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U.S. Department of Health and Human Services

Hurricane Response Playbook

2010 Hurricane Season Scenario

Threat Assessment:

National Oceanic Atmospheric Administration


14-23 Named Storms
8-14 Hurricanes
3-7 Major Hurricanes


2-3 Named Storms

Planning Assumptions:
  1. Probabilities for at least one major (category 3-4-5) hurricane landfall on each of the following coastal areas:
    1. U.S. East Coast Including Peninsula Florida - 39% (average for last century is 31%).
    2. Gulf Coast from the Florida Panhandle westward to Brownsville - 38% (average for last century is 30%).
    3. Above-average major hurricane landfall risk in the Caribbean.
    4. Increased risk of a direct strike from a hurricane/typhoon in the Federal Emergency Management Agency (FEMA) Regions I, II, III, IV, VI, and IX.
  2. A major severe weather event making landfall in the United States or its territories could overwhelm State, local, tribal, territorial (SLTT) and private sector emergency response and recovery capabilities and require the sustained deployment of Federal assets under the National Response Framework (NRF).
    1. Advance warning of severe weather from the National Weather Service could range from mere minutes to over a week.
    2. Two or more severe tropical storms or hurricanes may make landfall simultaneously or in quick succession, particularly in the Western Atlantic - US East Coast, Gulf of Mexico - US Gulf Coast, the Caribbean - Puerto Rico, and the US Virgin Islands affecting more than one FEMA Region, or other countries requesting support by the Department of State (DOS) simultaneously.
    3. The interagency Emergency Support Functions (ESF) and support annexes at the national and regional levels will be prepared to support and sustain overall federal coordinating structures established at the National Response Coordination Center (NRCC), Regional Response Coordination Centers (RRCC) and Joint Field Offices (JFO).
    4. The NRCC and appropriate RRCCs may be activated and operational as soon as the potential for a severe weather event is identified.
    5. Pre-landfall evacuations of populations along low lying areas are expected to occur with a lower threshold than in previous hurricane seasons.
    6. The public health and medical infrastructure in some locations of the Gulf Coast region remains in a state of significant compromise as a result of previous hurricane seasons.
    7. States will partner or participate in all pre-landfall actions.
    8. SLTTs will be responsible for organizing movement of patients to casualty collection points, local medical facilities, and to designated air marshalling points.
    9. Decision to evacuate medical patients must be made in adequate time for response assets to get in place. Request for Federally supported aeromedical must be made at least 96 hours before landfall. Within 24 hours of landfall, patient movement becomes hazardous. Medical evacuations (air and ground) will cease 18 hours prior to landfall and operations may resume post-landfall.
    10. Increased need to support At-risk individuals. At-risk individuals are those who, in addition to their medical needs, have other needs that may interfere with their ability to access or receive medical care. Subsets of "at-risk individuals" include those with special medical needs. Special medical needs populations are defined as those individuals, typically living in the community outside of a medical setting or environment, who need support to maintain an adequate level of health and independence during times of emergency. Included under this category are individuals who before, during, and after an emergency are medically dependent on uninterrupted electricity for therapies, require continual or intermittent medical care/support from a health care professional, or are not self-sufficient with the loss of adequate support from caregivers.
    11. The Department of Homeland Security/Federal Emergency Management Administration (DHS/FEMA) and supporting Federal departments and agencies may be required to provide national-level support to non-federal and private sector partners in response to a variety of other disasters, emergencies, and events including National Special Security Events (NSSEs), domestic and foreign terrorism, physical and cyber attacks on critical infrastructures and key resources, and national and homeland security emergencies, concurrent with preparing for and responding to a potential or actual severe weather event.
    12. Public health and medical services include responding to the mental health, behavioral health, and substance abuse needs of incident victims, response workers, and providing veterinary medical care. Health care facilities include mental health and substance abuse treatment facilities.



