During the first hurricane season of the coronavirus pandemic, emergency officials warned residents in low-lying coastal areas to pack masks in their evacuation bags.
This year, they’re urging everyone to be vaccinated.
“The one thing that’s really changed since last year is we have vaccines,” Craig Fugate, a former Federal Emergency Management Agency administrator, said. “So part of hurricane preparation is getting vaccinated if you aren’t already.”
Late summer and early fall are the peak of hurricane season, when the biggest, most dangerous storms usually appear. But this year, hospitals in hurricane-prone states across the Gulf Coast are already dealing with disaster: a surge in COVID-19 cases that have intensive care units practically bursting at the seams, with the University of Mississippi Medical Center even staging two field hospitals in parking garages to cope with the onslaught of patients.
The Gulf Coast states where the virus is surging have some of the lowest vaccination rates in the nation, as less than 50% of residents in Louisiana, Mississippi, and Alabama have received their first shots.
A hurricane on top of the Delta variant would be “devastating,” even in Florida, which at 61% has the highest vaccination rate in the region, said Dr. Armen Henderson, a hospitalist at the University of Miami Hospital.
Henderson sees coronavirus patients — most of whom are unvaccinated — in the hospital at night and spends his days volunteering to provide care to Miami’s homeless population through Dade County Street Response.
“People are scared, they ask us what to do if a hurricane comes in these circumstances,” he said. “We are just biting our nails and hoping it doesn’t happen.”
If a major storm does hit the Gulf Coast this year, emergency management officials want to make sure potential evacuees are as protected as possible before they are grouped together in hurricane shelters.
“That’s kind of our No. 1 message, is that this hurricane season is different from previous years,” said Mike Steele, spokesman for Louisiana’s Office of Homeland Security and Emergency Preparedness.
When Hurricanes Laura and Delta hit the state last year, there were COVID patients, but no surge. Still, Louisiana was able to house evacuees in empty New Orleans hotel rooms, rather than congregate shelters, in an effort to stem the virus’ spread.
In a post-vaccine world, however, those hotels are back in business. Louisiana’s hurricane plans this year call for large shelters, complete with masks and social distancing, to be used in case of a major storm.
“That’s why our big message for the public right now is get vaccinated,” Steele said. “The more people who are vaccinated, it would give us more options for shelter plans.”
Time is running out. It can take six weeks from the first shot for someone to be fully protected against the virus, so American Public Health Association President Dr. Georges Benjamin says people worried about COVID-19 and hurricane season need to get vaccinated as soon as possible.
“For people who say, Well, I’ve got time,’ no, you really don’t, you’re out of time,” he said. “And for people who still have questions that need to be answered before they get vaccinated, they need to get those questions answered now.”
One and a half years into the pandemic, neither coronavirus nor hurricanes are new. Most Gulf Coast hospitals have evacuation plans for how to safely bring highly contagious or vulnerable, ventilated patients to safety, said Fugate, who is now chief resilience officer at One Concern. The problem is that those hospitals don’t have space for more COVID patients if there were an outbreak at a hurricane shelter.
Vaccination among the broader population is crucial — both for easing the strain on hospitals and for ensuring that people can protect themselves from storms by seeking higher ground without worrying about contracting the disease. Though there have been small numbers of “breakthrough” cases where vaccinated people contract coronavirus, the inoculation has been effective at preventing severe symptoms and death, even from the more infectious Delta variant.
Fugate is worried that all of the emphasis on the COVID surge and hospitalizations in hurricane-prone areas might scare people into staying home when they should be evacuating, and notes that vaccines are a good way for folks to keep themselves safe if they have nowhere else to go but a shelter in a storm.
“If you are told to leave, you have to leave,” he said, adding that even unvaccinated people should still go to shelters if they live in evacuation zones. “COVID is bad, drowning is worse.”
‘Our hospitals are inundated’
It’s not just the potential of COVID outbreaks in shelters that has experts worried about hurricane season this year.
Usually, hurricanes’ biggest stress on the health care system comes after the storm, when people leave their homes too early and begin trying to clean up the damage when hazards still abound.
“You get people using chain saws when they don’t usually use chain saws to cut down trees, electrocutions,” said Wayne Struble, director of emergency preparedness at the Health First hospital system in Brevard County, Fla.
This year, there’s no room for a cascade of new patients at hospitals that are already overflowing.
Texas, for example, was already experiencing a nursing shortage when the latest coronavirus surge began.
Now, there are even fewer nurses to go around. Full intensive care units mean more patients require even more attention. Non-ICU nurses are being pulled out of their usual jobs to help, said Cindy Zolnierek, president of the Texas Nurses Association.
“These patients are sicker, they need more people to care for them, and they stay a lot longer, so you don’t have beds freeing up,” she said. “There’s no room for new folks.”
A full ICU also means an overflowing emergency room and long wait times at urgent care centers.
“If there is a hurricane and people are injured and may need health care, we are already stopped up,” she said. “You hate to say it would be a disaster, because we are already experiencing a disaster, but a hurricane would be a second disaster.”
Darrell Pile is the CEO of the Southeast Texas Regional Advisory Council, which coordinates health care providers, including hospitals and ambulances, in a 25-county area.
He says the surge and the nursing shortage also mean that ambulances are unable to offload their patients at hospitals when they arrive, instead often waiting hours between arriving at an emergency room and when they become available for the next call.
“Our hospitals are inundated, and it trickles down and affects all levels of health care,” he said.
That’s why, Fugate said, it’s more important than ever for folks to not go anywhere for the first day after a storm and allow emergency crews to ensure conditions are safe again.
“It’s amazing how many people would still be alive if they had just stayed home the first 24 hours after a storm and let things settle down,” he said. “We don’t want people adding to the carnage this year.”