Hurricane Michael shows extreme planning may be key to protect medical care

mike-225x300As Florida, Georgia, and the Carolinas struggle with Hurricane Michael’s devastation and slow-rising death toll, hospitals, nursing homes, and other caregiving facilities across the country may need to reexamine their disaster planning, paying heightened attention to extreme and worst-case scenarios.

Although doctors, nurses, and other medical personnel deserve great credit, as always, for their courage and fortitude in helping the sick and injured, the New York Times reported that, even with disaster plans in place, care-giving facilities got caught short by the latest powerful hurricane:

As Michael bore down and then passed, some hospitals in the region closed entirely, and others evacuated their patients, but kept staff in place to run overwhelmed emergency rooms. In Florida, four hospitals and 11 nursing facilities were closed, according to the Federal Emergency Management Agency. Panama City has five hospitals, according to the Florida Health Association. Bay Medical, with 323 beds, and Gulf Coast Regional Medical Center, with 238, are the biggest. Florida officials also said food and supplies were being dropped in by air to the state’s mental hospital in Chattahoochee, which is cut off by land. The mental hospital has a section that houses the criminally insane, but the facility itself has not been breached, officials said. Gov. Nathan Deal of Georgia said 35 hospitals or nursing homes in that state were without electricity and operating with generators. Federal health officials said they were moving approximately 400 medical and public health responders into affected areas, including six disaster teams that can set up medical operations outdoors. Some were heading to an overwhelmed emergency department in Tallahassee. Other federal medical personnel were being assigned to search-and-rescue teams to triage people who were rescued. University of Florida Health Shands Hospital sent ambulances and four helicopters to assist in rescue efforts, transporting patients out of Panhandle hospitals.

As search, rescue, and recovery efforts increase, Hurricane Michael’s toll likely will become clearer, including the storm’s effects on nursing homes, which have been hammered in other hurricanes and have been faulted for insufficient storm preparation that led to residents’ deaths. Frantic families have said they are struggling to get information on loved ones in nursing homes, with power and telephone services down in swaths of Florida, Alabama, Georgia, and the Carolinas.

The Tampa Bay Times reported that, in Florida’s Panhandle, geography is challenging officials seeking to help storm victims:

Thousands of people have been informally reported missing to local authorities, the Red Cross and the state, as people look for their friends and relatives. The Panhandle is largely populated by small towns, spread out across dense, forested areas, which has only worsened more post-disaster communications problems when cell phone towers and internet services go out. Locating people was a top priority for emergency crews …

For smaller community hospitals in the hurricane’s path, “sheltering in place” became the prime option for patients, families, and dedicated staff who struggled to care for them and to provide needed emergency services. But the storm savaged at least two hospitals, so much that they have been forced now to evacuate patients. Florida officials say other facilities also are moving out patients because they can’t be sure they will have the power, water, and other basic and essential services, so they can care for any but emergency cases.

The storm’s isolation of Florida’s state mental hospital — fueled by some erroneous but quickly corrected early reports — may raise new concerns about disaster situations and the handling of psychiatric patients and those incarcerated. Sheriffs deputies in South Carolina are under fire over the deaths a month ago during Hurricane Florence of two women whom the officers were transporting to mental health facilities for involuntary commitment.

In my practice, I see not only the harms that patients suffer while seeking medical services but also their struggles to access and afford safe, efficient, and even excellent medical care in even the best of times. Hospitals play an imperfect but critical role in the delivery of care that sustains, changes, and saves lives. It can’t be said enough how we should praise and support the front-line work of doctors, nurses, medical staff, and hospitals and other care-giving facilities during man-made and nature-caused calamities, which medical services have borne the brunt of in recent days — in wildfires, floods, hurricanes, and tragedies like mass shootings.

At the same time, we need to think about and to plan even more for extreme circumstances, especially with basic and critical needs like medical services. Our policy- and law-makers need sound research and excellent data and rigorous modeling so Americans suffer and die less in dire situations, whether they’re due to climate change or gun violence or actions by terrorists or other nefarious actors. Real science matters. Our leaders can’t stoop to petty politicking in place of rigorous study of what’s going right and wrong with how the nation deals with disasters. Scenario planning like this might once have seemed the province of outlying naysayers but reality seems to be making our calamities exponentially more severe by the day.

Patrick Malone & Associates, P.C. listed in Best Lawyers Rated by Super Lawyers Patrick A. Malone
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