The new Jersey City Medical Center (2004) was constructed above the 100 year flood plain – then came Sandy, Harvey & Irma

In 2012 “The hospitals in Hudson County were the hardest hit by the superstorm, with Hoboken University Medical Center and Palisades Medical Center temporarily closed. While Jersey City Medical Center’s first floor was inundated, it moved patients to the second floor and remained open.
“Fortunately for us, we were able to maintain our generator,” Scott said, noting that the water came within inches of the generator fuel pumps. After the storm, the hospital raised the pumps eight feet above the high-water mark.
Jersey City Medical Center also is planning a series of raised embankments, automatic floodgates, and waterproofed walls to head off future disaster. The plans are inspired by Lourdes Medical Center in Binghamton, New York, which has used a similar system to keep water out.” (A)

“It’s been over a month since the last of Maria’s Category 4 hurricane-strength winds swept over Puerto Rico, but there is still damage yet to come…..Even with the aid of the federal government and the military, a health-care system facing multiple threats might not be able to protect some of the island’s most vulnerable citizens.
Many of those people are facing hard choices in Puerto Rico’s hospitals, which are at the front lines of disaster-relief efforts. While most hospitals have recovered from the storm’s early blows—which knocked most of them out of commission and left a few others dependant on generators—they have had to make do with shortages of power, water, and supplies; personnel crunches; and intensifying health-care needs from accidents and emergent diseases. Last week, a photograph posted by former Governor Alejandro García Padilla on Twitter showed doctors performing surgery by flashlight. From what physicians on the island tell me, such scenarios are common, as is physicians working double and triple shifts—circumstances made even more remarkable by the fact that the doctors themselves are victims of the storm.…. (B)

“…Over the weekend, the island’s power company fired a key contractor working to restore electrical service. The cancellation of the $300 million contract with Whitefish Energy, after the Federal Emergency Management Agency and other agencies expressed significant concerns about the deal, is expected to further delay the return of power throughout Puerto Rico.
The Puerto Rican government has prioritized getting power back to hospitals. Many smaller clinics and doctor’s offices, like other businesses on the island, still don’t have electricity.
Take, for instance, San Patricio Medflix, a diagnostic imaging center in greater San Juan. The center has state-of-the-art MRI, CT and nuclear medicine equipment.
Problems with a diesel generator recently led to the cancellation of 70 patients’ appointments, says Dr. Fernando Zalduondo Dubner, medical director of San Patricio Medflix in San Juan, Puerto Rico.
With Puerto Rico’s electric grid down since Sept. 20, the diesel generator, housed in a metal box the size of a shipping container, has been the sole source of power for his four-story medical complex.
Fuel has been a big problem. The generator consumers about 500 gallons of diesel a day…. (C)

“Waterborne illnesses are on the rise in Puerto Rico in the wake of Hurricane Maria — and health professionals fear the storm’s aftermath could unleash an epidemic on the devastated island.
The death toll from the storm rose to 51 on Tuesday, with the two latest victims dying of leptospirosis, a bacterial disease usually spread by contact with contaminated water, Puerto Rico Public Affairs Secretary Ramon Rosario told The Associated Press….
The disease is transmitted via exposure to the urine of infected animals, but humans are most commonly infected by coming in contact with contaminated water, especially through skin abrasions and the nose, mouth and eyes, according to World Health Organization…
The disease has a wide range of symptoms including high fever, headache, chills, vomiting and diarrhea, but some may have no symptoms at all, according to the CDC. Leptospirosis is treated with antibiotics, but without treatment it can lead to kidney damage, meningitis, liver failure and death, according to the CDC.” (D)

“Students and faculty from Ponce Health Sciences University (PHSU) in Ponce, Puerto Rico have been the sole providers of aid for residents in southern and central Puerto Rico who hadn’t received assistance since Hurricane Maria landed five weeks ago. Since the crisis began, the students/faculty have provided medical and psychological support services – and delivering privately donated goods and supplies – to the residents, most of whom lost their homes and all of their possessions in the hurricane.
“Every day, PHSU students, doctors, psychologists, public health professionals, staff, and community volunteers have been tirelessly delivering privately donated medicine, water, and food – and providing critical care medical attention – to our neighbors in rural mountain towns,” says Dr. David Lenihan, CEO of PHSU. “They’re clearing roads, wading through waterways, and going door-to-door to offer their help. In many cases, they’ve been the first responders who have made contact with, and offered assistance to, these remote areas since Maria made impact.”
PHSU restored operations and classes on October 9, and is one of only a few universities in Puerto Rico that have reopened since Maria hit. (E)

“We cannot weaken the EPA as hurricanes are growing worse…
When hurricanes hit, EPA’s emergency response staff, scientists and engineers are essential to keeping people safe. The agency helps prevent and monitors toxic releases and chemical spills from industrial facilities and Superfund sites, and helps inform the public about any local environmental dangers. EPA also helps local communities protect drinking and wastewater systems from sewage leaks and works to get them working again….
The situation in Puerto Rico and the U.S. Virgin Islands is much more severe. Millions of our fellow Americans do not have electricity, reliable clean drinking water or functioning sewage treatment. St. John has not had electricity since early September. On St. Thomas, the street lights don’t work, the smell of diesel generators lingers in the air and if you are indoors you often smell mold.
Keeping up with these kinds of challenges is hard enough for the EPA. But remarkably, the Trump administration and its allies have been working to cut funding for many of the EPA’s most important disaster-relief programs.” (F)

