Hurricane Ian shows that coastal hospitals are unprepared for climate change

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

Hurricane Ian forced at least 16 hospitals in central and southwest Florida to evacuate patients after it struck near Fort Myers on Sept. 28 as a deadly Category 4 storm.

Some evacuated their patients before the storm and others ordered full or partial evacuations after the hurricane damaged their buildings or knocked out power and running water, said Mary Mayhew, president of the Florida Hospital Association, which coordinates needs and resources among hospitals statewide during hurricanes. by doing .

About 1,000 patients were evacuated from hospitals across five Florida counties for various reasons, Mayhew said, including after the storm tore off part of a hospital’s roof and flooded the ground floor. Other hospitals emerged with no structural damage but lost power and running water. Broken bridges, flooded roads and a lack of clean water added to the challenges for some hospitals, Mayhew said.

And that’s before considering the need to help the victims of the hurricane and its aftermath.

“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 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 — from elevating homes to building networks of seawalls, floodgates and pumps. Residents and infrastructure against strong flooding from storms.

Some hospitals are strengthening buildings and improving campuses. Others are moving inland, as they prepare for a future when even weak storms could bring flooding that could overwhelm facilities.

“They are on the front lines of climate change, bearing the costs of these increased weather events as well as the increases in injury and disease that come with them,” said Emily Mediat, director of US Climate and Health Care Without Harm. Nonprofit that works with hospitals to prepare for climate change.

Even as hospitals prepare for extreme weather, a recent study by Bernstein and a team of Harvard researchers predicts that many facilities along the Atlantic and Gulf coasts will face problems, even from mild weather events.

The study analyzed the flood risk of hospitals within 10 miles of the Atlantic and Gulf coastlines. In more than half of the 78 metropolitan areas analyzed, some hospitals are at risk of flooding from storm surges 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. Winds will reach 110 mph. Home to six of the 10 most vulnerable metropolitan areas identified in the Florida study, the Miami-Fort Lauderdale-West Palm Beach region ranked as the greatest risk of hurricane impact.

The researchers considered the risk of flooding for streets within 1 mile of a coastal hospital during a Category 2 hurricane. That’s what happened on Florida’s west coast, where Hurricane Ian’s maximum winds of 150 mph contributed to flooded roads and washed away bridges.

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

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

Several Florida hospitals located on waterfront properties have moved their essential electrical systems and other critical operations above ground level, elevated their parking lots and buildings, and built water barriers around their campuses, including Tampa General Hospital, whose west-central only trauma There is a center. Florida.

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

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 institutions.

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

But Bernstein said the “Fort Knox model” of spending millions of dollars on state-of-the-art hurricane-proof hospital buildings is not enough. He said the strategy does not account for flooded roads, pre-storm transport for patients, medically vulnerable people in flood-prone areas, emergency hospital evacuations or failure of backup power sources.

Mediate, of the group Healthcare Without Harm, said asking hospitals to strengthen for more severe hurricanes and sea-level rise can feel overwhelming, especially as many struggle to recover from pandemic-related financial pressures, labor shortages and fatigue.

“Certainly a lot of things make it hard for them to see it as a problem. But how many other problems are there on top of that?” she said.

As Hurricane Ian approached the South Carolina coastline north of Charleston on Sept. 30, the city’s low-lying hospital district reported about 6 to 12 inches of water. “It’s much lower than expected,” Republican Gov. Henry McMaster said at a news briefing.

Although Hurricane Ian was a relatively minor weather event in South Carolina, flooding is not uncommon for Charleston’s downtown medical district, making it dangerous and sometimes impossible for patients, hospital employees, and city residents to navigate nearby streets.

In 2017, the Medical University of South Carolina transported doctors across its large campus by boat during severe flooding from Hurricane Irma. A year later, the Charleston-based hospital system bought a military truck to navigate future floodwaters.

Despite flooding, even heavy rains and high tides, Roper St. Francis Healthcare — one of three systems in Charleston’s downtown medical district — has announced plans to finally move Roper Hospital off the Charleston peninsula after operating there for more than 150 years.

“It can make it very challenging for people to get in and out of here,” said Dr. Jeffrey DeLisi, CEO of Roper St. Francis.

The hospital system continues to experience mild flooding in one of its suburban medical office buildings from Yan, but it could be worse, DeLisi 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 more interior, the less likely you are to have any of those problems,” he said.

Unlike St. Francis in Roper, most coastal nonprofit and public hospitals have chosen to stay in place and fortify their buildings, said Justin Sr., president of Florida’s Safety Net Hospital Alliance and former secretary of the state’s Agency for Healthcare Administration. , which controls hospitals.

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

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