Hurricane Ian shows coastal hospitals unprepared for climate change

As rapidly intensifying storms and rising sea levels threaten coastal cities from Texas to the tip of Maine, Hurricane Ian has just demonstrated what researchers have warned: Hundreds of US hospitals are unprepared for climate change.

Hurricane Ian forced at least 16 hospitals from central to southwest Florida to evacuate patients after it made landfall near Fort Myers on Sept. 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 shut off power and water, said Mary Mayhew, president of the Florida Hospital Association, which is coordinating the needs and resources of hospitals across the state during hurricane.

About 1,000 patients in five Florida counties were evacuated from hospitals for various reasons, Mayhew said. hospital patients moving after the storm tore off part of the roof and flooded the first floor. Other hospitals were structurally undamaged but lost power and water. Broken bridges, flooded roads and a lack of clean water have all made things difficult for some hospitals, Mayhew said.

And this is before considering the need to provide assistance to victims of the hurricane and its consequences.

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

How climate change increases the intensity of hurricanes, coastal cities under the threat of rising sea levels from Miami to Charleston, South Carolina, reviewed billion-dollar storm surge protection plans — from erecting homes to creating a network of levees, locks and pumps to protect residents and infrastructure from severe flooding from storms.

Some hospitals are strengthening buildings and erecting campuses. Others are moving inland, bracing for a future when even mild storms will cause flooding that can overwhelm facilities.

“They are on the front lines of the fight against climate change and bear the costs associated with this increase weather phenomena and an increase in injuries and related illnesses,” said Emily Mediate, director of climate and health at Health Without Harm, a nonprofit that works with hospitals to prepare for climate change.

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

The study analyzed flood risk at a hospital within 10 miles of the Atlantic and Gulf coasts. In more than half of the 78 metropolitan areas analyzed, some hospitals are at risk of flooding from the weakest hurricane, a Category 1. In 25 coastal metro areas, half or more of the hospitals are at risk of flooding from a Category 2 storm with winds of up to 110 mph. Florida is home to six of the 10 highest-risk populations metropolitan areas The Miami-Fort Lauderdale-West Palm Beach region is considered to be at the highest risk of hurricanes, the study found.

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

All three hospitals in Charlotte County were closed during the storm. One emergency room reopened the next day, and two remained open by October 1.

In nearby Lee County, the state hospital system was forced to partially evacuate three of four hospitals, potentially affecting about 1,000 patients, after the facilities lost running water. A state of emergency remained in the county as of Oct. 6, with many roads and bridges closed due to flooding and damage, according to a Florida Department of Transportation traffic advisory.

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

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

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 strengthen schools, hospitals and other facilities.

“It’s about being the last resort. We are the only medical center and trauma center on this barrier island,” Santorio said.

But Bernstein said the “Fort Knox model” spends hundreds of millions of dollars on state-of-the-art hurricane– there are not enough protected hospital buildings. The strategy does not address flooded roads, patient transport ahead of the storm, medically vulnerable people in areas most at risk of flooding, emergency evacuations from hospitals or the failure of backup power sources, he said.

The call for hospitals to brace for stronger hurricanes and rising sea levels may seem extreme, especially as many are trying to recover from pandemic-related financial stress, labor shortages and fatigue, said Mediate of the group Health Care Without Harm.

“Of course, many things make it difficult for them to see that this is a problem. But on top of how many other problems?” she said.

As Hurricane Ian neared the South Carolina coastline north of Charleston on September 30, the city’s hospital district reported 6 to 12 inches of water. “It’s a lot less than expected,” Republican Gov. Henry McMaster said during a briefing.

Although Hurricane Ian was a relatively minor weather event in South Carolina, it is not uncommon for the downtown Charleston medical district to experience flooding, making it dangerous and sometimes impossible for patients, hospital staff and residents to navigate the surrounding streets .

In 2017, the Medical University of South Carolina transported doctors across its large campus by boat during severe flooding caused by Hurricane Irma. A year later, the hospital system in Charleston purchased a military truck to navigate future flood waters.

Flooding, even after heavy rain and high tide, is one of the reasons why Roper St. Francis Healthcare — one of three systems in the heart of Charleston’s medical district — has announced plans to eventually relocate Roper Hospital from 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 withstood mild flooding in one of its downtown medical buildings from Ian, but it could have been much worse, DiLisi said. He also said that downtown is no longer the geographic center of Charleston and that 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 coastal nonprofit and public hospitals chose to stay put and fortify their buildings, said Justin Sr., president of the Florida Safety Net Hospital Alliance and a former secretary of the state’s Public Health Agency. , which regulates hospitals.

“They don’t budge,” said the Elder. “They’re in a catchment area where they’re trying to catch everyone, not just the wealthy, but everyone.”

Kaiser Health News 2022.
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