With floodwaters in New Orleans leveling off, experts are turning to the massive health problems left in the wake of Hurricane Katrina and the plight of hundreds of thousands of refugees.
The situation in New Orleans "is rapidly deteriorating," said Ivor L. van Heerden, director of the Louisiana State University Hurricane Center. "The lawlessness has been spreading, and that is hampering search-and-rescue efforts."
People who are still in the city don't have any water and food and are becoming dispirited, van Heerden added. And the tens of thousands who have been evacuated, and left homeless, face a similar plight, he said.
"Right now, there are over 400,000 refugees in Baton Rouge. Most of them have very few resources, they don't have water, they don't have gasoline and their credit cards won't work," he said.
There also appears to be a large number of missing people, he added. There are more than 300,000 people who didn't leave the city, van Heerden said. Echoing what the mayor of New Orleans and Louisiana's governor have predicted, he said, "The final death toll will be substantial; it will be in the thousands."
There were widespread media reports that at the New Orleans convention center, a new haven for about 25,000 refugees, desperate people were clamoring for food and water while dead bodies, some slumped in wheelchairs or wrapped in sheets, lay in their midst.
"Some people there have not eaten or drunk water for three or four days, which is inexcusable," Joseph W. Matthews, the director of the city's Office of Emergency Preparedness, told The New York Times.
Van Heerden predicts the contamination in New Orleans is only getting worse: "There are thousands of dead bodies, a lot of dead wildlife, and a lot of contamination coming from chemical facilities, railcars and gas stations."
In addition, there is gas bubbling up from underground pipelines, the Louisiana official said. There is also increasing danger of fire, he added.
"There are parts of New Orleans where it's going to be months and months and months before people can go back," van Heerden said. "There is going to be problems of contaminated buildings, and problems with toxic molds developing in the wall spaces."
Van Heerden also believes that because people have been exposed to mosquitoes for several days, and the mosquitoes are breeding, the risk of West Nile is going to rise dramatically. So far this year in Louisiana, there have been 52 reported cases of West Nile and four deaths, according to the latest count by the U.S. Centers for Disease Control and Prevention.
One expert thinks that a variety of health dangers are a significant problem for refugees along the 90 miles of Gulf Coast that took the brunt of Monday's storm.
The first problem is access to clean, potable water, said Dr. Eric A. Weiss, an emergency medicine expert at Stanford University School of Medicine. He also noted that "people, particularly elderly people, have been displaced from their normal medical care. They need access to their medications and to physicians."
Weiss isn't concerned that there will be outbreaks of cholera or other similar diseases. "We don't have cholera here in the United States," he said. "I would expect to see outbreaks similar to what you see on cruise ships -- think of the Superdome as a large cruise ship."
In shelters where people are crammed together, infectious disease such as respiratory and viral infections spread quickly, Weiss said. "There can be mini-epidemics of viral and bacterial illnesses in these shelters," he noted.
Weiss also donwnplayed concerns about diseases from the vast number of corpses floating in the water.
"The danger is highly overrated," he said. "There is not a significant danger of disease from floating bodies."
Another health expert agreed.
Richard Garfield, an international clinical nursing professor at Columbia University in New York City, told Fox News that "people who are alive can give you a whole lot more diseases than people who are dead." Garfield helped coordinate the medical response in Indonesia following last year's devastating tsunami.
Another expert sees the raw sewage mixing in the floodwater as a potential threat to public health. This is particularly true for people who are exposed to the water, and who have open wounds or who can't wash their hands.
"While there are a lot of chemicals in the water, they probably don't rise to the level of an acute toxin," said John Pardue, director of the Louisiana Water Resources Research Institute at Louisiana State University. "Probably the biggest danger right now is the sewage."
Within the next 24 hours, Pardue plans to start sampling the water in New Orleans to determine its chemical and biological elements that could cause public health problems. People who have been in contact with the water do have a risk of getting infected, he said.
As far as the sewer system is concerned, Pardue said there were lots of leaks in the sewer system before the hurricane. The whole system was being rebuilt at the time of the storm, he added.
And for everyone caught up in what has become one of the worst natural disasters in U.S. history, mental health is a big concern.
"The days and weeks of a hurricane like this are very rough," Weiss said. "There are tremendous psychosocial ramifications. There is a high likelihood of seeing sleep disorders, anxiety, depression and other post-traumatic, stress-related illnesses."
As rescue and relocation efforts continue, agencies have been receiving donations from individuals and companies alike. For example, the Red Cross reported it had collected $21 million, almost $15 million of that from individual donations through its Web site.
And corporate donations to the relief effort could total more than $100 million, the Associated Press reported.
But more is needed: Medical supplies ranging from antibiotics to insulin to tetanus shots are desperately needed at the shelters where refugees have been sent, the wire service said.
And pharmaceutical companies plan to send what medicines are needed most as soon as they get a list from the government. Besides medications to treat infections and wounds, shelter workers also need drugs to treat chronic conditions such as high blood pressure, heart disease, diabetes and epilepsy, according to the AP. Insulin shipments are already planned.
Friday morning, the U.S. government announced that six truckloads of medical materials from the Strategic National Stockpile are headed to the hurricane-stricken areas, and 10 temporary hospitals should open at area military bases by Friday night.