Harvey Strains Hospitals, Shuts Down Services

Marcia Frellick

August 29, 2017

As tropical storm Harvey resumed its torrential assault on the Houston area today, some hospitals and clinics continued to shut down services and others operated with smaller staffs of providers who often struggled mightily to get to their patients.

Dr Amrou Sarraj (Photo courtesy of Dr Salman Arian)

Amrou Sarraj, MD, a vascular neurologist specializing in stroke care, who lives a mile from his work at Memorial Hermann Mischer Neuroscience Institute, told Medscape Medical News that his first thought when the worst of the downpour came early Sunday was that consults could be done remotely with in-house staff. Then he had a second thought: "My patients deserve better than this. We have an oath, right?"

So Dr Sarraj, who is 6-foot-2, walked out his door where the water was at first knee deep and then quickly chest deep. His neighbor and colleague, cardiologist Salman Arian, MD, an associate professor at the University of Texas, joined him and they slogged through the water together to help their patients and relieve their staffs.

Dr Sarraj, who had taken call on the weekend after a full week of coverage, rounded on 30 patients Sunday on all four services because other neurologists couldn't make it in, and waded back home the way he had come.

"I'm pretty beat up," he said late Monday, "but any of my colleagues would have done the same."

Memorial Hermann has remained open, but other hospitals have had to evacuate patients and shut down services.

Harvey, as of Tuesday morning a tropical storm looming over the Gulf of Mexico, is expected to drench southeastern Texas and southwestern Louisiana with two more feet of rain on top of the more than 30 inches already seen, the Associated Press reported.

This morning the levee at Columbia Lakes breached in Brazoria County, just south of Houston, prompting officials to tweet: "Get out Now!!"

By late Monday, Ben Taub, Houston's largest level 1 trauma center, with 440 beds, was getting an infusion of food and supplies that had been dwindling when waters surrounded the hospital Sunday, Bryan McLeod, a spokesman for the Houston hospital's parent company, Harris Health System, told Medscape Medical News.

The roads surrounding the hospital were flooded waist deep, he said, and efforts to evacuate patients Sunday night were abandoned.

"Things are improving," he said Tuesday morning. "Our supply chain is being reestablished. We actually got a linen delivery yesterday. We had a food supply delivery last evening. We had a 5- to 7-day food supply on hand, but with minor flooding in the basement, some of that food we couldn't use," he said. "We're in good stead now for a couple more days."

When there was a break in the weather yesterday, he said, they were able to refresh some of the staff.

While many of the staff were at the hospital, they knew their homes were flooding, he noted. "[The Federal Emergency Management Agency] projects there will be 450,000 flood claims in this area. We have some staff, I know for certain, that are under mandatory evacuation orders."

He said surgeons at another Harris Health System hospital, Lyndon Baines Johnson General Hospital on the northeast side of Houston, had to perform a craniectomy on a patient with a head injury in the midst of the storm Sunday night.

It was an unusual procedure for the hospital to do, McLeod said, and after the surgery was done to minimize the pressure and the bleed on the brain, the Coast Guard airlifted the patient to a neighboring level 1 trauma center.

"That was a yeoman's effort to take care of that patient while they were landlocked," he said.

Many Services Closed

As many hospitals limited or closed services, the US Department of Health and Human Service Monday declared a public health emergency in the wake of Harvey's devastation.

That will help providers treat patients, such as Medicare beneficiaries, when they are transported to hospitals that have no record of their history or needs.

MD Anderson Cancer Center reports it will remain closed for outpatient services, appointments, and surgeries at all Houston-area locations through Wednesday and urged their patients with immediate needs to seek help at their local hospitals.

Texas Children's Hospital continued inpatient operations Tuesday but all clinics and outpatient services on the three campuses and all Texas Children's Health Centers and maternal-fetal medicine and ob-gyn clinics and Texas Children's urgent care remained closed today.

Daniel Cano, MD, medical director for Citizens Medical Center in Victoria, Texas, said in a statement Monday, "As much as we want to help our patients, I know we can help them more by getting them to a safer spot. To ensure the safety of our patients and continuity of care, Citizens Medical Center safely transferred our patients to San Antonio area hospitals that were unaffected by Hurricane Harvey."

Citizens is a nonprofit, 338-bed acute care hospital with more than 1200 employees in hard-hit Victoria, Texas, southwest of Houston.

Baylor College of Medicine and its clinics are closed today. "Flood gates have been activated and there is no entry into the main campus," the college states on its website.

CHI St Luke's Texas Division said Monday it is evacuating its hospitals in the Vintage and Sugar Land areas.

"With many neighborhoods surrounding these facilities under mandatory evacuations, patients will be moved to other CHI Texas Division facilities," their Facebook page states. 

The Texas Medical Association (TMA) said in a statement, "Harvey is having an unprecedented and catastrophic impact on Texans and Texas physicians. This event is not over and will continue to impact more of our friends and families…. As TMA did after Hurricane Ike in 2008, we are looking into ways we can provide long-term help to the practices that have been hit hard (or demolished) by this storm."

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