Flooding in hospitals located in hurricane risk coastal communities will see deaths

Hurricane Ian 'We've never seen a flood event like this,' Florida governor says;  Ian a deadly, 'life-changing' storm, Lee County sheriff says.

St. Augustine, Florida on Thursday.Credit...September 29, (Nicole Craine for The New York Times)

(AP) - Thousands of people were evacuated from nursing homes and hospitals across Florida on Thursday even as winds and water from Hurricane Ian began receding. Hundreds of those evacuations were taking place across the hard-hit Fort Myers region, where damage cut off potable water to at least nine hospitals.

Kristen Knapp of the Florida Health Care Association says 43 nursing homes evacuated about 3,400 residents as of Thursday morning, mostly in southwest Florida.

As many as 20 facilities had reported electricity outages, but Knapp says generators are powering those buildings. Water was shut off at some facilities, too. And one area hospital began assessing the full damage from ferocious winds that tore away parts of its roof and swamped its emergency room.

Fort Myers Beach, Florida after Hurricane Ian

AP - Authorities transport a person out of the Avante nursing home in the aftermath of Hurricane Ian, Thursday, Sept. 29, 2022, in Orlando, Fla. Hurricane Ian carved a path of destruction across Florida, trapping people in flooded homes, cutting off the only bridge to a barrier island, destroying a historic waterfront pier and knocking out power to 2.5 million people as it dumped rain over a huge area.

Even as the problem was too much water in much of the state, at least nine hospitals in southwest Florida had the opposite problem.

“We have one large health system in southwest Florida that is without water in all of their facilities. And so they are fast approaching a point where they will not be able to safely take care of their patients. So that is an urgent focus to get those patients transferred,” said Mary Mayhew, the president of the Florida Hospital Association.  Mayhew said more 1,200 patients were being evacuated.

Reported by Molly Gamble:  A study published as Hurricane Ian made its way through Florida found that at least 50 percent of hospitals in 25 metropolitan areas along the Atlantic and Gulf coasts are at risk of flooding from a Category 2 hurricane. 

The study, from the Harvard T.H. Chan School of Public Health in Boston, is the first to systematically investigate hospitals' flooding risk from storms in Categories 1 to 4. It was published Sept. 29, one day after Hurricane Ian made landfall along the southwestern coast of Florida as a Category 4 storm. 

Researchers identified 682 acute care hospitals in 78 metropolitan areas located within 10 miles of the Atlantic and Gulf coasts, covering a population just under 85 million people — about a quarter of Americans. The vulnerability of each metro area to hurricane-induced disruptions in healthcare delivery was determined by both how far inland storm surge reaches and the likelihood that a hurricane strike occurs in the metro area.

Water gushed down Wednesday from above onto the ICU, forcing staff to evacuate the hospital's sickest patients — some of them on ventilators — to other floors. Staff members resorted to towels and plastic bins to try to mop up the sodden mess.

In 25 metro areas, half or more of the hospitals are at risk of flooding from a Category 2 storm. Just over one-half of all MSAs are predicted to contain flooded hospitals if struck by a Category 1 storm. An estimated 147 hospitals with 41,493 beds may be at risk of inundation from a Category 1 storm; 306 hospitals with 84,842 beds may be at risk of flooding with a Category 4 storm. 

The study accounted not only for hospitals' brick-and-mortar infrastructure, but for access to facilities. In 18 metro areas, at least half of the roads within 1 mile of hospitals were at risk of flooding from a Category 2 storm. 

Risk of flooding increases exponentially for certain metro areas when accounting for forecasted rises in sea level this century, with the Baton Rouge, La.; Virginia Beach, Va.; Corpus Christi, Texas; Philadelphia; and Boston metro areas facing increases greater than 90 percent to the number of beds at risk of flooding from a Category 2 storm. Overall, the sea level rise expected within this century from climate change increases the odds of hospital flooding by 22 percent, the study found. 

The 10 metro areas where a Category 2 hurricane threatens access to hospital care most are listed below, along with the number and proportion of hospitals at risk in each area.

• Miami-Fort Lauderdale-West Palm Beach — Fla. (38, or 77.6 percent of hospitals)
• New York-Newark-Jersey City — N.Y., N.J., Pa. (25, or 19.5 percent of hospitals) 
• Boston-Cambridge-Newton — Mass., N.H. (6, or 15 percent of hospitals) 
• Orlando-Kissimmee-Sanford — Fla. (1, or 33.3 percent of hospitals)
• New Orleans-Metairie — La. (15, or 78.9 percent of hospitals)
• Tampa-St. Petersburg-Clearwater — Fla. (8, or 28.6 percent of hospitals)
• North Port-Sarasota-Bradenton — Fla. (6, or 85.7 percent of hospitals) 
• Jacksonville — Fla. (6, or 42.9 percent of hospitals)
• Cape Coral-Fort Myers — Fla. (4, or 80 percent of hospitals) 
• Philadelphia-Camden-Wilmington — Pa., N.J., Del., Md. (5, or 10 percent of hospitals)

"We now have a better sense of which hospitals are likely to flood from a hurricane today and those that need to prepare for greater risks in the future," said senior author Aaron Bernstein, MD, interim director of the Center for Climate, Health, and the Global Environment at Harvard T. H. Chan School of Public Health. "Hurricanes are expected to get more severe and may strike regions further north than in the past due to climate change. In places like my hometown of Boston, we can avoid crises that other hospitals have had to endure by learning from their experience and creating plans that build on best practices. But we must act now, before disaster strikes." * ??  (FYI the "disaster" has already happened and there is a great risk for seeing it happen again!)

* Check out "Five Days at Memorial: Life and Death in a Storm-Ravaged Hospital" (ALA Notable Books for Adults)

Coastal community hospitals will see deaths resulting from hurricane flooding and there is very little (probably none) back up plan to prevent patient deaths caused by loss of power and water.