(Source: Department of Homeland Security, National Preparedness Guidelines,
Scenario 10: Natural Disaster – Major Hurricane; reflects organizational change)

Casualties  1,000 fatalities, 5,000 hospitalizations
Infrastructure Damage Buildings destroyed, large amounts of debris
Evacuations/Displaced Persons 1 million evacuated
150,000 seek shelter in safe areas
200,000 homes destroyed
20,000 domestic pets and service animals
Contamination From hazardous materials, in some areas
Economic Impact Billions of dollars
Potential for Multiple Events Yes, seasonal
Recovery Timeline Months to years

Scenario Overview:

General Description:

Hurricanes are intense tropical weather systems consisting of dangerous winds and torrential rains. Hurricanes often spawn tornadoes and can produce a storm surge of ocean water that can be up to 24 feet at its peak and 50 to 100 miles wide. The most destructive companion of hurricanes is the storm surge.

A typical hurricane is 400 miles in diameter and has an average forward speed of 15 miles per hour (mph) in a range of 0 to 60 mph. The average life span of a hurricane is 9 days in a range of less than 1 day to more than 12 days. Hurricanes’ highest wind speeds are 20 to 30 miles from the center. Hurricane force winds cover almost 100 miles, and gale-force winds of 40 mph or more may cover 400 miles in diameter. A fully developed hurricane may tower 10 miles into the atmosphere.

A hurricane is categorized by its sustained wind intensity on a Saffir-Simpson Hurricane Scale that is used to estimate the potential for property damage and flooding. “Major” hurricanes are placed in Categories 3, 4, or 5 with sustained wind intensities between 111 mph to greater than 155 mph. The most dangerous potential storm would be a slow-moving Category 5 hurricane, making landfall in a highly populated area.

The National Hurricane Center (NHC) provides the following description for a Category 5 hurricane:

  • Winds are greater than 155 mph (135 knots or 249 kilometers per hour [~ 155 miles]).
  • Storm surge is generally greater than 18 feet above normal.
  • Complete roof failure occurs on many residences and industrial buildings, as well as severe and extensive window and door damage.
  • Mobile homes are completely destroyed.
  • Some complete building failures occur with small utility buildings blown over or away.
  • Shrubs and trees blow down. All signs blown down.
  • Low-lying escape routes are cut by rising water 3 to 5 hours before arrival of the center of the hurricane.
  • Major damage occurs to lower floors of all structures located less than 15 feet above sea level and within 500 yards of the shoreline.
  • Massive evacuation of residential areas on low ground within 8 to 16 kilometers (5 to 10 miles) of the shoreline may be required.

In this scenario, a Category 5 hurricane hits a major metropolitan area (MMA).

Detailed Scenario:

This scenario represents a Category 5 hurricane that makes landfall at an MMA. Sustained winds are at 160 mph with a storm surge greater than 20 feet above normal. As the storm moves closer to land, massive evacuations are required. Certain low-lying escape routes are inundated by water anywhere from 5 hours before the eye of the hurricane reaches land.

Planning Considerations:

Geographical Consideration/Description –

The overall terrain of the MMA is generally low-lying land with topography ranging from flat to gently rolling hills. The coastal plain extends inland for approximately 100 miles. There are numerous bays, inlets, and rivers within the region.

Timelines/Event Dynamics –

After more than 25 inches of rainfall in the past 4 months, the MMA and the region (to include multiple States) are saturated, and rivers are at above normal levels for this time of the year.

Near the end of July, a tropical storm has developed in the Atlantic. The storm has been gaining strength as it has moved west at 10 mph. After 5 days in the open waters of the Atlantic, on August 11, the tropical storm was upgraded to a hurricane. The NHC warns that there are no steering currents that would cause this hurricane to turn away from making landfall in the continental United States. The NHC also warns that conditions are favorable for the storm to intensify over the warm Atlantic waters.

By August 15, the hurricane has steadied at dangerous Category 4 level on the Saffir-Simson Hurricane Scale and models indicate a track that includes a possible landfall along the coast adjacent to the MMA on the morning of August 17. Forecasters at the NHC are not sure whether the storm will strengthen or weaken over the next couple of days. Evacuation decisions are made difficult by this unpredictability of the storm’s future intensity. The Governor and local officials order the evacuation of tourists and people living in certain designated low-lying areas along the coast.

