Florida hospitals weren't prepared for Hurricane Ian. Some concern the subsequent massive storm. – POLITICO

It was solely after the hurricane had pounded the amenities for a number of hours that workers moved not less than 640 sufferers from 5 hospitals in Charlotte, Sarasota and Lee counties. In a single occasion, hospital workers needed to delay transferring sufferers for hours as a result of it was too harmful to maneuver anybody outdoors the hospital because the storm raged. In different instances, workers evacuated sufferers days later as a result of amenities couldn’t get water resulting from broken infrastructure.

“My anticipation and expectation is that while you’re requested to evacuate, you evacuate,” Florida Division of Emergency Administration Director Kevin Guthrie stated in an interview. “When folks have been, I exploit the time period, in concern for his or her life, these issues may have been prevented 36 hours earlier.”

No state in America is extra vulnerable to hurricanes than Florida, and the way hospitals, first responders and different important emergency providers deal with cataclysmic climate occasions can imply the distinction between life or loss of life.

Whereas Ian was one of many state’s deadliest storms — and many individuals are nonetheless rebuilding after it struck — the potential for extra hurricanes is an inevitability. That would put strain on state leaders, together with Republican Gov. Ron DeSantis, to drive hospitals to rethink their evacuation procedures and act extra shortly when the subsequent massive storm approaches.

No hospital sufferers or workers have been damage or killed throughout Ian or the next evacuations, and consultants level to many components that might lead a hospital to delay shifting sufferers. That features jeopardizing the care of medically-fragile sufferers, whose well being could possibly be additional broken by being transported.

However Joseph Barbera, a George Washington College professor and skilled on hospital emergency administration, stated the amenities that evacuated sufferers within the aftermath of Hurricane Ian ought to take into account themselves fortunate.

Barbera was on the bottom in New Orleans after Hurricane Katrina brought about huge flooding on the Memorial Medical Middle nursing house in 2005. The getting older facility was left with out electrical energy or air-con after its emergency generator died with 2,500 sufferers inside. Forty-five folks on the New Orleans facility died.

“For those who consider you’ll be able to shelter-in-place, then you definitely additionally need to have an inexpensive strategy to evacuate if that shelter-in-place fails,” stated Barbera, who testified as a witness in lawsuits related to the New Orleans hospital. “That was all fully ignored in Katrina in New Orleans — they clearly anticipated the feds and the state to cowl their downside, they usually didn’t act till it was too late.”

DeSantis has oversight of hospital emergency preparedness by way of the Florida Company for Well being Care Administration. When requested about any enforcement motion in response to post-landfall evacuations, spokesperson Brock Juarez stated the company doesn’t touch upon potential or ongoing investigations.

Ready out the storm

Hurricane Ian started forming within the Atlantic in mid-September and regularly gained power because it moved north off the east coast of South America. DeSantis declared a state of emergency days earlier than the storm reached Florida. Faculties throughout the state closed, inns started turning folks away and three airports suspended operations in preparation for the storm. By the point Ian handed over Cuba, it was a fully-formed hurricane with wind speeds of round 120 mph.

Greater than a day earlier than the storm made landfall on Florida’s southwest coast on Sept. 28, state officers started warning folks to start evacuating folks from areas within the storm’s path. That included the counties of Lee, Charlotte and Sarasota.

However 5 hospitals in these counties selected to attend out the storm: HCA Florida Fawcett Hospital, HCA Florida Englewood Hospital, Gulf Coast Medical Middle, HealthPark Medical Middle and Golisano Youngsters’s Hospital.

Every of the amenities is inside two miles of the coast, they usually have been in zones for which native officers had issued evacuation orders greater than 24 hours earlier than Ian made landfall, county and state information present.

The day earlier than the storm got here ashore, officers at Fawcett Hospital in Charlotte County known as the state Emergency Operations Middle in Tallahassee for assist transporting 4 critically-ill sufferers on ventilators. An ambulance service moved three of the sufferers, however Fawcett staffers determined to maintain the fourth affected person moderately than attempt to transfer them, in keeping with studies obtained from the state Division of Emergency Administration. Information supplied by the state’s Division of Emergency Administration don’t specify why the fourth affected person was not moved.

