburses medical facilities and hospitals for the medical care costs of patients medically evacuated following disasters.•	Bureau of Alcohol, Tobacco, and Firearms is coordinating airlift and deployment of four Quick Response Teams to San Juan post landfall to conduct forecasted security measures.Thursday, September 21 – Post-Landfall•	FEMA’s NRCC is fully activated with all emergency support functions operational.  FEMA holds daily video-teleconference with leadership across various departments and agencies.•	There are more than 3,500 federal staff on the ground in Puerto Rico and U.S. Virgin Islands supporting response and recovery operations from Hurricanes Maria and Irma.•	Two FEMA US&R task forces and support resources are in Puerto Rico conducting reconnaissance and search and rescue. An additional team is on St. Croix conducting search and rescue and reconnaissance. •	Commodities in FEMA’s Puerto Rico Distribution Center include more than 274,000 meals, 25 generators, and more than 500 cots. •	USACE completes a Blue Roof install on Cyril E. King Airport on St. Thomas. Additionally, USACE has 27 generators on hand in St. Thomas with additional commodities to be delivered when conditions permit.•	HHS declares a public health emergency in Puerto Rico and the U.S. Virgin Islands. Four additional DMATs will arrive in Puerto Rico on September 22.•	Vessels are loaded for U.S. Virgin Islands with 1.3million meals, 2 million liters water, 30 generators, 6,000 cots.•	There are six U.S. Navy helicopters stationed and three Marine Osprey aircraft in the Caribbean.•	More than 700 National Guard are mobilized to Puerto Rico and more than 900 National Guard are mobilized to the U.S. Virgin Islands.•	Western Area Power Administration, in coordination with Department of Energy, deploys an eight-member advance team in Puerto Rico.•	Department of Interior Office of Law Enforcement has 50 personnel in Puerto Rico.•	Air support (MH-60s) and other assets from the amphibious ships USS Kearsage and USS Oak Hill  begin performing search and rescue flights and aerial damage assessments over U.S. Virgin Islands and Puerto Rico, and assist with restoration of damaged airfields.Friday, September 22•	FEMA’s NRCC is fully activated with all emergency support functions operational.  FEMA holds daily video-teleconference with leadership across various departments and agencies.•	There are more than 7,000 federal staff, including 280 FEMA staff, on the ground in Puerto Rico and U.S. Virgin Islands supporting response and recovery operations from Hurricanes Maria and Irma. •	Four FEMA US&R teams and support resources are in Puerto Rico, and one US&R team is in U.S. Virgin Islands conducting reconnaissance and search and rescue. These task forces assist in the rescue of 65 individuals, searching 45 buildings. The U.S. Coast Guard (USCG) is conducting search and rescue operations in St. Croix, and in the surrounding waters. •	National Guard Bureau (NGB) has 1,600 service members in the U.S. Virgin Islands and Puerto Rico.•	Vessels loaded with commodities are arriving or awaiting port opening and clearance with an air bridge to deliver commodities to Puerto Rico and the U.S. Virgin Islands.  •	More than 70 Federal Law Enforcement Officers are in San Juan supporting search and rescue and medical teams. Three ATF Quick Response Teams (QRT) are arriving to join the four QRTs operating in San Juan.•	USACE and other supporting agencies have completed several temporary power installs on Puerto Rico and the U.S. Virgin Islands, and completed nearly 100 inspections. Additional generator support is en route. USACE has 120 responders in Puerto Rico and the U.S. Virgin Islands.•	The General Services Administration (GSA) is assessing 80 leased/owned properties.•	USS Kearsarge/26th Expeditionary Unit Amphibious Ready Group (MEU ARG) aircraft including helicopters and MV-22s, continue damage assessments over the U.S. Virgin Islands and Puerto Rico, and complete patient evacuation movements from St. Croix to nearby facilities.Saturday, September 23•	FEMA’s NRCC is fully activated with all emergency support functions operational.  FEMA holds daily video-teleconference with leadership across various departments and agencies.