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Natural disasters trigger complex chains of events within human societies 1 . Immediate deaths and damage are directly observed after a disaster and are widely studied, but delayed downstream outcomes, indirectly caused by the disaster, are difficult to trace back to the initial event 1 , 2 . Tropical cyclones (TCs)—that is, hurricanes and tropical storms—are widespread globally and have lasting economic impacts 3 – 5 , but their full health impact remains unknown. Here we conduct a large-scale evaluation of long-term effects of TCs on human mortality in the contiguous United States (CONUS) for all TCs between 1930 and 2015. We observe a robust increase in excess mortality that persists for 15 years after each geophysical event. We estimate that the average TC generates 7,000–11,000 excess deaths, exceeding the average of 24 immediate deaths reported in government statistics 6 , 7 . Tracking the effects of 501 historical storms, we compute that the TC climate of CONUS imposes an undocumented mortality burden that explains a substantial fraction of the higher mortality rates along the Atlantic coast and is equal to roughly 3.2–5.1% of all deaths. These findings suggest that the TC climate, previously thought to be unimportant for broader public health outcomes, is a meaningful underlying driver for the distribution of mortality risk in CONUS, especially among infants (less than 1 year of age), people 1–44 years of age, and the Black population. Understanding why TCs induce this excess mortality is likely to yield substantial health benefits. A large-scale evaluation of the long-term effects of tropical cyclones on human mortality in the contiguous United States estimates that the average tropical cyclone results in 7,000–11,000 excess deaths, far exceeding previous estimates.

About a third of the sediment delivery of the Mekong River is shown to be associated with rainfall generated by tropical cyclones, suggesting that future delta stability will be strongly moderated by changes to tropical cyclone intensity, frequency and track. Cyclones shaping tropical mega-deltas The delivery of sediment to deltas is crucial for their survival, especially when faced with rising sea levels. Human activities, such as dam building and land-cover alterations, can affect sediment supply, but Stephen Darby et al . show that, for the Mekong River, about a third of the sediment delivered is associated with rainfall generated by tropical cyclones. More than half of the decline in suspended sediment supply to the delta between 1981 and 2005 arose from shifts in tropical-cyclone climatology, suggesting that future delta stability will also be strongly moderated by additional changes to tropical-cyclone intensity and track. The world’s rivers deliver 19 billion tonnes of sediment to the coastal zone annually 1 , with a considerable fraction being sequestered in large deltas, home to over 500 million people. Most (more than 70 per cent) large deltas are under threat from a combination of rising sea levels, ground surface subsidence and anthropogenic sediment trapping 2 , 3 , and a sustainable supply of fluvial sediment is therefore critical to prevent deltas being ‘drowned’ by rising relative sea levels 2 , 3 , 4 . Here we combine suspended sediment load data from the Mekong River with hydrological model simulations to isolate the role of tropical cyclones in transmitting suspended sediment to one of the world’s great deltas. We demonstrate that spatial variations in the Mekong’s suspended sediment load are correlated ( r  = 0.765, P  < 0.1) with observed variations in tropical-cyclone climatology, and that a substantial portion (32 per cent) of the suspended sediment load reaching the delta is delivered by runoff generated by rainfall associated with tropical cyclones. Furthermore, we estimate that the suspended load to the delta has declined by 52.6 ± 10.2 megatonnes over recent years (1981–2005), of which 33.0 ± 7.1 megatonnes is due to a shift in tropical-cyclone climatology. Consequently, tropical cyclones have a key role in controlling the magnitude of, and variability in, transmission of suspended sediment to the coast. It is likely that anthropogenic sediment trapping in upstream reservoirs is a dominant factor in explaining past 5 , 6 , 7 , and anticipating future 8 , 9 , declines in suspended sediment loads reaching the world’s major deltas. However, our study shows that changes in tropical-cyclone climatology affect trends in fluvial suspended sediment loads and thus are also key to fully assessing the risk posed to vulnerable coastal systems.