Hurricane Ian made landfall in Florida’s southwest coast at 3:05 p.m. with 150 mph winds. The devastation that adopted was immense.

Fawcett Hospital suffered probably the most injury. The hurricane winds have been so sturdy that it tore a gap within the 238-bed facility’s roof, permitting heavy rains to pour into stairwells and all through its third and fourth roofs. The flooring of the intensive care unit have been coated in water, in keeping with movies posted to social media.

About 5 hours after the storm made landfall, hospital officers known as the state to assist evacuate sufferers, in keeping with information, however by that time, it was too harmful. Rescuers needed to await six hours earlier than they may start shifting nearly 200 sufferers from the hospital.

Different hospitals that remained open fared barely higher.

HCA Florida Englewood Hospital in Sarasota County suffered from water strain points and moved 48 sufferers in the future after the storm made landfall. Two different hospitals, Gulf Coast and HealthPark medical facilities, transferred a complete of 295 sufferers whereas 91 sufferers have been evacuated from Golisano Youngsters’s Hospital.

The amenities, all in hard-hit Lee County, moved the sufferers two days after the hurricane struck the realm — one of many amenities misplaced adequate water strain, and hospital leaders decided that any repairs to the county’s badly-damaged water strains would take too lengthy for critically sick sufferers.

“Our constructions fared nicely, they usually’re in fine condition, however our infrastructure — primarily our water and electrical energy — was challenged,” Lee Well being President and CEO Larry Antonucci stated on the day after the storm. “We can’t run a well being care facility with out operating water.” Lee Well being represents the Gulf Coast, Well being Park and Golisano amenities.

‘Extremely disruptive’

Florida Hospital Affiliation President and CEO Mary Mayhew defended the hospitals’ choice to attempt to wait out the storm, saying shifting sufferers poses dangers and lots of amenities have hardened buildings to higher face up to storms.

“It’s extremely disruptive to evacuate sufferers,” Mayhew stated. “It takes a very long time to do an evacuation, and then you definitely get into that window of time the place air and floor transport are now not accessible.”

Debra Burbridge, a spokesperson for Nashville-based HCA Healthcare, which owns Fawcett hospital and Englewood hospital, stated Ian’s predicted path over Florida had modified considerably within the days main as much as landfall, leaving the hospital with lower than 24 hours to start the sophisticated means of transferring sufferers with out diminishing a steady degree of care. Like Fawcett, Englewood moved a number of the most important sufferers simply earlier than the storm made landfall, however the majority have been moved a day later.

“Wind circumstances forward of the storm prevented the secure switch of extra sufferers,” Burbridge wrote in a press release. “Affected person transfers, which require the receiving hospital to offer the suitable degree of care, are fastidiously deliberate and coordinated.”

Burbridge additionally stated Fawcett, Englewood and different HCA Florida hospitals all have lengthy histories of staying open throughout hurricanes to proceed to serve the neighborhood.

Federal well being regulators tightened emergency preparedness pointers for hospitals within the wake of Hurricane Katrina. The rules require hospitals to carry out danger assessments of all threats, together with pure disasters, develop an emergency communications plan and carry out common testing and coaching.

The rules are intertwined with state legislation, which requires that hospitals keep what’s often called a Complete Emergency Administration Plan. The plan have to be accepted by a neighborhood emergency administration official and reviewed by the Florida AHCA yearly. Hospital workers should additionally perform the emergency administration plans every year throughout a simulated catastrophe.

“You’ll be able to’t simply get up immediately and evacuate,” George Washington College’s Barbera stated. “How are you going to quickly discover the placements for sufferers, and the staffing?”

Guthrie estimated that 90 % of hospitals going through a risk from a hurricane will evacuate sufferers to increased flooring of the hospital moderately than to a different facility outdoors the realm. However, he stated, underground infrastructure resembling water pipes may be broken throughout hurricanes, leaving these amenities in dire want of assist. Hurricane Ian, for instance, severely broken a water major in Lee County, leaving nearly 800,000 folks there with out water.

“What occurred with Fawcett, and with a few different hospitals, is that they determined they have been going to remain on the river, on the coast, in a excessive influence space, and vertically evacuate their sufferers,” Guthrie stated. “When all the infrastructure is on the bottom.”