LISTERIOSIS AND HURRICANE KATRINA

Comparing the 2008 Canadian Listeriosis Outbreak and 2005 Hurricane Katrina Response Joi Chadwick Gonzaga University

The 2005 landfall of Hurricane Katrina and 2008 Listeriosis outbreak were national crises for the governments of the United States of America and Canada, respectively. Each event was a matter of public health and security. How effectively officials communicated with each other and the public during these times impacted the extent of loss of well-being, livelihood, property, and life. This paper will compare and contrast the communication response of those managing each crisis. Roles/priorities Maple Leaf The management team of Maple Leaf Foods, Inc. played a crucial role in the 2008 Listeriosis outbreak and response. This team included President and CEO Michael McCain, who oversaw the company as it instituted recalls, facility cleansing and sanitization efforts, employee training on cleanliness and the disease, and new safety protocols. McCain also served to inform and reassure the public by holding a press conference during the outbreak. Another vital player in the company's response to the crisis was spokesperson Linda Smith who handled media inquiries. As there are a number of stakeholders involved in a public health and food safety investigation and recall, Maple Leaf Foods, Inc. worked in conjunction with the Canadian federal government during this time. (Canadian Food Inspection Agency [CFIA], 2009) The major agencies involved were the Canadian Food Inspection Agency (CFIA), Public Health Agency of Canada (PHAC), , and Health Canada (HC). On August 6, 2008, the Toronto Public Health Unit informed the CFIA of two listeriosis cases at a nursing home. The agency's Office of Food Safety and Recall (OFSR) then conducted a food safety investigation, from August 7 to the 23 rd, that ultimately linked the Listeria to meats produced at Maple Leaf Foods' Bartor Road Facility. The agency contacted Maple Leaf Foods and issued a Health Hazard Alert, triggering the recall and retrieval of contaminated deli meats. In its 2008 report, the PHAC outlined its strong federal leadership role during the Listeriosis outbreak as follows: The Outbreak Management Division in the Centre for Food-borne, Environmental and Zoonotic Infectious Diseases coordinated the national epidemiological investigation. The National Microbiology Laboratory led the laboratory arm of the national outbreak investigation, coordinating and analyzing all laboratory data including results generated elsewhere, and providing analyses and interpretation of genetic fingerprints.

 The Agency's considerable investment in information technology infrastructure, namely the Canadian Network for Public Health Information, was invaluable for sharing information among local, provincial/territorial and federal organizations. The Emergency Operations Centre helped to facilitate extensive communication and coordination between federal, provincial/territorial and local public health officials, as well as with the Minister's Office and Central Agencies which were intensely involved. The Communications Directorate led the national public health communications response with a variety of communications products for the general public, at-risk populations, and health practitioners. (Public Health Agency of Canada [PHAC], 2009) Health Canada summarized its role in its own follow-up report. The agency described itself as providing consistent and timely laboratory services to its federal partners, such as sampling, testing, and health risks assessments. (Health Canada, 2009) In addition, HC coordinated well with its partners in transferring and sharing relevant laboratory information and collaborated with its partners to provide timely advice on health and food safety to the public. Hurricane Katrina The National Response Plan (NRP) set forth that incidents are typically managed at the lowest possible geographic, organizational, and jurisdictional level. (Department of Homeland Security [DHS], 2004, p. 6) In this plan, management of the Hurricane Katrina preparedness and response first fell to local authorities. For instance, in the most notably impacted city, New Orleans, the crisis was to be managed by Mayor Ray Nagin and Police Superintendent Eddie compass. According to the plan, after local authorities exhausted resources, they were then to request resources at the county level and proceeding upward to state, regional, and national levels. This chain moved upward from Nagin and Compass to Louisiana governor Kathleen Blanco, and to Federal Emergency Management Agency (FEMA) director Michael D. Brown who was designated Principle Federal Officer (PFO) for the disaster. According to the NRP, roles are outlined as follows: I. A mayor or city or county manager, as a jurisdictions chief executive, is responsible for the public safety and welfare of the people of that jurisdiction. The Local Chief Executive Officer: Is responsible for coordinating local resources to address the full spectrum of actions to prevent, prepare for, respond to, and recover from incidents involving all hazards including terrorism, natural

