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“Since asthma surveillance data were not available at the census tract level for most of Louisiana, we estimated asthma burden using the inpatient discharge data available through LDH.”  (4)

“Case counts are not provided for CTs with a 2018 population of less than 800 to safeguard privacy.” (4)

“To minimize the need for suppression, inpatient discharge data was aggregated for the three most recent years available (2017–2019) and average annual crude rates were calculated for cases where asthma (ICD-10 code J45) was the primary diagnosis, as well as where asthma was any diagnosis.” (4)

“Spearman’s Rank Correlation was utilized to analyze the correlation between various social and environmental vulnerability factors, COVID-19 incidence, and the measures of asthma risk by CT.” (4)

“This was performed by first ranking the values in each dataset using RANK.AVG function in MS Excel 2016, followed by applying the PEARSON function to compare two datasets. Significance was set at alpha less than 0.05 (α < 0.05), with degrees of freedom (df) equal to two less than the total number of data points represented in both datasets” (4)

The research team works for the Section of Environmental Epidemiology and Toxicology, Office of Public Health, Louisiana Department of Health in Baton Rouge. Team members included Arundhati Bakshi; Shanon Soileau; Collete Stewart; Kate Friedman; Collete Maser; Alexis Williams; Kathleen Aubin; and Alicia Van Doren. 

“Currently, much of the environmental focus of the pandemic remains on PM2.5 levels; however, we noted that higher levels of ozone was consistently associated with higher incidence rates of COVID-19, and it was the only environmental factor that appeared to have an additive effect over SVI on COVID-19 incidence (Fig 1).” (11)

“Specifically, our data show a moderately strong positive correlation between SVI due to minority status/language barrier and three health data variables: asthma hospitalization; estimated asthma prevalence; and cumulative COVID-19 incidence at 3 months (Table 2). Interestingly, SVI measures were either negatively or not significantly correlated COVID-19 incidence at the 9-and 12-month time points, indicating that social vulnerability factors may have played a greater role in COVID-19 spread early in the pandemic, but may have been of diminishing importance as the pandemic wore on (Fig 1 and Table 2).” (9)

Bakshi A, Van Doren A, Maser C, Aubin K, Stewart C, Soileau S, et al. (2022) Identifying Louisiana communities at the crossroads of environmental and social vulnerability, COVID-19, and asthma. PLoS ONE 17(2): e0264336. https:// doi.org/10.1371/journal.pone.0264336. 

This document uses data resources from the Center for Disease Control/Agency for Toxic Substances and Disease Registry (CDC/ATSDR), the Environmental Protection Agency (EPA), and the Louisiana Department of Health (LDH).

These data resources include the Social Vulnerability Index (2018 - CDC/ATSDR), the NATA Respiratory Hazard Index (EPA 2014), PM2.5level (average annual concentration in ug/m3, EPA 2016), ozone level (summer seasonal average of daily maximum 8-hour concentration in air in parts per billion, EPA 2016), indoor mold concerns reported to IEQES program (average annual number of calls, LDH 2017-2019), cumulative COVID-19 incidence rate at 3-, 6-, 9- and 12-month increments (LDH March 2020 - March 2021), asthma hospitalization (average annual crude rate, where asthma was a primary diagnosis among hospitalization cases, LDH 2017-2019), and estimated asthma prevalence (average annual crude rate, where asthma was any diagnosis among hospitalization cases, LDH 2017-2019).

The main point of this article is to look at the shortcomings of the response to the World Trade Center on 9/11/01 by the NYPD, PAPD, and FDNY. The article shows that the response was plauged by communication breakdowns between fire companies and commanders, a complete lack of communication between fire and law enforcement agencies with heavy roots in the history of the two departments, and an uncoordinated response by off duty firefighters, who swarmed the area after the attacks. The article discusses various improvements that could have been made after the 1993 bombing and would have significantly effected response on 9/11 such as the improvement and standardization of radio hardware and channels between departments, joint training drills, more rigid command durring response, and the adoption of the FEMA incident command system.

FDNY, Fire Department, City of New York
-composed of individual Engine, Truck, Ladder, Rescue, HazMat, and EMS companies, as well as other specialized units which handle most of the city's emergencies that could cause dammage to life and property. The FDNY was technically the agency in command of the response at the WTC site.

NYPD - New York City Police Department. 
-Provides law enforcement for the NYC. Police Emergency Service Units are also mentioned. These are groups which share some of the responsibilities and training of firefighters, and are familuar with technical rescue equiptment.

PAPDNYNJ - Port Authority Police Department of New York and New Jersey. 
-Responsible for providing protection at all of the major ports and entrances to NYC, incluing bus terminals, shipping docks and ports, train stations, rail yards, bridges, tunnels, and other commuter and shipping hubs.

This article is entirely about the shortcomings of emergency response, and how the history and traditions of the FDNY and NYPD got in the way of an effective response, resulting in communication barriers, an uncoordinated response, unknown and unaccounted responders, and even possibly avoidable deaths. Public health was not explicitly mentioned, as this article focused more on the efficacy of the multi-agency response itself.

“A six­month examination by The Times found that the rescuers' ability to save themselves and others was hobbled by technical difficulties, a history of tribal feuding and management lapses that have been part of the emergency response culture in New York City and other regions for years.”

''It's a disgrace,'' he said. ''The police are talking to each other. It's a no­brainer: Get us what they're using. We send people to the moon, and you mean to tell me a firefighter can't talk to a guy two floors above him?''

The author of this article drew on first hand accounts of the WTC attacks from fire, police, and EMS personel, as well as witnesses to reconstruct the events that transpired on the morning of 9/11/01 with regards to the response. The author also conducted and cited interviews with high ranking active and retired members of the Police and Fire Departments, such as FDNY Chiefs and officers and NYPD Commissioners. Based on this, the author examines specific shortcomings, such as lack of coordination between Fire and Police, comminication barriers, and the overwhelming and uncoordinated response by both on and off-duty firefighters.

1. I tried to find more information on the current radio system that the FDNY and NYPD employ to see how they would facilitate interagency communication and communication with mutual aid from departments in surrounding counties.

2. I did more research into the NYPD ESU

3. I attempted to find more information on any FDNY response policies developed after 9/11/01 to limit and coordinate response to major disasters to avoid the confustion found at the WTC response.

“Those who responded [off duty] were upholding the Fire Department’s finest tradition: the selfless struggle to save the endangered. But they were also rushing to fight a fire that department officials had already decided was unfightable. And they did so in such numbers, with so little coordination, that some fire officials are now questioning whether the department known as the Bravest acted too bravely that day.”

“Chief Baccellieri recalled seeing “at least 100 of them.” When he shouted that rescuers were evacuating, no one moved. “They said, We’ll come down in a few minutes,’” Chief Baccellieri said. “These firemen had no idea that the south tower collapsed.””