The Overwhelming Task of Preparing Hospitals for Climate-Related Disasters

Updated: Apr 26

The height of the COVID pandemic put extraordinary pressure on hospitals across the country. Hospitals were required to setup extra beds when overwhelmed with patients (sometimes even in hospital cafeterias), and meet demands for ventilators (of which there have often been not enough, or not the right kind). This means hospital staff have been experiencing enormous stress in a myriad of ways.

Naturally, most of the attention has been on new imperatives and precautions that COVID has forced on healthcare providers and hospitals. However, when climate catastrophe strikes, such as wildfires, floods, and hurricanes, hospitals are hit just as hard, or harder. Medical supply chains can be disrupted, transportation routes blocked, patient records lost or destroyed. And the hospital facilities themselves may suffer significant damage. Providing adequate care, or maintaining basic physical safety for patients and staff, can become an overwhelming challenge.

In many cases, hospitals will need to evacuated due to climate-related disasters. Simply evacuating is an enormously disruptive and potentially hazardous procedure. For example, in the aftermath of Hurricane Harvey in 2017, hospitals in the Dallas-Ft. Worth metropolitan area saw patient increases of 600%. This was the result of the influx from Houston-area evacuees. During Hurricane Sandy in New York in 2012, patients in critical condition couldn’t be moved. And doctors were put into the position of having to decide who is likely to live or die.

According to a study published by Cambridge University, during the eight-year period from 2010 to 2017, 89 hospital evacuations in the United States were precipitated by “external causes” – specifically: 60 hurricanes, 21 wildfires, and 8 severe storms.

As global climate continues to warm, extreme weather and the destruction it wreaks will only grow more frequent in years to come. According to the World Health Organization, “A warmer and more variable climate threatens to lead to higher levels of some air pollutants, increase transmission of diseases through unclean water and through contaminated food … [and] floods and droughts will have a dramatic impact on health.”

There will be a greater need for hospital services, even as hospitals’ capacities are critically compromised and stretched perilously thin. And as the National Resources Defense Council points out, when disaster comes, the hospital may be the only place for miles around where survivors can get a meal or a place to sleep. People generally know there is shelter, blankets, food, water, medicine, power and other resources at a hospital. This observation underscores why food security is a crucial element of disaster preparedness for hospitals. What happens if these high-reliability organizations become further overwhelmed by the local population? People will simply be seeking safety, and a little bit of food and water until the storm has passed. Items earmarked specifically for patients, their doctors, and support staff will suddenly be at-risk because of general desperation.

The Hospital Preparedness Program (HPP), which is administered under the U.S. Department of Health and Human Services, is the only source of federal funding designed to help the nation’s healthcare delivery systems prepare for and respond to emergencies. Sadly, HPP’s funding has been cut by over 60% since 2003, adjusting for inflation. The grim reality is that, to a large extent, hospitals and other healthcare facilities are on their own for emergency planning. However, will for-profit organizations struggle to create a budget to advance this form of organizational security? It will take a small amount of quarterly profits from shareholders to form a literal rainy-day fund of critical back-up supplies. Or, will those in the expanding at-risk areas of the country, have to take their own medicine?


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