Eye on the Storm: Two NASHP Staffers in Texas Reflect on Weathering Winter Storm Uri

Last month, Winter Storm Uri caused catastrophic power outages across Texas. National Academy for State Health Policy staff Eskedar Girmash and Sarah Lanford, who work remotely from Dallas and Houston during the pandemic, were both without power for four days as temperatures fell to single digits and they lost access to water. At least 58 people died trying to stay warm, and more than 13 million Texans lost access to safe drinking water and were under a boil-water notice for days after the storm passed.

Sarah Lanford: We lost power at my home in Houston at 1:30 a.m. on Monday, Feb. 15, and did not regain it until mid-day Thursday, Feb. 18. As a lifelong Texan, I’m used to being without power for weeks at a time after hurricanes, but never in cold weather. I have never been as worried for my safety as I was on Monday evening, when the temperature in our house dipped below 40 degrees and we could not get warm despite many layers of clothing and blankets. We eventually decided to sit in the car in our driveway for the remainder of the evening, where heaters and seat warmers kept us warm until we were able to safely make our way to my grandmother’s house. Fortunately, my family is in a closed COVID-19 bubble, which we were able to maintain throughout the week, and my grandmother had already received her vaccine. The following day, we sat near my grandmother’s fireplace under layers of blankets. We tried to conserve our phones’ batteries in case we needed to communicate with anyone, and we read books by flashlight. Power came on and off, but we never knew when it would come or go. We flushed the toilet sparingly and did not shower for days.

Throughout the week, the only time I heard from local or state leaders was when Harris County was placed under a boil notice. We couldn’t help but laugh when we got that alert – we had lost access to most of our water and even if we had water, we did not have the electricity required to boil it. The absence of local and state leadership was jarring. It felt like we had been abandoned. 

Eskedar Girmash: I grew up in the City of Dallas and later moved to the northern suburbs. I was used to everything shutting down or at least drastically slowing at the sight of snow, but never experienced such mass infrastructure failure as last week. Like Sarah, I lost power late Sunday night and did not regain it fully until Thursday. I spent days charging my phone in my car, wearing layers of clothes and blankets, finding whatever cardboard boxes and newspapers around to make a fire in our fireplace, and making sure my two-year-old niece was as warm as she could be. Luckily, we had a close family friend who offered up her home to us for warmth on Tuesday. Though we were warm, we were also met with the confounding variable of COVID-19 as there were other families seeking warmth at her home. It was dystopic, roads were dangerously iced over, all businesses were shuttered and dark, grocery stores were empty, and families were suffering.

As I write this, it is now 74 degrees outside, making the realities of last week seem like a distant disaster. However, so many families are now left with new disasters, including extensive home damage, medical bills, and contaminated water. This storm and our infrastructure failures make me increasingly aware of the immediacy of addressing climate change and its effects on public health. Further, it reinforced my understanding that it is often everyday people who are forced to step up and care for their communities when disaster strikes. Community organizers – particularly Black and Latinx women – across the Dallas-Forth Worth metroplex are the true heroes of last week’s disaster. They led life-saving efforts when local and state leaders were nowhere to be found. 

Overlapping Crises 

Sarah Lanford: The energy crisis happened against the backdrop of a pandemic that has already wreaked havoc on Texas, causing more than 40,000 deaths. Texans were left with little ability to avoid contact with people outside their household as many people gathered with neighbors or went to large warming centers to avoid freezing temperatures. The bad weather closed COVID-19 vaccination sites, and Harris County rushed to distribute more than 8,000 doses after a storage facility lost power Monday and officials urged people to stay off icy roads. It will likely take the state three weeks to recover from the week-long delay in vaccinations.

Impact on Seniors and Adults with Chronic Health Conditions 

Sarah Lanford: After we regained power, I made welfare calls to seniors across the state as part of a community-led effort to ensure people had access to drinking water and were able to stay warm. At the end of those calls, we inquired about other immediate needs. Again and again, I heard from people who were either unable to get to the pharmacy to refill prescriptions or who were in dire need of dialysis. Many pharmacies were closed due to power outages, and those that were open could not obtain shipments due to icy roads. Nearly all outpatient dialysis centers in the state were closed due to power outages, and many hospitals were unable to perform inpatient dialysis after they lost access to water. This put the nearly 50,000 people in the state suffering from kidney failure in life-threatening situations. Power outages also affected access to medications that require storage at specific temperatures, such as insulin, and rendered life-sustaining medical equipment, such as oxygen, inoperable.