“Five years after Hurricane Sandy struck on Oct. 29, 2012, much of the region’s inundated infrastructure has been repaired and some of it has been improved. But most of the big plans to stormproof New York City remain just that: plans. And throughout the planning, the city has continued to advance toward the water, with glass high-rises stretching across the riverfront in Queens, Brooklyn and the Far West Side of Manhattan.
“Each year we don’t get a hurricane here we know we’ve dodged a bullet,” said Robert Freudenberg, the vice president for energy and environment at the Regional Plan Association, an urban research group. “We’re racing the clock still to try and prepare for another storm like Sandy.”…
A bright flash that could be seen from Brooklyn signaled the failure of a substation on the site and heralded the long blackout that began minutes later. More than seven million gallons of salt water poured into the Canarsie Tunnel, which carries L trains under the East River. Twelve blocks north, the sprawling Bellevue Hospital Center complex, New Yorks’ flagship public hospital, had to be evacuated for the first time because it had no power, elevator service or drinking water….
At Bellevue, a wall will be built behind the hospital as part of a flood barrier along the East River. “We would really rather shelter in place than evacuate,” said Roslyn Weinstein, a vice president for operations for NYC Health & Hospitals, the city’s public health system…
After Sandy, NYC Health & Hospitals was awarded $1.7 billion in federal aid to repair and improve three of its 11 public hospitals — Bellevue, Coney Island and Metropolitan in Manhattan — and a skilled nursing center on Roosevelt Island. Since then, electrical systems and generators have been moved out of basements and elevators and loading docks protected with waterproof panels.
Near Bellevue, NYU Langone Medical Center, which had to evacuate 300 patients, got $1.1 billion in federal aid. But the privately run hospital refused to say how it has spent that money, making it difficult to assess if the hospital is any better prepared today.” (G)

‘After every natural calamity, American politicians make big promises. They say: We will rebuild. We will not be defeated. Never again will we be caught unprepared.
But they rarely tackle the toughest obstacles. The hard truth, scientists say, is that climate change will increasingly require moving — not just rebuilding — entire neighborhoods, reshaping cities, even abandoning coastlines.
Resettling neighborhoods, making certain places off-limits to development, creating dikes and reservoirs is difficult, both financially and politically. It takes longer than most election cycles. Memories fade. Inertia sets in. Residents just want to get their lives back to normal. Politicians want votes, not trouble.
After Hurricane Katrina in 2005, New Orleans, for better and worse, used its cataclysm as an opportunity to reboot, not just fixing levees but overhauling public schools, hospitals and many neighborhoods. It was a wrenching process….”
“Three 500-year floods in three years means either we’re free and clear for the next 1,500 years,”… “or something has seriously changed.” (H)

“Hurricane Sandy “filled up Hoboken like a bathtub,” the mayor of that New Jersey city told reporter Eric Jaffe. The storm flooded 1,700 homes, knocked out the power grid and did $100 million worth of local damage….
Planners envision a combination of “hard” and “soft” infrastructure: “Hard” flood walls will protect high-risk sites along the riverfront. Meanwhile, a “soft” system of parks, green roofs and terraced wetlands will act like sponges, soaking up water long enough to keep the sewer system from being overwhelmed; remaining runoff will be held in a combined park/water-storage site until the storm passes, when pumps will return floodwater back into the river.” (I)

“ “This project serves as a model for how to address threats from storm surge in urban areas,’’ said Department of Environmental Protection Commissioner Bob Martin. His agency collaborated with the city, HUD, and the state Department of Community Affairs in developing the project.
The proposed system will utilize natural higher ground to maximize protection and will be designed to blend in seamlessly with the urban streetscape. It will provide protection for critical infrastructure such as the North Hudson Sewerage Authority, as well as public-safety facilities and three fire stations and a hospital.
The project calls for construction of a flood-resistant structure stretching from 19th Street in Weehawken and extending south to Hoboken, slightly inland from the river. An additional flood-resistant structure will be built along the southern end of Hoboken.” (J)

(B) Puerto Rico’s Dire Health-Care Crisis, by VANN R. NEWKIRK II,
(C) Lingering Power Outage In Puerto Rico Strains Health Care System, by JASON BEAUBIEN,
(D) Puerto Ricans at Risk of Waterborne Disease Outbreaks in Wake of Hurricane Maria, by DANIELLA SILVA,
(E) PHSU Medical Students/Faculty Have Been Sole Providers of Aid to Rural Towns in Southern Puerto Rico,
(F) We cannot weaken the EPA as hurricanes are growing worse, by JUDITH ENCK,
(G) Five Years After Sandy, by PATRICK McGEEHAN and WINNIE HU,
(H) Lessons From Hurricane Harvey: Houston’s Struggle Is America’s Tale, by MICHAEL KIMMELMAN,
(I) After Hurricane Sandy, Hoboken works on plan to avoid future flood damage, by Nancy Szokan,
(J) Feds to Fund Massive Flood-Control Project for Hoboken, Nearby Towns, by Tom Johnson,