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Disastrous hurricanes, fires and floods put strain on US physicians, hospitals and patients

Oct 13,2017

Nursing

John Murphy

Source: https://www.mdlinx.com/nursing/article/1179

As fast-moving Northern California wildfires raged into Santa Rosa, CA, in the early morning hours of Monday, October 9, the staff of Santa Rosa Kaiser Permanente Medical Center evacuated its 130 patients, shutting down the hospital and its emergency department. News footage showed nurses and emergency workers wheeling out patients in beds, while fires burned down the street coming closer.


Comfort in the storm
US Navy nurse treats a patient aboard USNS Comfort after a medical evacuation from San Juan, Puerto Rico. (Photo: US Navy/Stephane Belcher)

Patients were transported—some by city bus commandeered for the evacuation—to Kaiser Permanente in San Rafael or other local hospitals and health care centers.

“There’s certainly been a strain on some of our facilities,” Josh Weil, MD, chief of the Emergency Department at Kaiser Permanente Santa Rosa, told the Los Angeles Times. “You keep thinking…‘All right, we’re through this.’ And then we’re not,” he said. “You think it’s safe, and then it’s under threat again. You think it’s safe…and then it’s gone.”

Like many other hospital employees, Dr. Weil lost his home to the fire. Meanwhile, the Santa Rosa Medical Center remains shut down until further notice. Health officials in the area advised residents to keep their windows closed and air conditioners on to avoid breathing in smoke. The air quality in Napa County reached unprecedented, hazardous levels as more than 20 wildfires burned in the area, filling the skies with smoke and fine particulate pollution.

Smoke inhalation is particularly harmful to children, elderly, and people with respiratory conditions such as asthma, COPD, emphysema, and heart disease, advised the Bay Area Air Quality Management District, which has issued air quality alerts for several days running.

The hazardous conditions could continue for days to come, the organization warned.

Struggling with shortages

As the West Coast copes with the health care crisis posed by wildfires, residents on the hurricane-battered islands of the East Coast continue to struggle with barely manageable conditions weeks after devastating damage caused by Hurricanes Irma and Maria.

If not addressed quickly, the health situation in Puerto Rico and the US Virgin Islands could become much worse, authorities warned.

“Infectious disease risks in the wake of these hurricanes include exposures to waterborne pathogens, the spread of infections in crowded shelters, food-borne illnesses, mosquito-borne infections and mold-related illnesses. Reliable access to medicines for patients with HIV and tuberculosis is also critical to preventing treatment disruptions that increase patients’ risks of serious illness, disease progression, and to avoid the emergence of drug-resistance or transmission of these infections,” advised Paul Auwaerter, MD, president of the Infectious Diseases Society of America, and Melanie Thompson, MD, chair of the HIV Medicine Association, in a joint statement.

“Health workers in the affected areas struggle with shortages of antibiotics and hydration solutions, and they are bracing for potential infectious disease outbreaks. Ensuring that basic needs are met including access to clean water, safe food, and sanitation as essential for infection control,” they added.

Indeed, Puerto Rico Governor Ricardo Rosselló recently announced that 10 potential cases of leptospirosis, including four deaths, are under investigation.

Dr. Auwaerter and Dr. Thompson pleaded in their statement for an immediate infusion of emergency funds to provide essential medicines and fundamental health care supplies on those islands. They also appealed for support to rebuild critical health infrastructures in devastated areas.