“Houston’s world-renowned health care infrastructure found itself battered by Hurricane Harvey, struggling to treat storm victims while becoming a victim itself.”

“Water poured into hospitals. Ambulances were caught up in roiling floodwaters. Medical transport helicopters were grounded by high winds. Houston’s world-renowned health care infrastructure found itself battered by Hurricane Harvey, struggling to treat storm victims while becoming a victim itself….
The response to Harvey, now a tropical storm but still wreaking havoc over the state, promises answers to whether health officials learned lessons from the catastrophe of Katrina when it comes to the medically vulnerable — in particular whether they did enough to prepare for the disaster and to move patients out of its path.
“We’ve made significant investments,” Dr. Umair Shah, executive director of Harris County’s public health department, said in a telephone interview on Sunday. “The challenge is until it unfolds there’s so many moving pieces and it’s never the same as the situations you’ve previously encountered.”
Responders point to dozens of improvements, from better engineered structures to well-practiced cooperation, that are helping protect lives. Still, sometimes even the soundest plans have been foiled.” (A)

“Houston’s unprecedented rainfall on Sunday pushed area medical facilities to take precautions — including, in some cases, evacuations — in a bid to protect patients.
Texas Medical Center early Sunday began closing its massive “submarine” doors, designed to seal off lower floors — Texas Children’s Hospital, as well as Memorial Hermann-Texas Medical Center and TIRR Memorial Hermann Hospital, deployed the doors, a spokeswoman told the Houston Chronicle.
The system is part of a safety upgrade installed after Tropical Storm Allison devastated the medical campus in 2001, the Chronicle reported. That storm drowned tens of thousands of laboratory animals and forced patient evacuations. Decades of medical research were lost as well…. (B)

“But for the patients and staff inside, it was pretty much business as usual. Most of the TMC hospitals adopted a shelter-in-place strategy, which meant they called in staff prior to the storm and divided them into shifts of working and rest, on the premises, so they wouldn’t have to leave the hospital. Previous experience from storms suggested this was the best strategy; evacuating patients is a tricky process, since sometimes the evacuation procedure can be more medically dangerous if traffic jams out of a vulnerable area mean people will be stuck in ambulances or makeshift mobile care units for hours on end.” (C)

“Water flooded the basement of the Ben Taub General Hospital, disrupting food, pharmacy and central supply services. Ben Taub, one of only two comprehensive, level 1 trauma centers in Houston, says their concern now is finding ways to get critical care patients to safety.
“Our first concern is patients on ventilator support,” hospital spokesman Bryan McLeod said.
For now, 17 to 18 patients require ventilator support to breathe, McLeod told ABC News. After they have been evacuated, McLeod said, the hospital plans to move the rest of the approximate 350 patients.” (D)

“Nurses and doctors at Cook Children’s are preparing for at least 10 babies’ arrival as Hurricane Harvey edges closer to making landfall.
Children’s Medical Center in Dallas is also flying out to bring back several babies to care for away from the storm. Physicians are worried high winds and flooding could create major power outages and a shortage of clean water and food.” (E)

“At Texas Children’s Hospital, staff took turns on 12 hour shifts beginning Friday night to care for the 600 patients across three facilities. Doctors also called in women with high risk pregnancies who were due to give birth imminently as a precaution, and housed them in the Marriott next door to the main campus so they could be at the hospital quickly when their labor began. That meant their babies would also have access to the neonatal ICU if they needed it, rather than risking a dangerous ride through the storm to get to the hospital. “We assessed every patient, every pregnant mom, knowing that if they delivered and were unable to get to us, it would be devastating,” said Cris Daskevich, senior vice president at Texas Children’s.”(C)

“Preparation is key, according to Dr. Andrew Rhim, a physician and assistant professor at the University of Texas MD Anderson Cancer Center, one of the leading oncology institutes in the world. “MD Anderson was hit really hard in 2001 during Hurricane Allison,” he told Fortune in a phone interview. Rhim wasn’t at the center back then–but he says that administrators took that event as a wakeup call and worked to shore up disaster management in the years since. “The response to Harvey has been a product of those preparations.”
MD Anderson is currently experiencing some flooding, forcing appointment cancellations and closures for outpatient procedures. But there hasn’t been an evacuation, and the facility remains staffed for inpatients who cannot be discharged, according to Rhim. That’s thanks to preventive measures like flood gates which minimize damage and so-called “Ride Out” teams that prepare to, well, ride out the storm. These include nursing and technical support staff, custodial and food management, and extra food, water, and changes of clothes (in addition to a barrage of emails and other communications between administrators and staff).” (F)

(A) Houston’s Hospitals Treat Storm Victims and Become Victims Themselves, by SHERI FINK and ALAN BLINDER, https://www.nytimes.com/2017/08/28/us/hurricane-harvey-houston-hospitals-rescue.html?_r=0
(B) Harvey: Houston flooding pushes hospitals to act, Greg Toppo, https://www.usatoday.com/story/news/2017/08/27/houston-flooding-pushes-hospitals-act/606802001/
(C) What Happens When a Hurricane Hits a Hospital, by Alice Park, http://time.com/4919261/hurricane-harvey-houston-texas-medical-center/
(D) Hurricane Harvey: Houston-area hospitals preparing to evacuate patients, by MERIDITH MCGRAW DAN CHILDS, http://abcnews.go.com/US/hurricane-harvey-houston-area-hospitals-preparing-evacuate-patients/story?id=49457425
(E) Hospitals Join State Agencies Helping People In Hurricane Harvey’s Path, by Jeff Paul, http://dfw.cbslocal.com/2017/08/24/hospitals-join-state-agencies-helping-people-in-hurricane-harveys-path/
(F) How Hospitals Prepare for a Hurricane Like Harvey, by Sy Mukherjee, http://fortune.com/2017/08/28/hurricane-harvey-md-anderson-hospitals/

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