Hospitals Prep as Hurricane Michael Set to Slam Florida Panhandle

Roxanne Nelson BSN, RN

October 09, 2018

Less than a month after Hurricane Florence wreaked havoc in the Carolinas, the southern states are bracing themselves for yet another storm. This time, the hurricane is taking aim at the Florida panhandle.

Hurricane Michael, currently a category 4 storm with over 140-mile-per-hour winds, threatens to hit more than 300 miles of the Gulf Coast Wednesday, which has prompted emergency declarations in more than 100 counties.

Healthcare providers, hospitals, and health agencies are mobilizing to prepare for what is forecast to be the most destructive storm to hit the Florida Panhandle in decades. Mandatory or voluntary evacuation orders have already been issued in at least 16 Florida counties, and about 3.7 million people are under hurricane warning. This includes not only Florida residents but individuals living in parts of southeastern Alabama and southern Georgia.

A tweet by Florida Governor Rick Scott is urging residents to follow evacuation orders if their homes are located in high-risk areas.

"I cannot emphasize enough. Hurricane Michael is forecast to be the most destructive storm to hit the FL panhandle in decades. It will be life-threatening and extremely dangerous. You cannot hide from this storm. You can rebuild your home, you cannot rebuild your life."

President Trump and Health and Human Services (HHS) Secretary Alex Azar have also declared a public health emergency in Florida. According to an HHS news release, the declaration gives Medicare and Medicaid beneficiaries and their healthcare providers and suppliers greater flexibility in meeting emergency health needs.

An additional 2.4 million people live in areas where a tropical storm warning has been issued.

Hospitals Preparing

Anna Saunders, communications strategist at Tallahassee Memorial HealthCare, a private, not-for-profit community healthcare system that serves a 17-county region in North Florida and South Georgia, explained that storm preparations are already in place.

"We are not evacuating patients and are making sure we have adequate supplies of food and water," she told Medscape Medical News.

There has been ongoing construction at the facility, and those sites have been secured. "We already have generators in place, but we have obtained extra ones," she said. "All elective surgeries for Wednesday and Thursday have been cancelled, both for the main operating rooms and surgical centers."

However, emergency services will remain open, and all emergency or urgent surgeries will be performed.

Saunders explained that while they are preparing for potential flooding with sandbags and other equipment, their main facility, a 772-bed acute care hospital, is located about 20 to 30 miles from the coast, so they are not in danger from the anticipated storm surge.

"Our campus is also on higher ground, so flooding may not be too much of a problem," she said. "But the eye of the storm is expected to come close."

Landfall is forecast for about 1 PM on Wednesday near Panama City. The Agency for Health Care Administration is cautioning all facilities providing residential or inpatient services to "double check your evacuation plans and ensure that the location you plan to evacuate to is fully equipped to handle your residents" as well as to "consider alternative plans if your primary evacuation location is in an area likely to be affected by the storm."

Several of the hospitals and healthcare systems in the region have begun posting updates on what services will be available to patients. University of Florida Health, for example, posted that UF Health Physicians practices in Old Town (Dixie County) and Tallahassee (Leon County) will be closing on Wednesday. However, hospital and outpatient operations in the Gainesville and Jacksonville areas, which are further away from the targeted area, will proceed as usual at this time until further notice.

Flowers Hospital, in Dothan, Alabama, has also issued an update that all outpatient and elective procedures scheduled for Wednesday will be rescheduled, but that they have "undergone preparations" and will keep the emergency department open.

Make Final Preparations Now

The Red Cross is urging everyone in the path of Hurricane Michael to listen to local and state officials, obey evacuation orders, and make final storm preparations now.

People should turn on their TV/radio or check their city/county website regularly to get the latest weather updates and emergency instructions, explained Greta Gustafson, a spokesperson for the Red Cross.

"If told to evacuate, do so immediately," she told Medscape Medical News. "Do not drive around barricades, or through high water."

The Red Cross emphasized that anyone planning to stay in a shelter do some advance preparation and make sure to bring any prescription medications, extra clothing, pillows, blankets, hygiene supplies, other comfort items, and important documents.

"Build an emergency kit that contains supplies for about three days, to include a gallon of water per person per day, non-perishable food, a flashlight and extra batteries, a first aid kit, medications and copies of important documents," Gustafson said.

She added that the Red Cross has an Emergency App that will give real-time information about the storm, open Red Cross shelter locations, and hurricane safety tips. The Emergency App is available in app stores by searching for the American Red Cross or going to redcross.org/apps.

Americares, a health-focused relief and development organization, is also preparing to respond to Hurricane Michael, according to Chief Medical Officer Julie Varughese, MD.

She gave advice that's good for both patients and physicians, emphasizing the focus on medications and medical devices.

"After a disaster, you may not be able to access the regular locations you receive medical care therefore it’s important to know what other locations and services might be available within and near your community (ie, dialysis)," Varughese told Medscape Medical News by email.

"It’s also very helpful if you write down a list of your medical conditions, current medications and dosages and any allergies so you can share this list with any medical providers or friends and family. If you have a hard-copy of your medical record, that can also be helpful to share with any medical staff that are not familiar with your medical history," she said.

"In particular, children and adults with chronic disease should take precautions to ensure that they have a refill of their prescriptions. Interruptions in medications can exacerbate chronic illnesses causing increased risk for other complications. It’s important to have a minimum of 7 days’ worth but an even longer supply is helpful.  Some insurance companies will allow for refilling medications sooner than needed for people facing potential disasters," she added.

Physicians can help their patients with advice on how to care for their medications. "Storing medications in waterproof containers such as Ziploc bags can help protect medications from damage," Varughese said. "If you take medications that require refrigeration, it can be helpful to set your fridge and freezer to the coldest setting to prolong the amount of time your fridge/freezer can stay cold should you lose electricity."

"For those using medical devices, it’s important to make sure all batteries are fully charged and also have back-up batteries in place if possible. In addition for those on oxygen, having a second oxygen tank is helpful as well," she added.

A Very Dangerous Storm

Ken Graham, director of the National Hurricane Center, emphasized in a briefing that a "very dangerous storm surge will occur along the coast and well inland."

The storm is moving north at about 12 miles an hour, and with the strong winds and rain, "we really have to think about the other hazards associated with this storm," Graham said. "Power outages, trees falling — those are some of the hazards we have to think about. Power outages can last for a week or more, so you have to think about that when preparing for the hurricane."

He also noted that there will be about 6-10 inches of rain, although that can go higher in some areas. "Right now our message is this — this is a very dangerous hurricane. A very dangerous storm surge will occur along the coast — the window is shrinking, it is time to be ready for this hurricane."

Mobilizing

Governor Scott tweeted that he has now "activated 2,500 @FLGuard troops and the FL Highway Patrol is making nearly 350 troopers available for deployment. They are standing by ready to respond to the storm."

The Florida Department of Health is also in the process of setting up five special-needs shelters in the Panhandle.

The governor of Georgia, Nathan Deal, has declared a state of emergency for 92 of his state's counties, and Scott has declared a state of emergency in 35 counties in Florida. The governor of Alabama has declared a statewide emergency.

Michael is expected to move further inland and north, which can potentially bring rain and strong winds to areas in both North and South Carolina — which are still recovering from Florence — and Virginia.

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