disasters, accidents, and other contingencies; Dependent upon State and local law, has extraordinary powers to suspend local laws and ordinances, such as to establish a curfew, direct evacuations, and, in coordination with the local health authority, to order a quarantine; Provides leadership and plays a key role in communicating to the public, and in helping people, businesses, and organizations cope with the consequences of any type of domestic incident within the jurisdiction; Negotiates and enters into mutual aid agreements with other jurisdictions to facilitate resourcesharing; and Requests State and, if necessary, Federal assistance through the Governor of the State when the jurisdictions capabilities have been exceeded or exhausted. II. As a States chief executive, the Governor is responsible for the public safety and welfare of the people of that State or territory. The Governor: Is responsible for coordinating State resources to address the full spectrum of actions to prevent, prepare for, respond to, and recover from incidents in an all-hazards context to include terrorism, natural disasters, accidents, and other contingencies; Under certain emergency conditions, typically has police powers to make, amend, and rescind orders and regulations; Provides leadership and plays a key role in communicating to the public and in helping people, businesses, and organizations cope with the consequences of any type of declared emergency within State jurisdiction; Encourages participation in mutual aid and implements authorities for the State to enter into mutual aid agreements with other States, tribes, and territories to facilitate resource-sharing; Is the Commander-in-Chief of State military forces (National Guard when in State Active Duty or Title 32 Status and the authorized State militias); and Requests Federal assistance when it becomes clear that State or tribal capabilities will be insufficient or have been exceeded or exhausted.

III. The Secretary of Homeland Security is responsible for coordinating Federal operations within the United States to prepare for, respond to, and recover from terrorist attacks, major disasters, and other emergencies. HSPD-5 further designates the Secretary of Homeland Security as the principal Federal official for domestic incident management. In this role, the Secretary is also responsible for coordinating Federal resources utilized in response to or recovery from terrorist attacks, major disasters, or other emergencies if and when any of the following four conditions applies: (1) A Federal department or agency acting under its own authority has requested DHS assistance; (2) the resources of State and local authorities are overwhelmed and Federal assistance has been requested; (3) more than one Federal department or agency has become substantially involved in responding to the incident; or (4) the Secretary has been directed to assume incident management responsibilities by the President Brown's position as Director of FEMA meant he was also the Undersecretary for Emergency Preparedness and Response for the DHS. As his position placed him under the umbrella of the Department of Homeland Security and in a critical office for national disaster management, he was appointed by the Secretary of the DHS as the principle Federal official to manage the Hurricane Katrina situation. A major issue in the handling of the Hurricane Katrina response, however, was a lack of a clear and decisive leadership or even a clear chain of command. In 2006, David Walker, Comptroller General of the United States Government Accountability Office (GAO) released a statement assessing government preparedness and response for catastrophic disasters, specifically Hurricane Katrina. The statement, based on a GAO report, claimed the following: No one was designated in advance to lead the overall federal response in anticipation of the event despite clear warnings from the National Hurricane Center. Furthermore, events unfolded both before and immediately after the landfall of Hurricane Katrina that made it clear that governmental entities did not act decisively or quickly enough to determine the catastrophic nature of the incident. For example, the DHS Secretary designated Hurricane Katrina as an incident of national significance on August 30ththe day after final landfall. However, he did not designate the storm as a catastrophic event, which would have

