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Evacuating the hospitals

By Brian | September 19, 2005 | Share on Facebook

Tropical Storm Rita could potentially be a Category 1 Hurricane by the time it reaches the Florida Keys, so Florida is taking standard precautions:

Officials ordered [40,000] residents evacuated from the lower Florida Keys on Monday.

The state was sending a National Guard cargo plane to evacuate 22 patients from Key West’s hospital to Sebring, near Lake Okeechobee. Several critically ill patients already had been evacuated to hospitals in Miami.

Gov. Jeb Bush declared a state of emergency.

This is because a Category 1 hurricane MIGHT hit the Florida keys in a couple of days. Note the absence of the federal government. Note the absence of FEMA. Note the absence of state and local officials waiting for help to arrive.

Now, one would assume that Louisiana, who’s largest city is below sea level would have a similar plan – at least for the hospitals, right? But then there’s this on the front page of the New York Times:

Of the dead collected so far in the New Orleans area, more than a quarter of them, or at least 154, are those of patients, mostly elderly, who died in hospitals or nursing homes, according to interviews with officials from 8 area hospitals and 26 nursing homes.

There were piecemeal plans. Hospitals were required to have enough emergency provisions to operate for two to three days during a disaster. State officials said it was their responsibility to evacuate patients if necessary. Nursing homes were required to have their own evacuation plans, complete with contracts with transportation companies.

In two public hospitals that primarily treat the poor, emergency generators and wiring were located on the ground floor, vulnerable to flooding, because state legislators had repeatedly refused to pay for upgrades. Both washed out in the storm.

It goes on and on – hospitals and nursing homes were not clear about whether Mayor Nagin’s evacuation order applied to them. Private hospitals, which could afford to do so, hired buses and helicopters, but when the time came, the bus companies had no drivers.

At HCA Healthcare (a large, for-profit hospital), the president had to be awoken at 3AM to be told the water was rising in the building. He had leased 20 helicopters, but the helipad wasn’t accessible from the hospital. He tried to turn Tulane University Hospital’s parking garage into a helipad, but Tulane was evacuating their staff before the other hospital’s patients. Tulane denies this, but most of the staff did get out before some of HCA’s incubator-ridden babies. You do the math.

Virginia McCall, director of the ICU at Methodist Hospital (who got all their patients out) says that Universal Health Services, the company that runs the hospital, told her that they had rented trucks, but that the trucks were commandeered by FEMA for other priorities. The company has no comment, and FEMA denies the accusation. FEMA, of course, has been roundly criticized for having no one on the ground until several days after the storm had passed. Again, you do the math.

People have argued with me recently that there’s no way a city can effectively evacuate 100% of its citizens in an emergency. There will always be people who don’t get the message, or who refuse to leave. I’ve argued that regardless of this, a plan should be in place. Even if it doesn’t work, at least there’s a plan, and people know what to expect.

But the hospitals and nursing homes? No bed-ridden patient is going to refuse to leave if his doctors and nurses tell him he has to. The lack of a plan for these people epitomizes the extent to which the city let its people down.

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