On August 16, the Governor and local officials have broadened their evacuation orders to include the evacuation of all citizens within 5 to 10 miles of the coast in the areas projected to be within the path of the storm. Over the 2-day period, 1 million people have been ordered to evacuate from MMA and coastal regions. Interstates and other evacuation routes are clogged with extremely heavy traffic.

On the morning of August 17, the hurricane reaches its peak with sustained winds at the inner wall of the eye of the storm recorded at 160 mph. At approximately 9:30 a.m., the eye of the hurricane makes landfall with a direct hit on the MMA and coastal resort towns. The MMA has been hit hard, with over 20 inches of rain since the afternoon of August 15. A storm surge of 20 feet has accompanied the storm. Forward movement of the storm system was slowed down by a strong high-pressure weather pattern. Outer bands of the storm still extend well into the warm waters, thus feeding its destructive center. In the afternoon, the hurricane begins losing strength over land, but continues to be an extremely dangerous and strong storm. The hurricane has spawned tornadoes that have added to its destructive power.

By August 18, the hurricane has moved out of the MMA and surrounding region, but has left a path of destruction in its wake. The storm has now been downgraded to a tropical storm with winds reduced to 60 mph near the barely discernable remnants of an eye. While the storm has weakened, the combinations of already saturated land and high -rain associated with the storm has caused rivers to overflow their banks, and several rivers systems are experiencing record flood levels.

Assumptions –

  • Many health care facilities will be unable or unwilling to pull the trigger on early evacuation 96 hours ahead of time due the potential economic impact to the facilities
  • SLTT and Federal officials have the benefit of forecasts that predict a major hurricane will make landfall at the MMA. With this information, SLTT officials have time to execute evacuation plans.
  • Evacuation routes are not available 5 hours before the storm (surge waters and rainfall block highways leading from the MMA).
  • Most of the local fire, police, and other response personnel and officials are victims of the storm and unable to coordinate immediate response resources.
  • As result of the storm surge, flooding and wind destruction, some 100,000 disaster victims are not able to immediately return to permanent housing within the MMA.
  • SLTT capabilities for triaging and treating casualties in the disaster area are overwhelmed. Most primary medical treatment facilities are damaged or inoperable.
  • The port facility is closed completely for 1 month and requires months of work to restore operations. Major airports in the MMA are closed for approximately 10 days.
  • The MMA area will be completely without electric power and potable water for the first 10 days following the disaster.
  • Food, medicine, gasoline, and other necessities that depend upon ground transportation and other infrastructures are also not readily available for the first 10 days following the disaster.
  • Communications systems – including telephones, radios, and cellular systems – are only at 90% capacity for the first week following the storm.
  • There is a 10-day disruption of sanitation/sewage services in the MMA.

Mission Areas Activated –


The NHC and the Department of Homeland Security (DHS)/Federal Emergency Management Agency (FEMA) hold numerous video teleconferences with State and Federal emergency officials and provide them with the latest forecasts. As the storm approaches, SLTT governments are given increasingly accurate forecasts and assessments of possible impacts. The path of the storm is predicted to a high degree of certainty 48 hours prior to landfall. Forecasters have difficulty predicting the intensity of the storm prior to landfall, but urge officials to prepare for the worst.

Federal and State emergency management officials pre-position initial response resources outside of the projected path of the storm.

Emergency Assessment/Diagnosis:

Infrastructure Assessments: Intergovernmental and private sector efforts are underway to assess and analyze the impacts of the disaster on national, regional, and local transportation, communications, power, and other systems. Specific assessments will be made on the condition of highways, bridges, seaports, airports, communications systems, electric grids, dams, water treatment facilities, sewage systems, etc.

Rapid Needs Assessments: Joint Federal/State teams deploy immediately after the storm has cleared to locate areas of highest need and to estimate types of resources that will be immediately required.