triggered additional provisions of the National Response Plan (NRP), calling for a more proactive response.1 As a result, the federal posture generally was to wait for the affected states to request assistance. At the same time, some federal responders such the Coast Guard and DOD [Department of Defense] did lean forward in proactive efforts anticipating a major disaster. Furthermore, other federal agencies took proactive steps to prepare for and respond to the disaster, such as the U.S. Postal Service and the National Finance Center Although the DHS Secretary designated a PFO to be the federal governments representative under the NRP structure and to coordinate the federal response, the efforts of all federal agencies involved in the response remained disjointed because the PFOs leadership role was unclear. In the absence of timely and decisive action and clear leadership responsibility and accountability, there were multiple chains of command, a myriad of approaches and processes for requesting and providing assistance, and confusion about who should be advised of requests and what resources would be provided within specific time frames. (Walker, 2006, p. 4) Stakeholders Stakeholders in the Maple Leaf outbreak included consumers, victims and families of victims, employees, investors, corporate management, vendors and suppliers, media, and Canadian local, regional, and national government and national population. Populations in the seven provinces that reported confirmed cases and related deaths particularly held stake in the handling of the crisis. More specifically, the province of Ontario, which reported the most confirmed cases and deaths due to the outbreak (41 and 16), was a major stakeholder. For the Katrina disaster, stakeholders primarily included the Gulf Coast regional population; families and loved ones of the affected region's population; and local, state, and federal agencies and government officials. Other stakeholders included businesses, employees, and consumers in the region; all consumers of products and services of the region; businesses from other regions offering products and services to the affected region; armed and volunteer personnel called in to assist with the disaster relief efforts; media; and the international community. Also, other American states and areas of Gulf Coast states not directly impacted by the hurricane were stakeholders as they managed an influx of refugees and sent resources to help with the effort.

Overarching strategy and goals Maple Leaf The overarching goal of Maple Leaf in responding to the listeriosis outbreak has been improved food safety in all of the company's plants and to instill and/or rebuild stakeholder confidence in their products The plan to accomplish this goal is laid out in four strategies. These strategies include improved sanitation protocols, testing, training, and food safety leadership. Hurricane Katrina In the lead-up to the landfall of Hurricane Katrina, each government intended to send the message to city/municipal, state, regional, and national publics that they were prepared to respond to it and other major catastrophic events effectively. The overarching goals in preparing for Hurricane Katrina and similar events was to minimize extraordinary levels of mass casualties, damage, or disruption that likely will immediately overwhelm state and local responders. (GAO, 2006, p.5) One early strategy in managing the crisis and public perception of organizational competence included developing and updating disaster preparedness plans to show that organizations were working to increase security and decrease probable damage and loss due to a disaster, specifically a Category 5 hurricane. This began years before Hurricane Katrina in response to similar events such as Hurricane Andrew in 1992. In the more immediate lead-up to and during Hurricane Katrina, government officials enacted emergency response procedures. Tactics Maple Leaf Maple Leaf's tactics in supporting its four strategies sanitation protocols, testing, training, and food safety leadership included the following: Strategy: Sanitation protocols Daily sanitization procedures to seek, find, and destroy bacteria Changed traffic patterns to minimize risk of cross-contamination, including color coding employees by coats designating where they can travel Disassembling and sanitizing parts of slicing equipment, including boiling and baking parts Physical improvement to walls, ceilings, floors, drains, airflow, and controls for condensation Run plants at consistently cooler temperatures to inhibit bacteria growth

 Adding shrouds, sleeves, and aprons to entry requirements Strategy: Testing Strengthened sample, testing, and data analysis Doubled testing sites and number of samples on every line in the ready-to-eat plant Review testing samples separately and as a whole Has two government accredited testing labs and will soon have a third

Strategy: Training Wrote new protocol into standard operating procedure Thousands of hours spent by employees learning new procedures Strategy: Food safety leadership Created position of Chief Food Safety Officer (CFSO) currently held by Dr. Randall Huffman CFSO identifies global best practices in food safety and new food safety technologies Developed food safety advisory council consisting of global experts in food safety, food microbiology, and food science CFIA inspectors are on site to monitor all food processing at all Maple Leaf processing facilities All plants are federally registered An independent company reviews proficiency of Maple Leaf microbiology testing three times a year Turnstile entry restricts access to ready-to-eat plants until bio-secure hand washing and sanitization is complete Participates in annual food safety audits Performs quarterly exercises to test ability to trace product through the supply chain Hurricane Katrina A partial list of strategies and tactics used leading up to, during, and in the aftermath of Hurricane Katrina include the following: Strategy: Updating disaster preparedness plans Conducted the Hurricane Pam drills in Baton Rouge, Louisiana on July 23, 2004. These were exercises using information from and involving the cooperation of the National Weather Service; the U.S. Army Corps of Engineers; the LSU Hurricane Center; emergency officials from 50 parish, state, federal and

