Maine leads the way in managing tick-borne illnesses and high heat in a changing climate, but it could learn from other states with more experience managing the public health impacts of climate-driven flooding, a federal health official said Friday.
And this particular health official – Dr. Nirav Shah – should know. He was the top public health official in Maine for four years and participated in the state’s climate action plan before he left in 2023 to become second in command of the U.S. Centers for Disease Control and Prevention.
“Flooding was on our minds, but I don’t think it had the front-of-mindness that it does now,” Shah said Friday during an online Coffee & Climate forum hosted by the Portland and South Portland sustainability offices. “There is much that Maine could draw upon as we’re improving our work there.”
The presence of Shah – who achieved near-celebrity status while leading Maine through the COVID-19 pandemic with a Diet Coke in one hand and a Prince or Rick Astley quote at the ready – drew about 50 people to the monthly talk show. Shah gave a quick 15-minute talk and then fielded climate questions.
The public health response to flooding can be broken down into stages, Shah said: Emergency response, immediate recovery, and long-term recovery.
When the flood begins, authorities focus on evacuation, including those who don’t have the means to evacuate themselves.
As the waters begin to recede, authorities must help with search and rescue operations, treat flood injuries, keep an eye out for potential infections or fungal disease outbreaks, confirm the public water supply is free of contamination, and begin a street-by-street, house-by-house cleanup.
Public health officials must also monitor the long-term impacts of flooding, which range from the persistent mental health difficulties that haunt the survivors of any natural disaster to the impact that flood erosion can have on the quality of the soil, especially agricultural lands, Shah said.
“So it’s an arc of response that Maine is I think only now starting to experience,” he said, referring to the deadly floods of last winter’s back-to-back-to-back storms that claimed four lives in Maine. “We are going to need to draw upon the lessons of other states.”
Local flooding is likely to increase as our climate gets warmer and wetter, according to Maine state climatologist Sean Birkel. The number of 2- and 3-inch rain days is growing fast. The number of 4-inch rain days is increasing, too, but slowly.
According to the last National Climate Assessment, the number of extreme rain or snow events in the Northeast is up 62%, the largest increase in the nation. Two-inch rain days were up 49% when comparing averages in 1958 to those in 2022.
The assessment puts most of its Northeast focus on the here-and-now impacts of the extreme snow and rain days already happening, but predicts this extreme precipitation will continue to increase in frequency and ferocity under all global warming scenarios heading into the future.
Most of Maine’s efforts to prepare for climate-driven flooding have focused on how to prevent drowning and economic losses of all sizes, from damage to waterfront homes to road washouts caused by undersized culverts to swept-away lobster-buying stations.
But flooding exacts a public health toll, too. Floodwaters can carry bacteria, parasites, viruses and pollutants, including chemicals and sewage, that cause disease, according to the American Public Health Association. Those who survive the floods report more stress, anxiety and depression.
The most direct link between climate change and public health in Maine can be found in warming temperatures and heat-related illnesses like heatstroke and diseases spread by the exploding population of ticks that no longer die off in the winter due to Maine’s milder seasonal weather.
In these areas, Shah gave Maine high marks. Shah commended leaders from a cold-weather state like Maine for recognizing that extreme heat poses a public health threat to vulnerable populations, like young children and the elderly, and that high-heat risk will only increase over time.
“In a parallel universe, what leaders in Maine are saying is well, you know, heat, yeah, but cold is really the bigger thing, and heat is going to be fine, it’s only two or three days a year, let’s worry about that later,” Shah said. “But that’s not what is happening in our universe.”
Maine focuses on teaching residents to protect themselves from the growing number of ticks surviving our increasingly mild winters: how to ward them off and use a state website to track where the disease-carrying ticks are, Shah said. Maine also trains doctors to diagnose tick-borne illnesses in patients.
“Diagnosing these things is really hard,” Shah said. “If you or one of your pets has ever had a tick-borne disease, as my family has, it is dizzying. Is it Lyme? Is it Anaplasma? Is it Babesia? What are these things? So clinician education is really critical … and I’m happy to see Maine taking the lead.”
Maine officials, however, still believe the state has a long way to go in this area. They say Maine lacks the experience and infrastructure to manage the health impacts of a changing climate when compared to other parts of the country that face far hotter and stormier futures.
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