Remote Sensing: Remote sensing products and assessments are requested to help determine the extent of the damages.

Modeling: Models are run given the path, size, and intensity of the storm to project damage and to estimate needs.

Search and Rescue Assessment: Immediate emphasis is on assessing needs for rescuing individuals trapped in structures or stranded in floodwaters.

Health and Medical Assessments: ESF #8 has mobilized and deployed an assessment team to the disaster area to assist in determining specific health/medical needs and priorities, including individuals with special medical needs.

Navigation Assessments: The U.S. Coast Guard (USCG) has deployed teams to assess the condition of the port and navigation channels and to identify obstructions to navigation.

Public Health Emergency Management/Response:

The following is a partial list of some of the emergency management/response actions required, e.g., triage, emergency room or hospital decompression, staff augmentation and shelter support, activate/deploy IRCT and ESF#8 LNOs to manage and coordinate ESF#8 activities in the field.

Search and Rescue Operations: There is a need for locating, extricating, and providing on-site medical treatment to victims trapped in collapsed structures. Victims stranded in floodwaters must also be located and extracted.

Mortuary Services and Victim Identification: There is a need for temporary morgue facilities; victim identification by fingerprint, forensic dental, and/or forensic pathology/anthropology methods; and processing, preparation, and disposition of remains.

Medical System Support: Emergency supplemental medical assistance is needed. Transportation of patients to operating facilities is required, e.g., FEMA ambulance contract. Assistance is required to provide emergency restoration to medical facilities.

Debris Clearance and Management: Debris clearance, removal, and disposal operations are needed. Many structures will need to be demolished. Emergency garbage removal support is also required.

Temporary Emergency Power: Temporary emergency power is required at critical facilities.

Transportation Infrastructure Support: There is a need for the construction of temporary access routes in certain areas. Assistance is needed in coordinating alternate transportation services, such as mass transit systems, to temporarily replace system capacity lost to disaster damage.

Infrastructure Restoration: Support is needed to assist in the restoration of power, communications, transportation, water, wastewater treatment, and other critical infrastructure.

Temporary Roofing: There is a need for temporary roofing assistance for homes and businesses that experienced roof failures and damages.

Vector Control: Measures will need to be taken to control vectors that may thrive in the areas after a catastrophic hurricane.

Law Enforcement Assistance: Support will be required to maintain law and order and to protect private property.

Hazard Mitigation: Support will be required to coordinate the development of plans to execute mitigation efforts that lessen the effects of future disasters. This will include studies to assess flood and coastal erosion and development of intergovernmental plans to mitigate future damages.

Evacuation/Shelter: SLTTs have time to execute evacuation plans. Roads leading from the MMA are overwhelmed, and massive traffic jams hinder the evacuation efforts. Measures will need to be taken to provide for temporary shelter and interim housing. Permanent housing support will also be required.

Veterinary Services: Veterinary services will be required to address veterinary medical and public health needs.

Victim Care -

Medical Assistance: There is a need for emergency medical assistance, which includes health surveillance; medical care personnel; health and medical equipment and supplies; patient movement; in-hospital care; food, drug, and medical device safety; worker health and safety; radiological, chemical, and biological hazards consultation; mental health care; and public health information.

Emergency Food, Water, and Ice: Disaster victims will require assistance in obtaining emergency food, water, and ice.

Sanitary Facilities: Portable/temporary and accessible sanitary facilities will be required to support disaster victims (to include portable toilets and showers).

Protection from Health and Safety Hazards: Support will be required to test and analyze health and safety hazards and implement measures to protect the public.

Recovery/Remediation: Hazardous materials will contaminate many areas, and decontamination and site restoration will be a major challenge.

Implications: The occurrence of a major hurricane in the MMA has caused significant numbers of deaths and injuries, has displaced thousands of people, has caused billions of dollars of property damage, and has greatly impacted the capability SLTT governments to provide the needed response.

Secondary Hazards/Events –

Tornadoes: In addition to the massive destruction caused by the hurricane itself, there are also areas within the MMA and scattered inland areas that have sustained severe damage from tornadoes that were generated by the storm.

