Sandy forces hospitals to rethink disaster planning
As nor’easter looms, facilities examine what worked and what didn’t
When Kenneth Davis heard ahead of time about the “life-threatening” surge and winds headed toward New York City, he had one thing in mind: put planning for Superstorm Sandy into emergency mode.
He knew the location of his hospital on the Upper East Side — more than 70 blocks away from lowest lying areas — might be coming to the rescue for hospitals closer to the waterfront. He had to find a way to open the doors to them.
“This was no Katrina,” says Davis, president and CEO of the Mount Sinai Medical Center in New York City. “There were other hospitals nearby to be evacuated to unlike in New Orleans.”
Mount Sinai ended up taking more than 100 patients from two hospitals when floodwaters crippled their backup generators. Davis said he was able to accept the patients and their doctors and nurses because he’d maximized capacity, set up hundreds of cots for staff and canceled all elective surgeries. He also credited “being lucky”: His hospital didn’t lose power or sustain heavy flooding.
“We were able to solve all the problems that presented themselves to us,” he says. “I’mnot sure what we would have done had unsolvable problems come up.”
Unlike Hurrricane Katrina in 2005, no deaths have resulted in New York City because of the evacuations, yet in spite of the lifesaving efforts of Davis and many others, disaster planning experts are faulting the city’s preparedness plans for the “unsolvable” problems that did force three hospitals and four nursing homes, some with acute care patients, to evacuate after Sandy hit on Oct. 29.
“Until it becomes personal like it did for us in Louisiana, you really don’t know you have to get your plan together,” says Jody DePriest, the regional vice president of operations for Southern Magnolia Management in Thibodaux, La. He helped develop emergency planning for several nursing homes along the Louisiana coast after Katrina.
“I saw what happened in New York and New Jersey,” he says. “They’d never seen a storm like the one that hit them this time, but they had been warned it would happen sometime. I’m sure they’ve learned some valuable
“There are more and more layers of complexity and challenge with this kind of large-scale disaster,” says Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University in New York. “The experience before during and after Sandy will inspire us to rethink large-scale disaster planning.”
Redlener said it’s “inadequate that no one in the planning process foresaw this (generator problem). “Things that needed to be improved after the 2003 power outage in the city still turned out to be our Achilles’ heel. You can have the best generators in the world, and it doesn’t matter if they’re in the wrong place.”
More than a thousand hospital patients were evacuated in the five boroughs, according to Brian Conway, spokesman for the Greater New York Hospital Association, which helped coordinate the evacuations.
“The response was fantastic, immensely challenging, but not unexpected,” Conway says. “We were prepared. The system worked.”
A “new vulnerability” faces coastal cities, says Tricia Wachtendorf, associate director of Disaster Research Center at the University of Delaware. Older hospitals near shorelines need to be re-evaluated for critical care units and undergo costly upgrades.
“We really need to be thinking about changing weather patterns, rising sea levels and highly populated areas along the coastlines,” she says. “Are facilities prepared to face the risks of today?” lessons.”
As Sandy approached, New York City Mayor Michael Bloomberg declared a state of emergency Oct. 28 and ordered residents in low-lying areas to evacuate. Two hospitals did evacuate before the storm hit Oct. 29. Bloomberg said “I think we’ve done everything we can to prepare” after coordinating with federal, city and state officials.
After the storm made landfall Oct. 29, three other hospitals had to evacuate. Two — NYU Langone Medical Center and Bellevue Hospital — sent patients to Mount Sinai and other hospitals. NYU Langone Medical Center started evacuating about 200 patients around 7 p.m. They reported the basement filled with water and the backup generators failed. Bloomberg said he had not counted on that and he’d been assured the generators had been tested.
Two days later, Bellevue Hospital had to close and start evacuating about 700 patients.
On Monday, a full week after the storm hit, the city sent mobile care units to the hardest-hit neighborhoods. Late Tuesday, as a nor’easter threatened to flood already-devastated areas, Bloomberg ordered the evacuation of three more nursing homes and an adult care center operating on backup power.