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In the Midst of Covid-19, Florida Healthcare Providers Prepare for Hurricane Season

With Atlantic hurricane season beginning June 1 and Covid-19 still unfolding, health officials prepare on two fronts.

Ebonie Allen-Williams, Nurse Practitioner and Nursing Supervisor at Bond Community Health Center, Inc. in Tallahassee, Florida, pictured with a  Direct Relief Emergency Medical Backpack. Health centers and free clinics in Florida have been responding to Covid-19 in their communities, and are now preparing for the start of hurricane season. (Photo by Donnie Lloyd Hedden for Direct Relief
Ebonie Allen-Williams, Nurse Practitioner and Nursing Supervisor at Bond Community Health Center, Inc. in Tallahassee, Florida, pictured with a Direct Relief Emergency Medical Backpack. Health centers and free clinics in Florida have been responding to Covid-19 in their communities, and are now preparing for the start of hurricane season. (Photo by Donnie Lloyd Hedden for Direct Relief

Responding to a natural disaster and a pandemic simultaneously is a scenario that’s top of mind for health officials in U.S. communities entering hurricane season, which begins June 1.  In the Florida panhandle, which was devastated by Hurricane Michael in 2018, healthcare providers are gearing up for what has been predicted to be a busier than average hurricane season.

On this episode of the podcast, we speak with two healthcare providers — both of whom treated patients in the aftermath of Hurricane Michael — about how they are preparing for this year’s hurricane season in the midst of the Covid-19 pandemic.

In response to Covid-19, Direct Relief is supporting health facilities across the United States, including along the Gulf Coast, with medical and financial support. The organization is also pre-positioning emergency medical supplies in hurricane-prone communities in preparation for the 2020 hurricane season.

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Transcript:

June 1st marks the beginning of hurricane season in the United States. With Covid-19, that means healthcare providers are preparing to respond to two emergencies at once. The situation is forcing providers to make tough decisions about which emergency is more pressing: a natural disaster or a pandemic?

“When we start communicating with patients and messaging the steps to prepare for a hurricane how do those align with the steps that we are telling people to prevent Covid?”

Dr. Temple Robinson is the CEO of Bond Community Health Center in Tallahassee, Florida.

“Do they blend with them, do they overlap, does one trump the other?”

Usually, Robinson tells patients to stay with family members or go to a public shelter if they’re in danger. But with Covid-19, those go-to steps could mean violate social distancing guidelines.

While there’s no official protocol yet, she says escaping a hurricane is more important, even if that means breaking quarantine.

“My order of logic is that a hurricane is going to come and go, the damage, immediate loss of life, if you had to make a choice between huddling with someone that has sturdy home than staying in a flimsy home I would err on the side of huddling with someone.”

When a hurricane is in the forecast, public health officials and providers like Robinson urge people to stock up on supplies, like food and water. It’s a common refrain in storm prone Florida, which was devastated by Hurricane Michael in 2018. But this year securing multiple weeks’ worth of groceries could be difficult.

1.5 million Floridians have filed for unemployment since the start of the pandemic and grocery shelves have been emptied by panic buying. Robinson says many of her patients already struggle with food insecurity.

“Most of us — and when I say ‘us’ I am talking about community health centers – are located in places with great food insecurity, so telling someone to stock up on food and supplies really become empty words if you live in an area where there’s food insecurity. So, I’m concerned that with Covid and a hurricane, that food insecurity could become worse.”

Her patients aren’t the only ones dealing with the financial fallout of Covid-19. Robinson says her health center is facing a host of unexpected expenses. From staffing a drive-up testing site to buying personal protective gear, the costs have been significant.

“For janitorial supplies, we’re spending four times as much, as much in a week as we do in a month.”

If a hurricane were to hit, those costs would only be compounded. After Hurricane Michael, the health center was closed for days due to flooding and, as a result, lost thousands in revenue. Not to mention the cost of repairing damages and replacing equipment.

“You think about how health centers are burning through cash with Covid and you put a hurricane on top it and it would truly be a perfect storm.”

While the added costs may threaten health facilities’ viability, providers are also concerned about the impacts Covid-19 would have on post-disaster care.

“I think it would make disaster relief, which is already pretty chaotic, even more chaotic.”

Hillary Glenn is the co-founder of Point Washington Medical Clinic in Santa Rosa Beach, Florida. The clinic provides healthcare for free to individuals who are underinsured or lack insurance all together.

“62% of our patients annual household income is less than 20K per year and 84% is less than $35,000.”

After Hurricane Michael, Glenn and her staff traveled to the epicenter of the disaster to give evacuees flu vaccines, tetanus shots, and chronic disease medication. But with Covid-19, providing care in this way will be much more difficult.

“If were to move into a hurricane or disaster relief on that level instead of just being able to pop up in a tent and treat everyone there would always be in the back of your mind are they infected.”

Every patient would need to be screened for Covid-19 — if they tested positive — separated and treated in a different unit. “It would almost be like you were running two clinics in the field.”

Taking these kinds of precautions would require two sets of volunteers and a surplus of PPE, both of which are in short supply. “It’s like having a clean and a dirty and keeping everything separated.

Without a vaccine, social distancing remains the most effective way to prevent the spread of the virus. But natural disasters make social distancing much harder, as people scramble to find shelter, often leaning on neighbors for help. It’s something Direct Relief’s Andrew Schroeder observed after a wave of gusty tornadoes tore through the South this April.

“We know that social distancing becomes more difficult after a disaster and we can show that.”

Schroeder has been using population data to track rates of mobility during Covid-19. He says that after the tornadoes, people began moving around much more, despite stay at home orders.

“You have a number of areas, particularly in Mississippi, that immediately following the storm saw much higher rates of mobility.”

In Jasper county, Mississippi—one of the most impacted areas—social distancing was hardly maintained. “By the 14th of April Jasper County was essentially back at baseline mobility.”

Now, Jasper County is a Covid hotspot. While there are several factors that may have contributed to the uptick in cases, Schroeder the disaster likely accelerated the spread of the virus. “The fact that you now have hundreds of cases in rural Miss, eh, that’s not nothing.”

This week, the Atlantic seaboard was hit by the first named storm of the season. Tropical Storm Arthur brought heavy rains and flooding to the North Carolina coast.

While the damage was minimal, it’s expected to be the first of many. According to meteorologists, this hurricane season is predicted to be more active than usual.

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