 Hull’s deputy fire chief, William Frazier, says the department stations emergency personnel and a firetruck on parts of the peninsula likely to be cut off when high tides or a storm approach. Credit: Doug Struck Even if residents can get out, there is a question as to whether they’ll be able to get to a functioning hospital if needed. Alexandra Tarabochia-Gast, a family physician in Baltimore, joined with researchers in Boston to study the vulnerability of hospitals on the Atlantic and Gulf coasts to storms. “We can t think about hospitals operating as an island. There needs to be access,” Tarabochia-Gast told EHN in a phone conversation. After hurricanes Sandy, Harvey and Katrina, she said, reviewers found “the hospital itself might be operational, there may be no flooding. But if the roads are flooded around it, you can t get staff in or out. You can t get any of the goods in or out, or patient transport.” Their study, published in September in GeoHealth, concluded that even with a relatively modest Category 2 hurricane, communities in Florida, New York and Massachusetts would see flooding that cut off more than half the roads surrounding many hospitals. Tarabochia-Gast’s study noted that 2012’s Hurricane Sandy cut off electricity to 40% of the hospitals in its path, and backup generators failed at a third of those. They estimated that, if sea level rise continues at the current rate, by century’s end 147 hospitals within 10 miles of the coasts would be flooded during a Category 1 storm, the weakest of hurricanes... Relatively weak hurricanes may flood many hospitals that care for roughly one in four Americans, the study concluded. Some hospitals are ready for this scenario. In Boston, plans for a new Spaulding Rehabilitation Center building were revised after Hurricane Katrina in 2005. In that New Orleans disaster, nursing homes and a major hospital became death traps when floods cut all access, smothered ground-floor utilities including electricity, air conditioning, water and sewer and desperate staff could not open windows to combat 100-degree heat. Spaulding Hospital, located almost at sea-level in the Charleston section of Boston, was redesigned to allow floodwaters to pass unimpeded through the ground floor, with patients on higher floors and utilities on the roof. Windows open for ventilation; the building is ready with water, food and emergency generators. “Our strategy is to make sure we’ve got what we need to operate the building,” John Messervy, head of design and construction for Mass General Brigham, which owns Spaulding and 11 other hospitals, told EHN. Many of the preparations for a hospital—such as bringing extra staff in—have to be done before a storm hits to avoid flooded roads, he said. “We’re not a business that can close the doors and send everybody home if there’s bad weather coming.” Messervy noted, however, that “medical service delivery is evolving, too.” More care—even for such things as dialysis—are being done remotely at patients’ homes, which could be a key strategy when access is cut off. Joseph Kvedar, a professor at Harvard Medical School who has been advocating for remote health care for more than three decades, sees telemedicine as a tool for reaching stranded patients and also for communicating with emergency personnel who cannot reach a hospital. “In the field, you make split-second decisions that are literally life and death decisions. And that can be really facilitated by connectivity back to the emergency room,” he told EHN. He said remote care burgeoned 24-fold during the Covid pandemic and is now more widely accepted. “If a procedure is required, if physical hands-on-something is required, that s not the role for that technology,” he noted. “But other than that, it s quite useful.”
“You might not be in a flood zone area, but you might be in an isolation risk area”
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