This study identifies a significant increasing trend in the frequency of cyclonic storms (CS; maximum sustained winds exceeding 34 kts) over the northern Indian Ocean (NIO), primarily contributed by a pronounced rise in the number of very severe cyclonic storms (VSCS; maximum sustained wind speed exceeding 64 kts) since 1979. The observed increase in the VSCS frequency is closely associated with the enhanced lower‐middle tropospheric relative humidity due to the vertical moisture advection processes. The strengthened upward motion is primarily caused by anomalous positive vorticity advection by mean westerly flows. Through analysis of Detection and Attribution Model Intercomparison Project (DAMIP) experiments, it is demonstrated that the mid‐level cyclonic circulation trend is predominantly forced by greenhouse gas emissions, while anthropogenic aerosols exert a dampening effect. These findings underscore an escalating risk of stronger cyclones for the densely populated coastal nations around the NIO under continued climate change.

The co-occurrence of the 2020 Atlantic hurricane season and the ongoing coronavirus disease 2019 (COVID-19) pandemic creates complex dilemmas for protecting populations from these intersecting threats. Climate change is likely contributing to stronger, wetter, slower-moving, and more dangerous hurricanes. Climate-driven hazards underscore the imperative for timely warning, evacuation, and sheltering of storm-threatened populations – proven life-saving protective measures that gather evacuees together inside durable, enclosed spaces when a hurricane approaches. Meanwhile, the rapid acquisition of scientific knowledge regarding how COVID-19 spreads has guided mass anti-contagion strategies, including lockdowns, sheltering at home, physical distancing, donning personal protective equipment, conscientious handwashing, and hygiene practices. These life-saving strategies, credited with preventing millions of COVID-19 cases, separate and move people apart. Enforcement coupled with fear of contracting COVID-19 have motivated high levels of adherence to these stringent regulations. How will populations react when warned to shelter from an oncoming Atlantic hurricane while COVID-19 is actively circulating in the community? Emergency managers, health care providers, and public health preparedness professionals must create viable solutions to confront these potential scenarios: elevated rates of hurricane-related injury and mortality among persons who refuse to evacuate due to fear of COVID-19, and the resurgence of COVID-19 cases among hurricane evacuees who shelter together.

In the United States, tropical cyclones cause destructive flooding that can lead to adverse health outcomes. Storm-driven flooding contaminates environmental, recreational, and drinking water sources, but few studies have examined effects on specific infections over time. We used 23 years of exposure and case data to assess the effects of tropical cyclones on 6 waterborne diseases in a conditional quasi-Poisson model. We separately defined storm exposure for windspeed, rainfall, and proximity to the storm track. Exposure to storm-related rainfall was associated with a 48% (95% CI 27%-69%) increase in Shiga toxin-producing Escherichia coli infections 1 week after storms and a 42% (95% CI 22%-62%) in increase Legionnaires' disease 2 weeks after storms. Cryptosporidiosis cases increased 52% (95% CI 42%-62%) during storm weeks but declined over ensuing weeks. Cyclones are a risk to public health that will likely become more serious with climate change and aging water infrastructure systems.

Tropical storms, such as cyclones, hurricanes and typhoons, present major threats to coastal communities. Around two million people worldwide have died and millions have been injured over the past two centuries as a result of tropical storms. Bangladesh is especially vulnerable to tropical cyclones, with around 718 000 deaths from them in the past 50 years. However, cyclone-related mortality in Bangladesh has declined by more than 100-fold over the past 40 years, from 500 000 deaths in 1970 to 4234 in 2007. The main factors responsible for these reduced fatalities and injuries are improved defensive measures, including early warning systems, cyclone shelters, evacuation plans, coastal embankments, reforestation schemes and increased awareness and communication. Although warning systems have been improved, evacuation before a cyclone remains a challenge, with major problems caused by illiteracy, lack of awareness and poor communication. Despite the potential risks of climate change and tropical storms, little empirical knowledge exists on how to develop effective strategies to reduce or mitigate the effects of cyclones. This paper summarizes the most recent data and outlines the strategy adopted in Bangladesh. It offers guidance on how similar strategies can be adopted by other countries vulnerable to tropical storms. Further research is needed to enable countries to limit the risks that cyclones present to public health.