Impact on Children  

Eskedar Girmash: As with seniors and adults with chronic health conditions, many children and youth with special health care needs (CYSHCN) rely on home health care services, refrigerated medications, and electronically powered medical equipment. Power outages and other infrastructure failures resulted in the loss of many services, creating a surge in pediatric hospital admissions. Cases of hypothermia, carbon monoxide poisoning, frostbite, and car accident injuries also contributed to a rise in pediatric hospitalizations and fatalities. Some children’s hospitals were met with their own power and water outages, resulting in additional challenges in caring for newly-admitted children on top of the patient care challenges brought on by the COVID-19 pandemic. 

Schools also suffered major infrastructural failures. Loss of power, water, and resulting damage interrupted student’s access to education, and the many additional essential services schools provide, such as meals, mental health, and physical health supports. There were over 130 burst pipes across schools in Dallas Independent School District, the second-largest school district in Texas. As a result, virtual and in-person school interruptions are in place until March 1 for schools that experienced extensive damage.  

Inequities and Mutual Aid  

Eskedar Girmash: As with all public health disasters, Winter Storm Uri laid bare many racial and class inequities that exist in our systems. Because of long-lasting systemic racism, such as redlining, many low-income Black and Latinx communities suffered disproportionate losses from the storm. To address these stark racial and ethnic inequities, mutual aid groups across the Dallas-Fort Worth metroplex sprang into action, becoming the main form of disaster relief for our communities. 

On Saturday after the storm, I volunteered with mutual aid groups in Dallas to cook meals and deliver groceries for families in need. Hundreds of people came out at various kitchens and sites across the city in a mutual effort to care for our communities. All individuals were masked, frequently washed hands, and following COVID-19 precautions. It was both incredible and devastating to witness how communities and organizers stepped up to take care of their own during a time when government was absent and slow to respond. Organizations like Feed the People Dallas, Lucha Dallas, and Not my Son helped place families who were experiencing freezing temperatures and damage to their homes in hotels and organized hot meal, grocery, hygiene, and other resource deliveries. Other organizations like North Texas Rural Resistance provided essential resources to low-income rural communities who were also disproportionately affected by the residual effects of the storm. These organizations are continuing their community-based efforts following the initial impact of the storm as many families remain without clean water and livable homes. 

The Aftermath and Looking Ahead

Winter Storm Uri is proof that climate change leads to public health emergencies. Though power has been restored to most Texas homes, many are now dealing with the financial and logistical hardships of home repairs, debt accrued from emergency hospitalizations, and wage losses contributing to financial and mental health burdens on families, especially low-income families with children and those caring for children with special health care needs. Damages to homes and businesses, cleanup costs, and lost wages are estimated at $50 billion.

As state leaders begin to address the aftermath of the storm and look ahead for ways to avoid a similar crisis in the future, these questions arise:

• How can public health agencies work to advise and collaborate on rebuilding energy and home infrastructure across Texas and particularly focus on strengthening infrastructure in low-income, rural, and predominately Black, Asian-American, Latinx, and Native American communities? 
• How can government agencies collaborate to develop resources and access to mental and physical health supports for CYSHCN and Black, Latinx, and Native American children who were disproportionately affected by the storm?  
• How will public health agencies strengthen their focus on preparation for climate change disasters? 
•  How will public health and safety agencies better prepare for climate change disasters so they can respond immediately and effectively?
• What measures will be implemented to ensure that vulnerable populations are prioritized in disaster preparation and relief measures? 

Some have said this is a once-in-a-lifetime storm, but this is the second time in a decade that Texans have experienced massive power outages after extreme winter weather. In 2011, a similar storm led to widespread power outages across the state. Policymakers failed to heed lessons from that storm and weatherize the power infrastructure, and last week Texans paid the price. Preparing for climate change is imperative. The climate crisis is life-threatening issue and requires public action to keep Texans safe.