https://goo.gl/krrALRThe damage inflicted by Hurricane Harvey has posed enormous health challenges in Houston and neighboring areas hit hard by the storm. As regional medical director of emergency medicine for the Houston Methodist Hospital System, one of us (Neil) has been on the front lines of the medical response. The other (Ranu) has been involved in responses to such public health disasters as the Ebola crisis in Africa, Hurricane Katrina in Louisiana, and the 2010 earthquake in Haiti. The response to Harvey is ongoing, but there are early lessons that could help governments and health systems in dealing with the aftermath of Hurricane Irma and other major catastrophes down the road.
Deploy existing resources creatively to address unforeseen challenges. All health systems have contingency plans and run drills for emergencies like a hurricane. However, the challenges wrought by a disaster can confound even the best-laid plans, and responding effectively requires using available resources in ways not previously considered.
Think twice before closing smaller medical facilities. Communities rely on a wide array of medical facilities to stay healthy, including smaller hospitals, physician offices, dialysis centers, nursing homes, and pharmacies. Severe flooding and damaged infrastructure made roads impassable and, along with power outages and water supply contamination, caused many of these facilities to shut down. (About 40% of dialysis centers in the area closed.) When any one of these medical contact points closed, patients did not know where to go for their routine, ongoing health needs. Consequently, many people developed complications from uncontrolled diabetes, heart disease, and other chronic conditions.
Schedule medical staff and give them time off to avoid burnout. When facing a crisis, there is a tendency to go to an all-hands-on-deck mode from the outset. However, creating a schedule to ration capacity and energy is indispensable for sustaining response efforts over the days and weeks required. Making sure teams have adequate time to sleep, eat, and rest while caring for patients is often overlooked, but hospitals that did not enforce downtime for frontline staff saw a downturn in morale, energy, and cognitive awareness even within the first 24 hours.
Establish clear and trusted sources of information. Amid any crisis comes hysteria that can lead to rapid dissemination of unconfirmed hearsay. During Harvey, rumors abounded about impending road closures, water shutoffs, and worsening conditions that influenced people’s decisions on when and where to seek care. When a disaster is imminent, public authorities should establish sources of accurate information that the public can be made aware of in advance. When rumors begin to spread, especially on social media, they need to be refuted so that people can make urgent decisions for themselves and their families with clarity.
Don’t underestimate the human spirit. At a moment of heightened polarization nationally, one of the most remarkable things that occurred in the area struck by Hurricane Harvey was that people facing hardship and tragedy worked together to care for one another. The number of ordinary people who stepped up with extraordinary acts of kindness are too numerous to count but have been the linchpin of the response so far.