•	The Department of Transportation announces three airports are open for military and relief flights in Puerto Rico and two airports open for military and relief flights in the U.S. Virgin Islands.  One port is open with restrictions in Puerto Rico and five ports are open with restrictions in the U.S. Virgin Islands.•	Support for federal response continues from the amphibious ships USS Kearsage and USS Oak Hill including search and rescue flights, aerial damage assessments, logistics support and route clearance for U.S. Virgin Islands and Puerto Rico.•	There are six commercial barges transporting meals, water, generators, cots and other commodities to Puerto Rico and U.S. Virgin Islands. •	The SS Wright is carrying 1.1 million meals and one million liters of water to the islands.•	The Defense Logistics Agency (DLA) is transporting 124,000 gallons of diesel fuel to Puerto Rico, with arrival anticipated in the coming days. •	There are 180 American Red Cross volunteers and staff in the Caribbean.Sunday, September 24•	FEMA’s NRCC is fully activated with all emergency support functions operational.  FEMA holds daily video-teleconference with leadership across various departments and agencies.•	Federal partners establish a fuel distribution site in San Juan for federal and local entities to support first responder and critical facility needs.   •	The port of San Juan re-opened for daylight operations and other ports are undergoing assessments.  On St. Thomas, the ports of Crown Bay, Cruz Bay, East Gregerie Channel, Red Hook, and West Gregerie Channel are open with restrictions while other ports are being assessed.  On St. Croix, the ports of Krause Lagoon and Limetree Bay are open with restrictions while other ports are being assessed.  •	The Department of Energy is coordinating with industry on mutual aid for Puerto Rico, and transported crews from New York Power Authority to support damage assessments. •	Eight FEMA US&R task forces are stationed in the Caribbean.•	At the federal staging area in St. Croix, there are more than 43,000 liters of water and more than 20,000 meals available for distribution by territory officials.•	USACE and the National Oceanic and Atmospheric Administration (NOAA) continue to survey damaged channels and ports in Puerto Rico.•	DoD CAISE re-inserted into the U.S. Virgin Islands to assist with communication and outreach support and DoD Area Support Medical Company re-inserted to U.S. Virgin Islands to assist with medical support needs.•	DoD assets from amphibious ships USS Kearsage and USS Oak Hill continue support for search and rescue flights, medical evacuation, aerial damage assessments, logistics support, port surveys and route clearance for U.S. Virgin Islands and Puerto Rico.Monday, September 25•	FEMA’s NRCC is fully activated with all emergency support functions operational.  FEMA holds daily video-teleconference with leadership across various departments and agencies.•	There are more than 10,000 federal staff, including more than 700 FEMA personnel, on the ground in Puerto Rico and U.S. Virgin Islands supporting response and recovery operations from Hurricanes Maria and Irma. •	Nine FEMA US&R task forces are stationed and conducting operations in the Caribbean. FEMA US&R task forces saved or assisted 516 individuals. The U.S. Coast Guard (USCG) is conducting search and rescue operations in St. Croix, and in the surrounding waters.  •	Officials in the U.S. Virgin Islands and Puerto Rico establish points of distribution for survivors to get meals, water, and other commodities. The National Guard supports commodity distribution.  •	Power is restored to Centro Medico Hospital in San Juan and San Pablo Hospital in Bayamon, Puerto Rico. •	Fuel arrives for several hospitals in Puerto Rico running on generators: Ashford Presbyterian, Pavia Santurce, Pavia Hato Rey, San Francisco, and Clinica Metro Pavia. The Schneider Regional Medical Center mobile hospital in St. Thomas was re-established.•	DLA, U.S. Northern Command, the U.S. Navy, and USCG, in coordination with the private sector, provide federal support for fuel transportation via air and sea logistical support.  •	FEMA, working in coordination with federal partners, provide more than 1.5 million meals, 1.1 million liters of water to the U.S. Virgin Islands and Puerto Rico since Hurricane Maria’s landfall.