While most of the follow-up attention from this month’s devastating ice storm has been focused on how long it took local utilities to get the power back on, there’s another failure that’s gone unmentioned. The storm was a public health emergency that went unrecognized far too long.

The most horrific result was the deaths of four people from carbon monoxide poisoning because they burned charcoal or propane in their homes. Hundreds more were treated at hospitals, most of them Hispanic immigrants. Before anyone died, there was a short notice in Friday’s News & Observer about 50 people being treated at WakeMed. That means people at local hospitals were aware of the problem as early as Thursday.

But no warning went out right away.

The problem isn’t limited to carbon monoxide poisoning. Indoor temperatures were low enough (in the mid to lower 40s), long enough (more than four days) for many people to start suffering the effects of hypothermia–confusion and lethargy.

Weather forecasters and emergency management personnel were well aware of the storm’s potential ahead of time. In Wake County, emergency managers had shelters ready to go, said Chris Cannady, speaking for the department. But there was no procedure in place for anticipating potential health problems and getting the word out. “No, we probably did not notify the public as far as health concerns,” he said.

In fact, it wasn’t until Friday or Saturday that Kim Gazella, Wake County’s public information director, says anyone at the county’s public health department even spoke to her.

Dr. Tom Keyserling, a professor at the UNC med school, says he’s appalled at the failure of local governments to anticipate public health concerns before the storm and quickly recognize the gravity afterward. “I don’t know why we didn’t hear anything about, ‘This is going to be a long period of potential exposure to cold,’” he said. “There was a window of opportunity to get messages out that would have made a difference.”

People could have been told that going someplace warm during the day, like a shelter or the mall, wasn’t just a matter of comfort, but an important health consideration, he said.

Gazella agrees we can do better. “There are a lot of lessons learned,” she said, particularly about finding new ways to reach immigrant populations–through the faith community and nonprofits, for instance.

The answer, Keyserling says, is an alert system during weather emergencies like others we’ve heard about recently. “For terrorism, we have all these stages, which seems pretty ridiculous.”

Keyserling suggests a system in which public health, emergency management and public information officials get health warnings to local media–particularly radio stations–that would be read at the top of the hour.

“The state has spent a lot of time to prepare itself for smallpox or anthrax or any of the other possible biological exposures,” he said, “so I know there has to be some system for that.”