Addressing Natural Disaster Takes Cooperation, Preparation to Ensure Patient Health

Making sure that patients can receive health care is of vital importance when natural disaster is on the horizon. With hurricane season fast approaching the states bordering the Gulf of Mexico and Atlantic Ocean, health care professionals need to prepare for treating patients who may not be able to access health care for an indeterminate amount of time. Collaboration and preparation among multiple teams is of paramount importance to addressing natural disasters when it comes to health care.

The period from June through December is usually regarded as hurricane season in the Atlantic Ocean and acts as the primary natural disaster that affects the east and southeastern coasts. Hurricanes can leave residents stranded without means of receiving their health care due to flooding, structural damage to their home, or downed trees and cable lines that make streets dangerous to drive on, assuming the patient has a means of transportation at all. According to an article from Texas A&M, it is estimated that only 35% of people in South Carolina who were recommended to evacuate for Hurricane Matthew in 2016 actually left their home.¹ This can leave a significant number of people in vulnerable situations once a hurricane actually hits, and can lead to a greater number of fatalities.

With so many people likely to be in a vulnerable situation, not only in the after effects of the hurricane itself but also when it comes to getting the health care and treatments that they need, with a 33% higher death rate following a hurricane due to contributing factors,² it is important that health care officials, government, and health care facilities work together to figure out ways to address the needs of as many people as possible.

Federally qualified health centers (FQHCs) and free clinics are an important resource when it comes to helping patients in low income areas. FQHCs can give extended supplies of medications to their patients to ensure that their patients have enough to last through the natural disaster, even providing methods of keeping perishable medications cool in case of a power outage.² Other methods of making sure patients can maintain contact with their providers included distributing smartphones and remote monitoring tools for patients in the area to ensure the patient is able to request help if they need it. The clinics can also help serve patients that are not their own in case of flooding and other emergencies.

Another aspect of care that the FQHCs can address is the care of undocumented immigrants during these emergencies. Undocumented immigrants are less likely to go to clinics for care during emergencies due to a fear of deportation. FQHCs can attempt travel to areas with the most need in order to encourage patients to get care and give care themselves in order to care for the patients as quickly and effectively as possible.²

Hospitals also act as facilities that have to prepare for natural disaster. All hospitals require an emergency plan in case of disaster, approved by the hospital’s accrediting body.³ These plans are implemented before natural disasters such as hurricanes, with coordination occurring between local government, first responders, and patients. Decisions include deciding whether to evacuate the hospital or have staff remain the hospital throughout the storm. However, transferring patients can have health consequences so these decisions are not taken lightly and are done only in extreme emergencies.

Right before natural disasters, patients needing elective surgery will have to wait, as these surgeries are often shut down in favor of utilizing resources solely on disaster relief and taking care of patients already admitted to the hospital.³ This includes making sure that there are 2 teams of health care professionals available to treat patients and able to relieve each other of work.

Emergency plans for hurricanes include making sure that there is air conditioning for patient comfort, backup power to power equipment keeping patients alive, and having enough food, water, and medicine in case of supply chain issues or difficulty in getting supplies to the hospital. This is vital when it comes to continuing to care for the patients within the care of the hospital.

An important factor when considering preparation in the future is the effect of climate change when it comes to both the extremity of the storms as well as the frequency of the storms. This can include the rising sea level or more frequent wildfires in some areas that can affect the way that residential patients live. Patients who are at a higher risk of being effected by extreme weather events were identified through a dashboard created in 2021.² This dashboard includes patients who have cancer, asthma, chronic obstructive pulmonary disease, dementia, and mental illness. The dashboard is able to indicate which regions are most at risk by assessing weather, climate, and air quality data in each region. This can allow for health centers and providers to narrow down who they need to target when it comes to preparation.

Hospitals, clinics, and health care workers prepare for hurricanes in advance to make sure all patients receive the care that they need | Image credit: Satoshi Kina - stock.adobe.com

Climate change is also likely to affect areas of low health equity, due to poorer air quality and lower funding in the area. Targeting these areas as regions to focus on during and outside of natural disasters should be a priority going forward, as reducing the disparities found in these areas could improve overall mortality and strain on health care resources during natural disasters.

Overall, a great deal of preparation is required to get the proper mechanizations in place to care for patients during a natural disaster. Preparing patients by giving them extra supply of necessary medication, addressing patients who have stayed during a call for evacuation, and addressing patients who live in particular areas of need are paramount in making sure that natural disasters do not affect the health care of patients in affected areas.

References

1. Horney J. Why don’t more people evacuate before hurricanes? Texas A&M Today. October 19, 2016. Accessed September 25, 2024. https://today.tamu.edu/2016/10/19/why-dont-more-people-evacuate-before-hurricanes/
2. Hostetter M, Klein S. How health care organizations are preparing for climate shocks and protecting vulnerable patients. The Commonwealth Fund. October 20, 2022. Accessed September 25, 2024. https://www.commonwealthfund.org/publications/2022/oct/how-health-care-organizations-are-preparing-for-climate-shocks
3. Hess DB. How do hospitals prepare for hurricanes. CNN Health. September 2, 2019. Accessed September 25, 2024. https://www.cnn.com/2019/09/02/health/hurricane-hospital-prep-partner/index.html