Forbes
September 1, 2021

As night follows day, public health crises follow closely on the heels of extended blackouts. Although only about four people have died due to the direct effects of Hurricane Ida, the electricity crisis in New Orleans and much of southeastern Louisiana will soon result in a surge in the death rate and a big jump in the number of fatalities and poisonings caused by inhalation of carbon monoxide emitted by small electricity generators.

In fact, the poisonings have already begun. Yesterday, according to a story in the New Orleans Times-Picayune, nine people in St. Tammany Parish were taken to the hospital due to carbon monoxide poisoning caused by an electric generator. More such poisonings are certain.

“The longer the power outage, the more certain we will have carbon monoxide poisonings,” says Dr. Neil Hampson, 66, a retired doctor who has been studying the problem for more than 30 years. In a phone interview on Tuesday evening, Hampson told me the “first wave” of poisonings “come in the first two to four days” after the blackout as people try to get their air conditioners and refrigerators running again. A second wave comes about a week later. Furthermore, data collected by Hampson and others show that Blacks, Hispanics, and Asians-Americans suffer a disproportionate share of those carbon monoxide poisonings and deaths. More on that in a moment.

At about 8 am this morning, about 1 million people in southeastern Louisiana were without power and multiple news outlets were reporting that due to damage to key high-voltage transmission lines, the blackout could last for weeks. While the duration of the blackout can’t be known at this point, history shows the close connection between blackouts and public health. Put another way, the longer the blackout, the deadlier its impact. That is particularly true for the elderly and the medically frail.

Indeed, the deadly effect of extended blackouts is undeniable. Shortly after Winter Storm Uri, the Texas Department of State Health Services determined that at least 111 Texans died due to the February blizzard. The majority of those deaths were associated with hypothermia, the agency said. It also determined that “multiple deaths” were caused by “motor vehicle accidents, carbon monoxide poisoning, medical equipment failure, exacerbation of chronic illness, lack of home oxygen, falls, and fire.” But the actual death toll was much higher. In May, BuzzFeed News reported that the actual death toll, when including the medically vulnerable who perished due to storm-related disruptions, could be as high as 700. That tally  includes people who had “chronic conditions including cardiovascular disease, diabetes, and kidney problems.”

A similar spike in deaths occurred after Hurricane Maria walloped Puerto Rico in 2017. In the wake of the hurricane, the initial death toll was put at 64 and was later increased to about 1,400. But a 2018 report by researchers at the Milken Institute School of Public Health at George Washington University found that about 3,000 people on the island died due to the effects of the hurricane. The peak of the dying – known as excess mortality – came in January 2018, four months after the storm when numerous people, many of them aged and infirmed, began succumbing due to the lack of medical treatment.

Another investigation into the after-effects of Hurricane Maria was done by the Associated Press, Puerto Rico’s Center for Investigative Journalism, and the news site, Quartz. The researchers analyzed mortality databases in Puerto Rico in the years before the hurricane to provide a baseline for death rates on the island. They went on to estimate that about 500 people died due to Hurricane Maria and its after-effects. The investigators attributed 166 of those deaths to the lack of electricity. Some of those 166 couldn’t get the medicines they needed due to the blackout. Others, like cardiorespiratory patient Eladia Dávila, depended on a mechanical ventilator to breathe. Davila didn’t die immediately after the storm. Instead, she died nearly two months after the hurricane, on November 15, 2017.

Carbon monoxide poisonings from small generators provide a vivid example of the essentiality of electricity to our lives. Deaths from carbon monoxide poisoning happen with surprising regularity. A 2013 report estimated as many as 400 people die every year in the U.S. due to carbon monoxide poisoning and that it “is a primary cause of both morbidity and mortality following severe weather events.” It said the poisonings, “consistently occur when residents improperly use portable gasoline-powered generators and other tools following severe storms and power outages.”

In August 2020, after Hurricane Laura hit Texas and Louisiana, three people died and 23 others were hospitalized due to carbon monoxide poisoning. The three deaths occurred inside a pool hall in Port Arthur where several people sought shelter from the hurricane. Their fatal mistake was putting an electricity generator inside the building.

In April of this year, the Texas Tribune ran an excellent piece on the surge in carbon monoxide poisonings that occurred during Winter Storm Uri. It reported that “At least 11 deaths have been confirmed and more than 1,400 people sought care at emergency rooms and urgent care clinics for carbon monoxide poisoning during the weeklong Texas outage,” a total that was “ just 400 shy of the total for 2020. Children made up 42% of the cases. The totals don’t include residents who were poisoned but did not seek care or those who were treated at hospitals and urgent care clinics that do not voluntarily report data to the state.” The report also found that “Black, Hispanic and Asian Texans suffered a disproportionate share of the carbon monoxide poisonings… Those groups accounted for 72% of the poisonings, far more than their 57% share of the state’s population.”

That finding is corroborated by Hampson’s data. In 2019, he published a study titled “Racial and ethnic trends in unintentional carbon monoxide poisoning deaths,” which concluded that the overall number of people killed by poisoning has declined over the past two decades. That decline is largely attributable to public education campaigns and warning labels on generators, an effort that Hampson has helped push. But Hampson’s study also found that “minority groups continue to display a disproportionate number of unintentional” carbon monoxide poisoning deaths. The report, which includes data from 2000 to 2017, found that while the carbon monoxide poisoning death rate among Whites and Hispanics had declined, that was not true for Blacks.

“People shouldn’t use generators indoors period,” Hampson told me. “Not in their garage, not outside their window. If they put it near a window unit, it will suck the carbon monoxide right into their home.”

There is much more to be written about Hurricane Ida. But at this moment, without the life-sustaining power of electricity, it appears that the people in southeastern Louisiana are in for a long period of hurt.

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