volunteer organizations; and other state and federal agencies. The purpose of these drills was to help officials develop joint response plans for a catastrophic hurricane in Louisiana. Created the National Response Plan, a 426 page document, which was to align Federal coordination structures, capabilities, and resources into a unified, all-discipline, and all-hazards approach to domestic incident management. (DHS, 2004, p. i) Strategy: Emergency response procedures Louisiana Gov. Kathleen Blanco issued a state of emergency on Aug. 26 and on Aug. 28 sent a letter to President Bush requesting a disaster declaration for the state in order to release federal assistance Additionally, the letter had to travel through points in FEMA before the federal government could respond. FEMA deployed regional responders before Katrina made landfall, but a major federal response wasn't evident until days later. (Shoup, 2005, par. 20) President George W. Bush declared a state of emergency in Louisiana, Mississippi, and Alabama two days before landfall and ordered Federal aid to supplement state and local response efforts in the parishes located in the path of Hurricane Katrina. (The White House Office of the Press Secretary, 2005) Mayor Nagin declared a state of emergency and called for voluntary evacuation on August 27, 2005 Mayor Nagin ordered a mandatory evacuation for the entire city on August 28, 2005, one day before landfall and opened the Louisiana Superdome as a shelter of last resort [...] for thousands of the area's poor, homeless and frail (The Associated Press, 2005) On August 29, 2005, Hurricane Katrina hit the Gulf Coast, and the 17 th Street Canal broke causing Lake Pontchartrain to flood the city. Michael Brown urged first responders to wait for requests and lawful dispatch before responding, and the American Red Cross was dispatched but did not enter New Orleans Governor Blanco announced that the Superdome would have to be evacuated on August 30 and evacuation began on August 31. The Superdome had become home to scenes of filth and misery (Roig-Franzia & Hsu, 2005) On September 1, the Bush administration sent Governor Blanco a proposed legal memorandum asking her to request a federal takeover of the evacuation of New Orleans (Roig-Franzia & Hsu, 2005) On September 2, President Bush visited New Orleans. During that time relief copters were grounded. Construction equipment on site during the President's visit was removed from the levees on September 3.

Also on September 3, President Bush announced the employment of active duty ground troops and Marines Time line and resources Maple Leaf The Canadian Government and leadership and employees at Maple Leaf have set up many new plans in response to the 2008 listeriosis outbreak. The day after being informed of Listeria cases at the health unit, the CFIA's OFSR began its investigation which was conducted in the span of a little over two weeks. The OFSR immediately reported its findings to Maple Leaf Foods which allowed the company to take immediate action. All the agencies quickly utilized the 4 R's - expressing regret, stating what will be done to resolve the issue, reforming, and offering restitution in the process of responding to the crisis. This helped maintain or recapture public confidence in the company and the government in handling crises and providing necessary products and services. Maple Leaf and these government agencies quickly dispatched all necessary personnel and resources to manage the problem. This included investigations, closing down facilities, recalling products, cleansing and sterilization practices, and training. These actions were taken with a multi-million dollar cost to ensure public health and lessen or prevent future loss of life due to similar contamination. The attitude taken by these parties displayed a sense of respect for the magnitude of the crisis, the lives affected by the events, and these groups' social responsibilities. Within six months of the outbreak, each agency had released its own Lessons Learned report detailing its part in the response efforts, its accountability, and areas where improvement was needed. By January 2009 five months after the outbreak Maple Leaf had created the position of Chief Food Safety Officer. Hurricane Katrina In contrast, authorities seemed not to learn or apply as much as quickly from previous disasters, including Hurricane Andrew which happened 13 years prior to Katrina. A major problem in Hurricane Katrina was timing and coordination of resources. As each level exhausted its resources and ability to effectively cope with the crisis they requested assistance from higher levels of government. Accusations and blame were cast from and upon all levels of government as mistakes came to light. From the local level, officials complained of communication breakdowns and the lack of leadership from the federal government, particularly from FEMA Director Michael Brown. (Shoup, 2005, par 22) These factors undermined public confidence in all levels of U.S. leadership regarding the crisis. Though the government received many offers of aid from other states, businesses, and international

