Page 6 - Winter 2024 Bulletin

President’s Message
Post-storm issues to address
Damian Caraballo, MD dcaraballo44@gmail.com
Our Tampa Bay community was rocked by the first two hurricanes to directly impact the area in 100 years. Hurricane Helene hit the Big Bend area of Florida on September 26, but its massive size and storm surge flooded the barrier islands and water adjacent areas of Tampa Bay, caus- ing billions in damage. It was then followed by the surreal nightmare of having a second hurricane come
right toward the Tampa Bay area in less than two weeks. The result was a dual disaster that left the area reeling and homes destroyed. It’s during these disasters we truly see the dual- ity of man—the best and worst of human nature. Having worked in local emergency departments during both storms, I’m grateful for the response of Tampa’s physicians, first re- sponders, nurses, and the healthcare community.
The storms highlighted the importance of communica- tion and cooperation among local hospitals and the medical community during natural disasters. I don’t think the gener- al public grasps the amount of preparation and collaboration that goes into keeping hospitals and EMS running during storms and during such a short time. Each hospital and EMS agency has a disaster management team that collaborates and communicates with the county, state, and federal teams. Hospitals form A and B teams, who alternate shifts to care for patients. This means hospitals need all emergency de- partment members, medical and surgical ward teams, spe- cialists, intensivists, anesthesiologists, obstetricians, and OR teams in-house. While the rest of Tampa Bay was evacuating or “hunkering down,” hospital staff packed their sleeping bags and left their vulnerable houses and families to sleep in the hospital to provide care for patients.
Meanwhile, coordinating EMS disaster teams are in con- stant communication to keep ambulances running as long as possible. During both storms, EMS was somehow able to transport patients despite winds over 40 mph and debris all over the roads. Tampa General made national headlines with its Aqua Fence which was able to keep it protected from flooding, allowing it to keep the hospital open. Unfor- tunately, traffic to Davis Island was shut during the storm
surge, which required hospitals and EMS to communicate with each other on where to divert patients. With multiple hospitals shut down by the storm, it’s up to the remaining opened and functioning sites to take the surges in patients seen during storms until other hospitals are back up and running. In addition to this, some Pinellas hospitals close to the barrier islands and in flood zones required evacuation of their patients—a massive undertaking, made tougher by back-to-back hurricanes with damaged roads, debris piles, and flooded areas.
Another underreported issue involves the vulnerable homeless, dependent elderly, and handicapped patients who have nowhere else to go during storms. The emergency de- partment remains the front door and the safety net where these patients turn to meet their safety needs during a hur- ricane. I saw patients wait ten hours for a mere sandwich or shelter during the storm. It seems that hospital emergency departments are the new 21st-century church sanctuaries where the vulnerable run to when they have nowhere else to go.
Despite all the challenges during the storms, I think the local hospitals did a great job. FEMA set up a make-shift cen- ter to help with surge at St Joe’s hospital and commented the St Joe’s and Hillsborough County response to the storm was “one of the most coordinated and well-organized responses during a disaster” that they had seen. Yet, still many issues remain for physicians and hospitals in responding to natural disasters. A serious underappreciated issue is the need for transport out of the hospitals for patients after the storm. We did a great job handling the post-storm surge of patients who came to the hospital in the 48 hours after the storm. Unfortunately, all the hospitals became saturated with pa- tients, and nursing home patients; patients who needed transport such as psychiatric patients were forced to board in emergency departments and inpatient wards until rides were available. EMS did a great job transporting patients into the hospitals but were unavailable to transport patients out of the hospital after the storms.
Florida needs a coordinated response in transporting dis- positioned patients back to appropriate facilities. This is true daily, but it really hit a critical level during the hurricanes.
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HCMA BULLETIN, Vol 70, No. 3 – Winter 2024