•	HHS and DoD conduct medical evacuations for more than 100 patients from the islands to the continental United States. Medical evacuations from the islands will continue. Additionally HHS medical teams are on the ground in Puerto Rico and the U.S. Virgin Islands. •	NGB has more than 4,300 Guard members on the ground in Puerto Rico and the U.S. Virgin Islands taking part in security and support operations. The Air National Guard is focused on transporting food, water, and communications capabilities as well as rapidly increasing airlift into affected areas.•	A Coast Guard mobile communications convoy is en route to Puerto Rico to help improve communications across the storm-impacted area. Coast Guard personnel continue to deliver critical FEMA relief supplies to Puerto Rico and the U.S. Virgin Islands.•	DoD assets from the USS Kearsage and USS Oak Hill continue support for response efforts including search and rescue flights, medical evacuation, aerial damage assessments, logistics support, commodity lifts, port surveys, and hospital assessments with HHS for U.S. Virgin Islands and Puerto Rico.Tuesday, September 26•	FEMA’s NRCC is fully activated with all emergency support functions operational.  FEMA holds daily video-teleconference with leadership across various departments and agencies.•	FEMA is delivering food and water to points of distribution and regional staging areas in Puerto Rico, St. Thomas, St. Croix, and St. John. •	American Red Cross (ARC) mobilizes to Puerto Rico 9,000 comfort kits and several thousand of tarps, flashlights, batteries, blankets, and hand sanitizer. To U.S. Virgin Islands, ARC will also send tens of thousands of bags of rice and beans with cots, blankets, comfort kits, tarps, trash bags, sponges, hand sanitizer, and insect repellent.•	Corporation for National and Community Service deploys two AmeriCorps to Puerto Rico and four Disaster response teams for Save the Children support.•	Ten FEMA US&R task forces are stationed and conducting operations in Puerto Rico. FEMA US&R task forces have saved or assisted 557 individuals and five pets, while searching over 2,600 structures.•	There are currently 32 points of distribution for commodities in Puerto Rico and U.S. Virgin Islands.•	More than 180 Federal Law Enforcement Officers are in San Juan and the U.S. Virgin Islands supporting search and rescue, medical teams, and other federal responders.  •	In support of Hurricane Maria relief and reconstitution operations, the U.S. Government established temporary air traffic flow management procedures for flights into San Juan International Airport in Puerto Rico. Roosevelt Roads and Aguadilla Airports in Puerto Rico are open for military and relief flights during daylight.•	Federal Aviation Administration (FAA) operations personnel are onsite in St. Thomas to evaluate, fix, and install FAA equipment, in support of air traffic control operations.•	USCG identifies eight ports with some restrictions in Puerto Rico, and nine open in U.S. Virgin Islands with restrictions. USCG reports the ports of Guayanilla, Salinas, and Tallaboa are fully open, and the ports of San Juan, Fajardo, Culebra, Guayama, and Vieques are open with restrictions in Puerto Rico. The ports of Crown Bay, Charlotte Amalie, East Gregerie Channel, West Gregerie Channel, and Redhook Bay on St. Thomas, the ports of Krause Lagoon, Limetree Bay, and Frederiksted on St. Croix, and the port of Cruz Bay on St. John are open with restrictions. Other ports are undergoing assessments.•	14 DoD flights arrived September 25 to deliver water and meals, helicopters, communications equipment, additional security forces, and communications and contingency response units for Puerto Rico and the U.S. Virgin Islands.•	USACE coordinates transportation of more than 300 FEMA or DLA generators from across the U.S. to meet anticipated requirements in the islands. In Puerto Rico, the team completes 27 of 32 requested temporary power assessments of critical facilities. In the U.S. Virgin Islands, USACE completed 90 of 131 requested temporary power assessments of critical facilities and began generator installations.