Florida braced for Hurricane Ian as the storm aimed for the state’s western coast, which is expected to land on Wednesday morning. The storm was upgraded to a Category Three with winds of more than 111 miles per hour and is expected to make landfall somewhere between Tampa and Fort Meyers. Of particular concern are older, medically fragile people that may not be able to evacuate the area in advance of the storm.

As of Tuesday, the storm was advancing at a speed of 12 miles per hour, however, the storm is expected to slow down to 5 miles per hour after making landfall, which means that “Floridians are going to experience the impacts from this storm for a very long time,” Deanne Criswell, FEMA Administrator told reporters on Tuesday morning.

Up to 25 inches of rain are possible in some parts of Florida, and Criswell urged caution since the exact path of the storm is still unknown. “As with any hurricane, it can still be unpredictable,” she said, urging communities in and outside of the projected storm path to prepare and be ready. “Do not underestimate the potential this storm can bring.”

Direct Relief’s Response

Direct Relief has twelve pre-positioned hurricane modules staged across the state, including in Tampa, Immokalee, Miami, Tallahassee, Pensacola, Port Charlotte, Fellsmere, Jacksonville, Miami Beach, and Panama City.

The organization was also responding to requests for medical aid on Tuesday, and hurricane modules containing essential medicines like insulin, medications for asthma and high blood pressure, antibiotics, wound care and other items were prepped for departure.

Currently, Direct Relief is processing requests from Osceola Health, Kissimmee; FoundCare, West Palm Beach; Virginia B Andes Clinic, Port Charlotte; Borinquen Health, Miami; Bond Health, Tallahassee; Good Health, Tavernier; Underground Clinic, Tampa; Freedom Clinic, Ocala; Agape Family Health, Jacksonville; Center Place Health, Sarasota; and Family Health Centers of SW FL, Fort Myers.

The organization has been coordinating closely with the Florida Primary Care Association, Florida Association of Free and Charitable Clinics, and Florida VOAD.

Direct Relief has provided more than $130.4 million worth of medical aid to 254 recipients across the state since 2008, and has responded to numerous hurricanes and tropical storms over the years, including Hurricane Michael in 2018. Mobile medical units and backup power stations have also been provided after storms to increase the resiliency of community health responders, and Direct Relief is ready to respond with resources as needed.

The storm also passed over western Cuba on Tuesday, with high winds of up to 125 miles per hour. Direct Relief has emergency supplies pre-positioned in Havana, and has additional shipments en route from Panama to the area in response to the storm.

Health Risks in the Storm’s Path

Several caches of prepositioned medicines are staged with health centers in evacuation zones on or near the storm’s path, including Tampa Family Health Center, one of the largest Federally Qualified Health Centers in Florida,

The health center operates 15 locations in the Tampa area and issued a statement that the health center would be closing as of 5 p.m. Tuesday to prepare for the storm’s impacts, and would tentatively remain closed until Friday, pending damage assessments.

There are currently 22 Federally Qualified Health Center administrative sites located in the path of Hurricane Ian, according to the hurricane’s forecast error cone projected Tuesday by the NOAA National Hurricane Center. Those sites serve a combined 1,053,323 patients annually, 50.2 percent of whom are at or below the Federal Poverty Level.

Disasters like hurricanes also disproportionately impact vulnerable people, including children, older adults, people without access to transportation, people with disabilities, and those for whom English is a second language.

People with chronic conditions are also at risk if they lose access to medications needed to manage their health. Conditions like asthma, diabetes and high blood pressure can prompt emergency room visits during times of high volume for acute injuries.

At health centers in the storm’s forecast error cone, 4.5 percent of patients had a diagnosis of asthma (46,947 patients), 8.3 percent had a diabetes diagnosis (87,342 patients), and 17.9 percent were managing hypertension (188,799 patients), according to the U.S. Health Resources and Services Administration.

Who is Most Vulnerable to the Storm’s Impacts?

Using data from the U.S. Centers for Disease Control and Prevention’s Social Vulnerability Index model, Direct Relief built a set of maps that showcase these disparities. The Social Vulnerability Index measures the likelihood that a given population will be disproportionately in need of support during an emergency. The index measures several factors, including access to transportation, rates of disability, and English as a second language.

Two counties expected to receive storm impacts also have a high number of older adults residing there, including in long-term care facilities that have a higher concentration of medically fragile adults. Pinellas County’s population of adults over 65 is 25 percent, and Hillsborough County, where Tampa is located, has 14 percent. (The U.S. National average is about 16.5 percent.) Pinellas County has 238 long-term care facilities, and Hillsborough County has 294.

The area also has a relatively high number of people with power-dependent medical devices, around 18,000 between the two counties of Pinellas and Hillsborough, according to Direct Relief analysis. Inconsistent access to power can be life-threatening for people dependent on medical devices like ventilators.

The organization will also be monitoring needs as the storm continues and will respond as needed.