With the death toll expected to rise and health concerns on the horizon, the Bahamas are in full emergency response mode, as the U.S. east coast prepares for another round of storms and related transportation and supply problems.

Update: The Bahamas

On Sept. 1, the Bahamas were hit with Hurricane Dorian in the form of a Category 5 storm – the strongest ever to hit the area, with winds of 185 mph and gusts of 220 mph. As of this writing, the death toll is at 20, but expected to rise as emergency search and rescue operations continue.

The United Nations estimates that over 60,000 residents – particularly those on the hardest hit islands of Grand Bahama and Great Abaco – are in immediate need for food and clean water. Healthcare facilities are among the infrastructure devastated by the hurricane, and road access to those facilities still in operations have been blocked by high water levels.

This has led to mid- and long-term concerns that the Bahamas could face subsequent public health crises, as communicable diseases can thrive in areas with inadequate sanitation and water treatment following the storm – including cholera, dysentery, and hepatitis A. Dengue fever is also a possibility, both because standing water is a breeding ground for mosquitoes and because the Bahamas have dealt with outbreaks in the recent past.

Update: Supplies and Preparedness in the U.S.

Dorian is expected to impact the southeastern U.S. and up the coastline at a lower severity than the Category 5 storm levels that hit the Bahamas, but evacuations are already underway for approximately 360,000 South Carolinians, while power has been knocked out for nearly 200,000 customers in South Carolina, along with 9,000 in North Carolina and 7,000 in Georgia.

Transportation and supply chain services have already been disrupted, as UPS alerted customers that service will cease in evacuation zones in Florida, Georgia, and the Carolinas. Earlier in the week, multiple ports closed down in Florida, Georgia, and South Carolina, while gas trucks in Florida received police escorts to keep fuel flowing and freight moving.

Commercially, southeastern retailers expect the usual emergency grocery and supply surges, but consumer spending (generally related to back-to-school needs) could take a hit by as much as $1.5 billion. However, Paul Walsh, director of consumer weather strategy at IBM, told CNBC that retailers are getting better at preparing for storms, developing flexibility with their supply chains and anticipating stock needs:

“Retailers are increasingly using data and weather data to understand what the forecast means as it relates to consumer behavior, and they can better execute against that.”