•	DoD assets from the USS Kearsage and USS Oak Hill continue support for response efforts including logistics support, route clearance, port restoration, and hospital assessments with HHS for U.S. Virgin Islands and Puerto Rico.Wednesday, September 27•	FEMA’s NRCC is fully activated with all emergency support functions operational.  FEMA holds daily video-teleconference with leadership across various departments and agencies.•	DoD expands its response, and sustainment forces to augment those already on the ground to support the Commonwealth of Puerto Rico and FEMA.  •	FEMA and its federal partners continue 24-hour operations to reach inaccessible areas of Puerto Rico to reach survivors, provide fuel to hospitals, and re-open.  •	FEMA US&R task forces have saved or assisted 841 individuals and five pets, while searching over 2,600 structures. FEMA US&R is also conducting operational assessments of hospitals in Puerto Rico.•	U.S. Customs and Border Protection has ten members providing security to two FEMA ships. •	DoD CAISE is assist with communication and outreach support to communities in Puerto Rico.•	Half of the dialysis centers in Puerto Rico are open and accessible for patients. •	USACE is conducting assessments and planning for power grid restoration in Puerto Rico, and addressing the 1.4 million cubic yards of debris across the U.S. Virgin Islands. •	In Puerto Rico, fuel is delivered to 19 hospitals for power generators. Fuel continues to be delivered to hospitals and other locations around Puerto Rico.•	The U.S. Virgin Islands Water and Power Authority drinking water system is back online, and other drinking water systems on the islands are top priority for receiving generators.•	17 chainsaw teams (34 individuals) and one Incident Management Team (IMT) (23 individuals) from the Department of Agriculture United States Forest Service arrive in Puerto Rico to conduct emergency road clearance and manage logistics.•	To bolster the delivery of fuel throughout Puerto Rico, 100 delivery trucks were dispatched by the DLA.Thursday, September 28•	FEMA’s NRCC is fully activated with all emergency support functions operational.  FEMA holds daily video-teleconference with leadership across various departments and agencies.•	FAA reports Luis Munoz Marin International Airport (SJU) accommodated 25 commercial flights and processed 5,000 ticketed passengers.•	Two generators are installed at Concordia Fresh Water Pump Station and the Herbert Grigg Shelter.•	Recovery efforts are now supporting more than a dozen commercial passenger flights per day at SJU in San Juan, Puerto Rico.•	The Concordia potable water pump station is online in St. Croix.•	FEMA search and rescue teams have accessed 90 percent of Puerto Rico, conducting search and rescue operations and helping to assess hospitals. •	All municipalities in Puerto Rico have been reached by FEMA US&R, the Department of Health and Human Services, Commonwealth officials, and/or the National Guard.•	Additional National Disaster Medical System staff arrive to support hospital assessments and medical needs of those in Puerto Rico.  Friday, September 29•	FEMA’s NRCC is fully activated with all emergency support functions operational.  FEMA holds daily video-teleconference with leadership across various departments and agencies.•	There are more than 10,000 federal staff representing 36 departments and agencies, including more than 800 FEMA personnel on the ground in Puerto Rico and the U.S. Virgin Islands engaged in response and recovery operations from hurricanes Maria and Irma.  •	The Federal Highway Administration (FHWA) made $40 million available to the PR Highways and Transportation Authority (PHRTA) for emergency relief work to impacted roads.•	In Puerto Rico, 56 of 68 hospitals are partially operational, and one hospital is fully operational.  •	FAA reports SJU begins international commercial service with two flights. •	The U.S. Postal Service (USPS) has limited handout mail service available today at 49 locations in Puerto Rico, which represents 43 percent of all post offices on the island. 41 of these locations are also able to provide postal retail services. Limited handout mail service, along with limited retail service, begins today in St. Croix. Limited mail service continues in St. Thomas. On St. John, limited mail service continues with no retail services available.


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