Hurricane Ian’s invisible toll: At least 41 cases of carbon monoxide poisoning confirmed

As the winds died and floods receded, a new, invisible threat was emerging in Hurricane Ian’s wake: carbon monoxide.

The odorless, tasteless gas — often a dangerous consequence of misusing a generator — poisoned 41 people in the first two weeks after Ian’s landfall, according to data provided by the Florida Department of Health. Officials are linking the confirmed cases directly to the storm, meaning most poisonings likely stemmed from unsafe generator use during a power outage.

In Fort Myers, the first carbon monoxide call rang out to responders at 11 a.m. the day after landfall. A resident had their generator running outside, but it still was too close to their home, said Todd Poland, the division chief of training and special operations at the Fort Myers Fire Department. Dangerous amounts of gas began to accumulate.

Over the next 48 hours, the city’s fire department would field two more calls, Poland said. Both were because of generator misuse, and both were flagged by functioning carbon monoxide detectors.

“The worst-case scenario would have happened if they didn’t have those monitors,” Poland said in an interview. “Somebody could have gotten sick — or worse.”

There are currently no confirmed deaths linked to the gas, said Jae Williams, assistant press secretary for the state health department. But he noted that detecting carbon monoxide poisoning as a cause of death requires a full autopsy and can take time. Local health officials in Lee and Polk counties, which make up nearly half of the state’s cases after the storm, both say there are no verified poisoning deaths.

The Ian-related cases make up nearly a quarter of Florida’s poisonings this year, data shows. There were 36 calls about carbon monoxide made to Florida’s Poison Control Centers in the first two weeks after Ian’s landfall, said Jemima Dougé, a healthcare education specialist at the Florida Poison Information Center in Tampa.

“The tragic carbon monoxide poisoning incidents following Hurricane Ian underscore the importance of knowing how to safely use portable generators as well as the need for working carbon monoxide alarms in every home,” Nicolette Nye, a spokesperson for the U.S. Consumer Product Safety Commission, said in a statement. “Poisoning from portable generators is preventable.”

In Lee County, where most customers were without power for days after the storm, at least 12 people were confirmed to have experienced carbon monoxide poisoning, according to data from the state health department’s office there. Every confirmed case there was “associated with incorrect use of generators during power outages caused by Hurricane Ian,” spokesperson Tammy Soliz said.

Palm Beach County had the second-most cases with nine; Polk County had seven; and Hillsborough had six, state data shows. At least six cases were in children younger than 5, and six more cases involved people 70 or older.

One portable, gasoline-powered generator can emit as much carbon monoxide as hundreds of cars, Nye said. That’s why it’s recommended that all gas-powered or charcoal-burning equipment be used only outdoors during a power outage and are placed at least 20 feet away from buildings’ doors, vents windows or air intakes.

The highly poisonous gas can cause abdominal pain, vomiting, confusion, lack of coordination, impaired vision, loss of consciousness and death. At least 85 people die in the U.S. each year from exposure, Nye said.

After a “power loss” storm, carbon monoxide exposures usually unfold after about two days, according to Kelly Johnson-Arbor, the interim executive director of the National Capital Poison Center. The reasons for the delay may relate to people acting out of desperation when the power is not restored after several days.

“In the current era, when many of our daily activities involve use of cell phones and computerized devices, we need power. When the power is no longer available, we sometimes resort to desperate measures,” Johnson-Arbor wrote in an email. “Public health departments need to remind the public of the risks of carbon monoxide poisoning well before storms occur; once the power goes out, it’s much harder to get the word out on TV or radio.”

Florida’s health department claims it did just that: Targeted social media advertisements on how to avoid carbon monoxide poisoning were broadcast across 14 counties and garnered 500,000 impressions during the first week of October, said Weesam Khoury, the department’s deputy chief of staff. Advisories also were aired on public radio stations in Tampa, Fort Myers and Orlando.

The State Fire Marshal’s Office began handing out carbon monoxide alarms nine days after the storm passed, according to spokesperson Ryan Walker. In all, 20,000 were distributed, including at disaster recovery areas in Port Charlotte and Fort Myers and among local fire departments.

“Carbon monoxide alarms are the first line of defense against carbon monoxide poisoning,” Nye said. “They can save your life.”

How does Ian’s trail of carbon monoxide compare to past storms?

Every hurricane is different when it comes to carbon monoxide exposure, Williams said. Hurricane Michael, for instance, was a menacing Category 5 storm that forever changed the landscape of Florida’s Panhandle. But for all its destruction, there were only two confirmed cases of carbon monoxide poisoning. There’s no need to use a generator when there’s no more house to power.

Compare that to Hurricane Irma in 2017, which buzz-sawed the state and knocked out power for more than 6 million electricity customers. All told, Irma left 539 carbon monoxide cases in its wake, Florida Department of Health data show. No two storms produce the same results.

“It’s like comparing an apple to an orange to a banana,” Williams said.

What you can do to stay safe

About 7,000 electricity customers remained without power in Lee County as of Friday morning, a map of the most recent outages shows.

Health officials recommend never using a generator indoors, including in homes or garages, according to a notice from the Florida Department of Health office in Hillsborough County. Equipment that uses gas or charcoal should only be used outside — at least 20 feet away from doors and windows. Opening doors or windows won’t help to prevent gas buildup indoors.

If you plan to buy a generator in the future, the U.S. Consumer Product Safety Commission recommends models that shut off automatically when high levels of carbon monoxide are detected, Nye said. The commission suggests having a working battery-operated carbon monoxide alarm, especially outside sleeping areas. Alarms should be tested frequently.

If you feel sick, weak or dizzy, seek fresh air immediately. If you think you have carbon monoxide poisoning, call 911 or the Florida Poison Information Center at 800-222-1222, according to the health department.

“Carbon monoxide poisoning, especially occurring after storms, is almost entirely preventable,” Johnson-Arbor said. “Prevention should start well before the storm.”