Coastal and Inland Flooding: Storm surges and heavy rains have caused catastrophic flooding to low lying areas of the MMA. Rainfall from the hurricane, in combination with earlier storms, causes significant flooding in multiple States along the coast.

Fatalities/Injuries: The catastrophic hurricane has resulted in more than 1,000 fatalities, and 5,000 thousand people have sustained injuries requiring professional treatment. Additionally, carcasses of numerous companion animals, livestock, and wildlife are observed.

Evacuations: Coastal areas adjacent to the MMA were in the midst of a busy summer tourist season, with hotels and seasonal homes filled to near capacity. Tourists and residents in low-lying areas were ordered to evacuate 48 hours prior to projected landfall. Twenty-four hours prior to predicted landfall, officials warned Federal and SLTT officials that the storm could make landfall as a Category 5 storm and that appropriate protective measures for this level storm should be taken. Massive evacuations have been ordered, and evacuation routes have been overwhelmed. As the storm approaches, evacuation routes become inundated or blocked by debris, and evacuation is no longer an option for many of those who waited for the storm to come closer.

Potential Impact on Facilities and Systems –

Flooding: Major portions of the MMA were completely submerged during the height of the storm. Low lying areas within a multi-State area are experiencing floods associated with the record amounts of rainfall associated with the storm.

Structural Damage: Structures in the low-lying areas were inundated when storm surges were at their peak. Many older facilities suffered structural collapse due to the swift influx of water and degradation of the supporting structural base. Newer facilities and structures survived the influx of water, but sustain heavy damage to contents on the lower levels.

Debris: Most all shrubbery and trees within the storm’s path have been damaged or destroyed, generating massive amounts of debris. This debris is interfering with transportation systems, and there is concern that the debris could become a health, fire, and safety hazard if not addressed in a timely manner. Debris has also been generated from structures destroyed from tornadoes and structures that have been destroyed or damaged by the hurricane. Many structures will need to be demolished.

Shelters: Shelters throughout the region, including co-located shelters for household pets are also filled to capacity. Many of the designated shelters within the path of the storm have been damaged and can no longer provide adequate accommodations for disaster victims.

Search and Rescue: The hurricane and the associated flood and surge waters have trapped hundreds of people in flooded areas. A few individuals have been trapped within destroyed and collapsed structures. Some of the individuals with disabilities may be accompanied by their service animals; many others have domestic pets which provide daily companionship and emotional/psychological support. Flooding associated with the storm has forced many to seek refuge on rooftops, bridges, and other high areas, and these individuals require transportation to safe haven. Until debris is cleared, rescue operations are difficult because much of the area is reachable only by helicopters and boats.

Water, Food, and Ice: All areas are in serious need of drinking water, as water treatment plants have been damaged and are without power. Food is in short supply, since roads are impassable and many of the grocery stores and restaurants sustained damage and are not open. Refrigeration is not available, and there is a large demand for ice to keep food from spoiling.

Sanitation Systems: Sewage treatment plants in the region have been flooded and sustained damaged from the storm. It is estimated that the systems will be down for about 10 days.

Homelessness: The hurricane has destroyed and damaged many structures in the path of the highest winds and has left thousands of people homeless. Mobile homes and many small buildings have been completely destroyed. Roofs, windows, and doors of many residences have experienced failure and/or damage. Structures in areas less than 15 feet above sea level and within 500 yards of the shoreline have received flood damage and destruction.

Power: Wind and downed trees have damaged nearly all of the electric transmission lines within the MMA. Power companies are completely overwhelmed and are predicting that it will up to 2 months to provide power to large portions of the service area.

Disease and Illness: Standing water, septic conditions, and vector-transmitted diseases threaten public health. Contaminated water and food has caused illnesses. There is concern that outbreaks of mosquito-borne diseases will be a problem in the future.