governments before and after the hurricane's landfall - many of these offers did not get through to manifest as actual help to those affected. As of September 4, 2005, 59 countries and international organizations had offered aid to the United States. Foreign nations offered medical and water-treatment services, medical teams, hospitals, temporary housing, soldiers, firefighters, disaster specialists, fuel, generators, cots, tents, donations to the American Red Cross and other aid. But what actually got delivered was dependent upon FEMA's identification of needs. FEMA was ill-prepared to handle this responsibility due to the following: No knowledge management plan existed for incident response. There was no central list of information needs, or listing of potential information sources, to help prioritize reconstitution efforts. Joint task force phone numbers were not preassigned, and several numbers changed while the response was underway. In many cases, key messages were printed and hand-carried around command centers to make sure incident managers had the right information. (Miller, n.d., p. 197) Also: There were challenges in integrating the efforts of the Salvation Army and smaller organizations, often local churches and other faith-based organizations. In addition, federal agencies involved in managing the international assistance were not prepared to coordinate, receive, distribute, or account for the assistance. Agency officials involved in the cash and in-kind international assistance told us the agencies had not planned for the acceptance of international assistance for use in the United States and, therefore, had not developed processes and procedures to address this scenario. (Walker, 2006, p. 8) The local, state, and federal governments would have likely fared better if, in advance, a system had been developed for managing aid and assistance during a crisis. Such a system should have been included during the updated preparedness processes and in the NRP. As there were failures or gaps in the proactive response and deployment of governmental resources, a better arrangement for reactive response would have served as a valuable back up in a catastrophic scenario. This would have increased probability that appropriate resources would have reached the people and areas that needed them in a timely manner. The disjointed chain of command, confusion on how to reach people, and ignorance on how to disburse aid were certainly detrimental to the preparation and relief efforts. There were also obvious lapses in judgment during the response, including a presidential visit that halted aid to the region. This and other tactics worked to counter the main goals, and therefore should have been avoided. In addition, there were some very useful tactics that were

implemented too late or not at all. Reinforcement or re-engineering the levees and crucial structures in New Orleans could have decreased probability of the breach. This would have lessened destruction and loss of life that resulted from the levees breaking. Though authorities were likely attempting to prevent a panic and unnecessary interruptions to regional life and economy by waiting until August 28 to order the mandatory evacuation, this may well have been the wrong usage of caution. Had they been cautious in an alternative manner, by ordering the mandatory evacuation sooner, they might have reaped several benefits. There would have been more time and less of an urgent situation in traffic out of New Orleans. Mortality during the evacuation could have been lessened. More people would have been able to make plans to evacuate with the extra time available, putting less of a strain on shelters of last resort, and likely decreasing the overall mortality rate of the disaster and destruction afterward by those left behind. Measurement In crisis situations, measurement can be difficult, especially taking into account variables in each scenario. However, certain methods of assessment must be developed to gauge and compare past, present, and future performance and effectiveness. For Maple Leaf, one method of measurement might be data on outbreaks that trace back to contaminated products from their facilities. Fewer reports of illness and death would be a sign of improvement and exhibit the competence of government and corporate management and potency of new safety measures. They might also seek to improve crisis response time which is an idea that was no doubt taken into account in developing the quarterly tracing exercises. For the United States Government, it would be useful to compare loss and destruction due to natural disasters. An example of this would be data comparing the effects of hurricanes hitting the U.S. - and in particular the Gulf Coast region during the 20th century to the effects of Hurricane Katrina. All stakeholders of U.S. Natural disasters would benefit from a quicker response, which can be measured by how quickly aid and resources are able to reach those in need. Perhaps one of the most crucial measurements would be figures of how many what percentage of the total population - were left behind in evacuated areas, what percentage were able to evacuate safely, how soon the majority or all were evacuated (within how many days or how many days prior to landfall), and the best estimates for the overall mortality rate. All levels of governmental agencies should seek to decrease the percentage left behind as low as possible, increase the percentage able to evacuate, and develop a safer window of time for evacuation. And importantly, these organizations must seek to clarify communications to alleviate

