Resort facilities

Ian challenges the hospitals; storm shows facilities ‘what we need to fix’

Daniel Chang and Lauren Sausser Kaiser Health News

As rapidly escalating storms and rising sea levels threaten coastal towns from Texas to the tip of Maine, Hurricane Ian has just demonstrated what researchers have warned: Hundreds of hospitals in the United States are not ready for climate change.

Hurricane Ian forced at least 16 hospitals in central to southwest Florida to evacuate patients after making landfall near the city of Fort Myers on September 28 as a deadly Category 4 storm.

Some moved their patients ahead of the storm while others ordered full or partial evacuations after the hurricane damaged their buildings or knocked out electricity and running water, said Mary Mayhew, president of Florida Hospital. Association, which coordinates the needs and resources of hospitals across the state during a hurricane. .

About 1,000 patients in five Florida counties have been evacuated from hospitals for different reasons, said Mayhew, a hospital moving patients after the storm tore through part of its roof and flooded the main floor. Other hospitals emerged without structural damage but lost electricity and running water. Broken bridges, flooded roads and a lack of clean water have added to the challenge for some hospitals, Mayhew said.

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And that’s before considering the need to help those injured by the hurricane and its consequences.

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“Climate shocks like hurricanes show us in the most painful way what we need to fix,” said Aaron Bernstein, acting director of the Center for Climate, Health, and the Global Environment, known as C-CHANGE. , at Harvard TH Chan School. of Public Health.

As climate change increases hurricane intensity, coastal cities threatened by rising sea levels from Miami to Charleston, South Carolina, have considered billion dollar storm surge protection plans. dollars – from raising homes to creating a network of levees, sluice gates and pumps to protect residents and infrastructure from powerful flooding caused by storms.

Some hospitals fortify buildings and raise campuses. Others are moving inland, as they prepare for a future where even weak storms will trigger flooding that could overwhelm facilities.

“They are on the front lines of climate change, bearing the costs of these heightened weather events and the increase in injuries and illnesses that come with them,” said Emily Mediate, U.S. director of climate and health for Health Care Without. Harm, a nonprofit that works with hospitals to prepare for climate change.

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Yet even as hospitals prepare for extreme weather, Bernstein and a team of Harvard researchers predicted in a recent study that many facilities along the Atlantic and Gulf coasts will face a series of problems, even in milder weather events.

The study analyzed flood risk for hospitals within a 10-mile radius of the Atlantic and Gulf coasts. In more than half of the 78 metro areas analyzed, some hospitals are at risk of flooding from the weakest hurricane, a Category 1 hurricane. In 25 coastal metro areas, half or more of hospitals are at risk of flooding from a Category 2 storm, which would pack winds of up to 110 mph. Florida is home to six of the 10 highest-risk metropolitan areas identified in the study, with the Miami-Fort Lauderdale-West Palm Beach area ranked as having the highest risk of hurricane impact.

The researchers also considered the risk of road flooding within one mile of coastal hospitals during a Category 2 hurricane. This happened on the west coast of Florida, where Hurricane Ian’s maximum sustained winds of 150 mph contributed to flooded roads and washed out bridges.

All three Charlotte County hospitals were closed during the storm. One reopened its emergency room the following day and two were operational on October 1.

In neighboring Lee County, the public hospital system was forced to partially evacuate three of its four hospitals, potentially affecting around 1,000 patients, after facilities lost running water. As of Oct. 6, the county remains under a state of emergency with many roads and bridges closed due to flooding and damage, according to traffic reports from the Florida Department of Transportation.

Several waterfront Florida hospitals have moved essential electrical systems and other critical operations above ground level, raised their parking lots and buildings, and erected water barriers around their campuses, including including Tampa General Hospital, which has the only trauma center in the Midwest. Florida.

Miami Beach is a barrier island where the roads are flooded on sunny days during extremely high tides. Building to withstand hurricanes and flooding is a priority for institutions, said Gino Santorio, CEO of Mount Sinai Medical Center, which sits on the edge of Biscayne Bay.

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Over the past decade, Mount Sinai has completed nearly $62 million in hurricane and flood protection projects. The projects were part of a countywide strategy funded by the Federal Emergency Management Agency and state and local governments to fortify schools, hospitals and other institutions.

“It’s really about being the facility of last resort. We’re the only medical center and emergency room on this barrier island,” Santorio said.

But Bernstein said the “Fort Knox model” of spending hundreds of millions of dollars on state-of-the-art hurricane-proof hospital buildings is not enough. This strategy does not address flooded roads, transporting patients ahead of a storm, medically vulnerable people in areas most at risk of flooding, emergency hospital evacuations, or failure of backup power sources. , did he declare.

Urging hospitals to fortify themselves for more severe hurricanes and rising sea levels can feel overwhelming, especially when many are struggling to recover from pandemic-related financial stress, labor shortages and fatigue, said Mediate, of the group Health Care Without Harm.

“A lot of things make it hard for them to see that it’s a problem, of course. But besides how many other problems?” she says.

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As Hurricane Ian approached the South Carolina coast north of Charleston on Sept. 30, the city’s low-lying Hospital District reported about 6 to 12 inches of water. “It’s a lot less than expected,” Republican Gov. Henry McMaster said at a press briefing.

Although Hurricane Ian was a relatively minor weather event in South Carolina, it is not unusual for Charleston’s downtown medical district to experience flooding, making it dangerous and, at times, impossible for patients, hospital workers and townspeople navigate the surrounding streets.

In 2017, the Medical University of South Carolina ferried doctors across its sprawling campus on johnboats during severe flooding from Hurricane Irma. A year later, the Charleston-based hospital system purchased a military truck to navigate future floodwaters.

Flooding, even after heavy rains and a high tide, is one reason Roper St. Francis Healthcare — one of three systems in Charleston’s Downtown Medical District — announced plans to move to term Roper Hospital off the Charleston Peninsula after operating there for more than 150 years.

“It can be very difficult for people to get in and out of here,” said Dr. Jeffrey DiLisi, CEO of Roper St. Francis.

The hospital system suffered mild flooding at one of its medical office buildings in downtown Ian, but it could have been much worse, DiLisi said. He also said the downtown district is no longer the geographic center of Charleston, and many patients say it’s inconvenient to get there.

“The further inland you go, the less likely you are to have some of these problems,” he said.

Unlike Roper St. Francis, most nonprofit and public coastal hospitals have chosen to stay on site and reinforce their buildings, said Justin Senior, president of the Safety Net Hospital Alliance of Florida and former secretary of the ‘State Agency for Health Care Administration. , which regulates hospitals.

“They’re not going to move,” Senior said. “They’re in a catchment area where they’re trying to catch everyone, not just the rich but everyone.”