Environmental/Health Impacts from Hazardous Materials: Flooded and damaged factories, chemical plants, petrochemical, sewage treatment plants and other facilities in the MMA have suffered severe damage. These facilities threaten the health of citizens, create a hazardous operating environment, and require cleanup and remediation. Hundreds of thousands of gallons of extremely hazardous substances have spilled into the floodwaters, causing an immediate health and environmental risk to victims and responders alike. Flooding waters also contain chemicals and waste from ruined septic systems, businesses, and homes. There is also gasoline, diesel fuel, and oil leaking from underground storage tanks. During the height of the storm, a 95,000-ton tanker was blown off course and struck a bridge, breaching the hull of the vessel, which then began to leak oil into waters adjacent to the MMA.

Business Impacts: Many businesses have experienced damage to buildings and infrastructure. Businesses located less than 15 feet above sea level and within 500 yards of the shoreline have received flooding related damage and destruction. Roofs, windows, and doors of many businesses have failed. Businesses also have been impacted by the lack of infrastructure support and services (transportation, communications, water, electricity, etc.). Many businesses have lost employees and customers as segments of the population have relocated to alternative housing in other areas outside of the MMA.

Military Facilities: Military facilities (naval bases, air force base facilities, army, etc.) in the path of the hurricane are damaged, and assistance is needed to provide for the military community and to reconstitute the facilities.

Flood/Hurricane Protection Works: The 20-foot storm surge has breached and overtopped flood control and hurricane protection works.

Transportation – Highways, Mass Transit, Bridges, Railroads, Airports: Major access roads into the metro area were damaged by floodwaters or are impassable due to the large amounts of debris. Mass transit systems, to include subways, are in disrepair and are lacking power. Railroads and seaports into the metro area are closed due to debris and damage to infrastructure. The major airports are damaged and runways are blocked with debris. A large barge struck and caused severe damage a major bridge that services the MMA. Other bridges that connect from the mainland to coastal resort areas have sustained significant damage.

Port Facility: The port has been adversely affected in its capacity to provide export/import and loading/unloading capabilities. Navigation structures have been temporarily closed and there have been slowdowns in the delivery of goods vital to the economy of the United States. Channel dredging projects will require immediate surveys to assess dredging requirements to restore the channels. There are numerous sunken vessels and other obstructions blocking navigation channels.

Medical Services: Many hospitals and health care services e.g., pharmacies, dialysis units, oncology centers have sustained severe damage and those that are open are overcrowded with at-risk individuals and family members. Backup generators are running out of fuel and hospital officials are searching for alternative locations for patients in need of care. There is a need to transport at-risk individuals with special medical needs to the closest appropriate hospital or other healthcare facility.

Communications Systems: Due to damage and lack of power, communications systems – including telephones, radios, and cellular systems – are only at 90% capacity for the first week following the storm.

Schools/Education Systems: Damage to schools within the MMA is high. Many windows have been blown out or damaged by flying debris. Roof conditions vary, with some schools having lost roofs completely and others having received significant damage. Schools that are not severely damaged are being used as shelters for the disaster victims.

Animals: Thousands of pets, domesticated animals, and wild animals have been displaced, injured or killed. Pets are of particular concern, and the Federal Emergency Management Agency (FEMA) - Emergency Support Function (ESF) #6 and state animal response teams have reported a high volume of requests for additional resources to meet the pet sheltering and pet-owner reunification resource needs. FEMA and ESF#11 (United States Department of Agriculture (USDA)) officials estimated that 20,000 cows, pigs, and horses have died in flooded rural areas in the region. Triage of carcass disposal is a major concern.

Economic Impact –

There are severe economic repercussions for the whole State and region. The impact of closing the port has national implications. The loss of the petro-chemical supplies could raise prices and increase demand on foreign sources.

Long-Term Health and Social Impacts Issues –

The long-term health issues depend on victims’ exposure to toxic chemicals and disease. Long-term environmental issues involve decisions about future land use. Survivors’ exposure to traumatic events may result in long-term mental health services stemming from the disaster due to loss of routine services and resources.

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  • This page last reviewed: February 14, 2012