confusion, blame games, and a crippled response effort. They should seek to reorganize and streamline the chain of command and then increase the number of individuals who know who holds what authority in crisis situations. Conclusion Many investigations have been conducted and reports have been released by the US and Canadian governments in response to these crises. These reports and discourse on how to manage these situations are crucial to handling future events of a similar nature. While the Maple Leaf response was quick and decisive and took more of an approach to contain and counteract, unfortunately for the victims of Hurricane Katrina, the same could not be said of the US management of that crisis. Maple Leaf has many protocols in place to prevent and effectively contain future outbreaks due to contaminated product. After similar events - particularly the fairly recent Hurricane Andrew - the United States should have in nearly the same position, if not better. That is, the government should have been more thoroughly prepared for several eventualities of such a disaster and been more proactive and less reactive. Hopefully, American leadership has now engaged in more actions that embody this attitude. Authorities, stakeholders, and communicators can use the hindsight of these scenarios as insight and foresight for future events. Prudence would have us acknowledge that these incidents are neither unprecedented nor unlikely to recur and it is all the more urgent that we draw appropriate lessons from these experiences. (Miller, n.d., p. 191)

REFERENCES Associated Press. (2005, August 28). USATODAY.com - New Orleans flees as Katrina approaches Gulf Coast. Retrieved October 21, 2009, from http://www.usatoday.com/weather/stormcenter/2005-08-28-katrinagulf_x.htm Canadian Food Inspection Agency. (2009). Lessons learned: The Canadian Food Inspection Agency's recall response to the 2008 listeriosis outbreak (Rep.). Retrieved October 20, 2009, from http://www.inspection.gc.ca/english/agen/eval/listeria1/listeria1e.shtml Forero, J., & Weisman, S. R. (2005, September 04). U.S. allies, and others, send offers of assistance.The New York Times. Retrieved October 21, 2009, from http://www.nytimes.com/2005/09/04/international/americas/04offers.html?_r=1&adxnnl=1&adxnnlx=1125 911318-ASJf32Sb1LTRvrXi2oACTg Health Canada. (2009). Lessons learned: Health Canada's response to the 2008 listeriosis outbreak executive summary (Rep.). Retrieved October 20, 2009, from http://www.hc-sc.gc.ca/fn-an/pubs/securit/execlisteriosis-res-eng.php Miller, R. (n.d.). Hurricane Katrina: Communications & infrastructure impacts (Rep.). Retrieved October 22, 2009, from National Defense University website: http://www.carlisle.army.mil/DIME/documents/Hurricane%20Katrina%20Communications%20&%20Infra structure%20Impacts.pd Niles, R. (Ed.). (2005, September 07). A timeline of government response to Hurricane Katrina. Retrieved October 21, 2009, from http://www.ojr.org/ojr/wiki/Katrina_Timeline/ Public Health Agency of Canada. (2009). Lessons learned: Public health agency of Canada's response to the 2008 listeriosis outbreak (Rep.). Retrieved October 20, 2009, from http://www.phac-aspc.gc.ca/fs-sa/listeria/2008-lessons-lecons-eng.php Roig-Franzia, M., & Hsu, S. (2005, September). Many evacuated, but thousands still waiting. The Washington Post. Retrieved October 21, 2009, from http://www.washingtonpost.com/wp-dyn/content/article/2005/09/03/AR2005090301680.html Shoup, A. (2005, September 09). The online NewsHour: After Hurricane Katrina | FEMA's role |. Retrieved October 20, 2009, from

http://www.pbs.org/newshour/bb/weather/july-dec05/katrina/fema_background.html U.S. Department of Homeland Security. (2004). National response plan (Rep.). Retrieved October 20, 2009, from http://www.nmfi.org/natlresp/files/NRPallpages.pdf U.S. Senator Mary Landrieu. (2005, September 03). Landrieu implores president to "relieve unmitigated suffering;" end FEMA's "abject failures" [Press release]. Retrieved October 21, 2009, from http://landrieu.senate.gov/releases/05/2005903E12.html Walker, D. M. (2006). Statement by Comptroller General David M. Walker on GAOs preliminary observations regarding preparedness and response to Hurricanes Katrina and Rita (Rep.). Retrieved October 20, 2009, from United States Government Accountability Office website: http://www.gao.gov/new.items/d06365r.pdf The White House Office of the Press Secretary. (2005, August). Statement on federal emergency assistance for Louisiana. Retrieved October 21, 2009, from http://georgewbushwhitehouse.archives.gov/news/releases/2005/08/20050827-1.html