AbstractObjectiveTo characterise and quantify the mortality risks for a range of causes after tropical cyclones in nine countries and territories.DesignTwo stage, time series study.SettingNine countries or territories (Australia, Brazil, Canada, South Korea, Mexico, New Zealand, the Philippines, Taiwan, and Thailand), covering tropical, subtropical, and extra-tropical regions.ParticipantsGeneral populations living in regions with tropical cyclones in the nine countries or territories, 2000-19.Main outcomes measuresExcess mortality risk of cardiovascular diseases, respiratory diseases, infectious diseases, injuries, neuropsychiatric disorders, renal diseases, digestive diseases, diabetes, and neoplasms as the leading cause of death. Wind speed and rainfall profiles were quantified with a physics based tropical cyclone field model.Results14.8 million deaths and 217 tropical cyclone events in communities from the nine countries or territories were included in the analysis. Mortality risks from various causes consistently increased after tropical cyclones, with peaks occurring within the first two weeks after the cyclone, followed by a rapid decline. During the first two weeks after a tropical cyclone, the highest increases were seen in mortality from renal diseases and injuries, with a cumulative relative risk of 1.92 (95% confidence interval (CI) 1.63 to 2.26) and 1.21 (1.12 to 1.30), respectively, for each additional tropical cyclone day. Relatively more modest risks were found for mortality from diabetes (cumulative relative risk 1.15, 95% CI 1.08 to 1.21), neuropsychiatric disorders (1.12, 1.05 to 1.19), infectious diseases (1.11, 1.05 to 1.17), digestive diseases (1.06, 1.02 to 1.09), respiratory diseases (1.04, 1.00 to 1.08), cardiovascular diseases (1.02, 1.01 to 1.04), and neoplasms (1.02, 1.00 to 1.04). Mortality risks were substantially higher in communities with greater levels of deprivation and in those with historically fewer tropical cyclones, especially for renal, infectious, and digestive diseases, as well as for diabetes. Rainfall related to tropical cyclones had a more consistent increasing exposure-response relation with mortality risks, particularly for deaths related to respiratory, cardiovascular, and infectious diseases.ConclusionsAfter tropical cyclones, mortality risk increased variably for different causes, populations, and regions. Integrating epidemiological evidence into the development of management systems for climate extremes is urgently needed, particularly in regions with higher levels of deprivation and in those with historically fewer tropical cyclones. These measures are necessary to improve the adaptive capacity in responding to the growing risks and shifting activity of tropical cyclones in a warming climate.

From Atlantic hurricanes to the Indian monsoons, storms are getting worse and becoming more erratic. From Atlantic hurricanes to the Indian monsoons, storms are getting worse and becoming more erratic.

Objective: Hurricane Katrina struck the US Gulf Coast on August 29, 2005, causing unprecedented damage to numerous communities in Louisiana and Mississippi. Our objectives were to verify, document, and characterize Katrina-related mortality in Louisiana and help identify strategies to reduce mortality in future disasters. Methods: We assessed Hurricane Katrina mortality data sources received in 2007, including Louisiana and out-of-state death certificates for deaths occurring from August 27 to October 31, 2005, and the Disaster Mortuary Operational Response Team's confirmed victims' database. We calculated age-, race-, and sex-specific mortality rates for Orleans, St Bernard, and Jefferson Parishes, where 95% of Katrina victims resided and conducted stratified analyses by parish of residence to compare differences between observed proportions of victim demographic characteristics and expected values based on 2000 US Census data, using Pearson chi square and Fisher exact tests. Results: We identified 971 Katrina-related deaths in Louisiana and 15 deaths among Katrina evacuees in other states. Drowning (40%), injury and trauma (25%), and heart conditions (11%) were the major causes of death among Louisiana victims. Forty-nine percent of victims were people 75 years old and older. Fifty-three percent of victims were men; 51% were black; and 42% were white. In Orleans Parish, the mortality rate among blacks was 1.7 to 4 times higher than that among whites for all people 18 years old and older. People 75 years old and older were significantly more likely to be storm victims (P < .0001). Conclusions: Hurricane Katrina was the deadliest hurricane to strike the US Gulf Coast since 1928. Drowning was the major cause of death and people 75 years old and older were the most affected population cohort. Future disaster preparedness efforts must focus on evacuating and caring for vulnerable populations, including those in hospitals, long-term care facilities, and personal residences. Improving mortality reporting timeliness will enable response teams to provide appropriate interventions to these populations and to prepare and implement preventive measures before the next disaster. (Disaster Med Public Health Preparedness. 2008;2:215–223)