Congress should gear up for the health impacts post-Harvey

Five years ago this fall, the sky over Manhattan darkened, rain fell, and the water rose; and rose; and rose.

Superstorm Sandy caused significant flooding in the nation’s most populous city, which ultimately killed more than 100 people and caused $70 billion in damages. In the midst of the storm, flooding and the disruption of utilities forced healthcare providers and first responders to urgently evacuate several major hospitals.

{mosads}In Sandy’s aftermath, we were part of a research team that conducted two studies on the healthcare and public health response to the disaster. The first looked at the experiences of the hospitals that received evacuated patients and the strategies they employed.

The second was a higher level, more holistic look at the storm’s impact on the resilience of New York and New Jersey’s health sectors, which we defined broadly to include hospitals, public health agencies, emergency medical service (EMS) providers, doctor’s offices, long term care providers, and outpatient services like dialysis clinics, methadone clinics, and others. We used this research to develop practical guidance that could help to strengthen health sector resilience in communities across the country.

This week’s unprecedented flooding in East Texas is, for many, reminiscent of the damage wrought by Hurricane Katrina, and more recently, Superstorm Sandy. We’ve seen harrowing rescues and tragic losses. At least a dozen healthcare facilities were forced to evacuate due to flooding or power outage and, because thousands of Texans have been displaced from their homes, medical care is being provided in shelters.

The following observations and suggestions derived from our work on the medical response to Superstorm Sandy will be highly relevant to Texas’s first responders, healthcare providers, and policymakers in the days and weeks ahead.  

Focus on the basics

A storm of this magnitude will substantially alter the health-seeking behavior of Houston’s 2.4 million residents. Over the next several weeks, hospitals that are able to keep operating are likely to see a significant influx of patients.

In one of our post-Sandy investigations, we found that functional emergency departments saw a sustained 20 percent increase in patient census in the storm’s aftermath. Operating and delivery rooms also experienced higher than average volumes. This surge only abated when hospitals that had to suspend operations were able to re-open.  

Importantly, the majority of the patients that present for care are likely to have routine medical needs such as medication prescriptions, management of chronic conditions, and minor illnesses and injuries, and some will require access to outpatient services such as dialysis, behavioral health, and homecare. Reestablishing access to these services and supply chains for essential medications should be a priority.

Protect and support healthcare providers

One consequence of this patient surge is that the local healthcare workforce is going to be under tremendous stress. Physicians, nurses, and other providers will have the double burden of having to care for many patients, while being directly involved in the event themselves.

As a result, the most important thing that healthcare administrations can do is to take extraordinary measures to support and protect their frontline providers and their families. In the past, the provision of cash advances or bonuses, food, temporary housing, transportation to and from work, and other services have proven helpful.

Call in the cavalry

While local healthcare providers will be at the core of the medical response to Hurricane Harvey, external volunteers from across the state and the nation could provide much needed surge capacity in the short term.

These include deployable federal medical assets like the Disaster Medical Assistance Teams, or local volunteer healthcare providers who have signed up with the Medical Reserve Corps or American Red Cross. While it will be challenging to integrate these temporary responders into a hospital’s main operations, using them to staff medical shelters or other alternate care sites should be feasible.  

Go mobile

One innovative strategy used by healthcare providers to reach people following Sandy was the use of mobile medical clinics. These clinics can be minimally staffed, but still provide access to prescription medications and routine care, especially to vulnerable or underserved populations.

Band together

Stepping back from the operational response, it’s important to recognize that Congress has a vital role to play in both preparing for and enabling recovery following large scale disasters. On the recovery front, it will be important for lawmakers to pass an emergency appropriation that provides emergency funding.

In addition, funding for the Hospital Preparedness Program — the federal mechanism administered by the Department of Health and Human Services that provides funding to hospitals and healthcare coalitions to prepare for and respond to disasters — has been on a downward trajectory since 2008.

It is critical that Congress reverse that trend and continue to support annual appropriations for hospital and public health preparedness so that the nation is able to respond to increasingly frequent natural disasters and other large-scale emergencies.

Mr. Matthew Watson s a Senior Analyst and Dr. Eric Toner is a Senior Associate at the Johns Hopkins Center for Health Security in the Johns Hopkins Bloomberg School of Public Health. The Center has previously been the recipient of grants and contracts from government agencies that support hospital preparedness work.

The views expressed by contributors are their own and are not the views of The Hill.