Hurricane Florence strikes today. Hospitals are getting ready—with military tactical vehicles, evacuations, stockpiles, and more.

President Trump on Tuesday approved emergency disaster declarations for North Carolina, South Carolina, and Virginia ahead of Hurricane Florence, as hospitals in the impact zone are working to prepare for the storm.

Details on the hurricane

Hurricane Florence is forecast to be a Category 2 storm with maximum winds of 110 miles per hour. The storm is expected to make landfall along the border of South and North Carolina by late Thursday—with high winds and potential flooding beginning as early as Wednesday, according to the Washington Post's "Capital Weather Gang."

According to the Washington Post's "Capital Weather Gang," the National Hurricane Center has warned Hurricane Florence could lead to:

  • A "life-threatening storm surge," which would be "a tsunami-like rise in ocean water over normally dry land";
  • "Damaging hurricane-force winds"; and
  • "Life-threatening freshwater flooding."

Federal officials have said the hurricane could result in millions of U.S. residents losing their electricity for several weeks if high winds knock down powerlines and high rainfall floods equipment, "Capital Weather Gang" reports.

HHS declares public health emergency, officials order evacuations

Trump on Tuesday approved emergency disaster declarations for North Carolina, South Carolina, and Virginia, and HHS Secretary Alex Azar declared public health emergencies in North Carolina and South Carolina to provide the states with "greater flexibility in meeting emergency health needs." The declaration allows HHS to direct medical personnel and supplies to the affected regions, Politico's "Pulse" reports.

According to "Vitals", HHS has put together a team of 230 volunteer health professionals who are prepared to provide medical assistance after the hurricane makes landfall. HHS also said it is monitoring Medicare beneficiaries in the affected areas who use special equipment.

State officials have ordered more than 1.5 million people to evacuate the coastal areas. South Carolina Gov. Henry McMaster (R) on Monday ordered mandatory evacuations in coastal counties where there are 17 hospitals, Modern Healthcare reports. The order gave affected hospitals 72 hours to comply with the evacuation requirement.

In North Carolina, officials ordered mandatory evacuation in six counties.

The National Hurricane Center said, "All interests from South Carolina into the Mid-Atlantic region should ensure they have their hurricane plan in place and follow any advice given by local officials."

Health care systems prepare for the storm

Health care systems this week started preparing for the storm by evacuating patients, testing power generators, and stockpiling extra medical supplies, and one hospital is planning to use a recently obtained military vehicle to transport physicians across the hospital's campus when water levels rise. 

Carl Lindquist, a spokesperson for Tidelands Health, on Monday said the three-hospital health system would "immediately begin taking steps to evacuate patients at Tidelands Waccamaw Community Hospital, Tidelands Georgetown Memorial Hospital, and Tidelands Health Rehabilitation Hospital." The hospitals are transferring patients to inland facilities outside of the evacuation zone. In addition, Tideland's hospitals in the evacuation zones had stopped accepting new patients as of Tuesday, Modern Healthcare reports. A small team of clinical staff, management, and security personnel will remain at Tideland's hospitals to provide care to patients who cannot be transported because they are too sick. The team also will help reopen the facilities as soon as the hurricane passes, according to Amy Stevens, vice president of marketing and communications at Tidelands Health.

Stevens said, "Hurricane preparedness is something we live with every year. We are always in preparation mode."

A spokesperson for New Hanover Regional Medical Center—a level-two trauma center with 885 beds in Wilmington, North Carolina—said the medical center is transferring patients to facilities in regions where Hurricane Florence is less likely to cause significant damage. The spokesperson said the medical center is not completely evacuating all patients because it is the region's only trauma center. As such, the center is making sure it has adequate supplies and staff to care for remaining patients through the storm.

The South Carolina Hospital Association is helping health systems in South Carolina coordinate patient transfers, according to Modern Healthcare. Schipp Ames—the association's VP of communications, education, and member services—said, "It's really been a family-like experience the way hospitals have graciously stepped up."

For instance, MUSC Health, which is exempt from the mandatory evacuation, has started to accept patients being transferred from hospitals along South Carolina's northern coastline. According to Modern Healthcare, outpatient clinics and elective operations at MUSC Health are being canceled beginning Wednesday, but MUSC Health's emergency departments (EDs) will remain open.

MUSC Health also will offer patients no-cost telehealth visits beginning on Tuesday and lasting throughout the storm. MUSC Health also plans to use its retired military tactical vehicle during the storm to transport clinicians through a much as six feet of water, and Matt Wain, MUSC Health's COO, said the system as of Tuesday had stockpiled enough food, medicine, and water to stay in operation for at least a week.

In Columbia, South Carolina, Palmetto Health and Greenville Health System are teaming up to accept patients who are being evacuated from hospitals and nursing facilities in the evacuation zone. As of Tuesday, Palmetto had accepted 16 evacuated patients, and the health system said it did not expect more patients. Greenville Health System said it expects to receive about 40 evacuated patients.

Palmetto and Greenville also have allowed their staff to stay at their facilities overnight if they are having problems with transportation. Tim Fitzgerald, operations executive for Palmetto, said the health system also is offering a day camp for employees' children through Friday.

In Horry County, South Carolina, officials at Conway Medical Center, which is not in the evacuation zone, said they plan to keep the medical center's ED open and accept new patients through the hurricane. Daniel Adamczyk, director of emergency management at the facility, said the medical center plans to work with other hospitals and government agencies to ensure patients are safely transferred from the evacuation zone. Adamczyk said the hospital has prepared power generators to keep the hospital's electricity running for at least 93 hours if the storm causes outages.

Further, Conway Medical Center's Pharmacy Director Robert Gajewski said, "[W]e're evaluating all our inventory [and] trying to make sure that we have plenty in stock when the storm reaches us—and especially being prepared for after the storm because we never know what the situation is going to be—if transportation is going to be hampered, power is going to be out, so we want to make sure that we put seven to 10 days of supply of medications and supplies in stock here at the hospital."

According to Politico's "Pulse," dozens of nursing and other long-term care facilities along North Carolina's, South Carolina's, and Virginia's costs also have evacuated and transferred patients to inland facilities. In addition, the North Carolina Health Information Exchange Authority has encouraged its members to make sure that physicians have log-in credentials so they can access health care information remotely, "Pulse" reports.

Drugmakers suspend manufacturing at plants in hurricane's path

Meanwhile, Pfizer has announced that two of the company's manufacturing plants, including a facility belonging to Pfizer's subsidiary Hospira, in North Carolina beginning on Thursday will temporarily close because of the hurricane.

According to Erin Fox, a drug supply expert at the University of Utah, Hospira's Rocky Mount facility plays a key role in providing U.S. health systems with sterile injectable drugs, which means if the facility remains closed for a long duration, national drug shortages might worsen. 

However, Pfizer spokesperson Steven Danehy said, "Pfizer has contingency plans in place to ensure the continuity of supply, and mitigate interruptions during natural disasters."

In addition, according to "Pulse":

  • Baxter has announced that it plans to keep its Marion, North Carolina, facility, which manufactures saline, open;
  • Merck has said it is temporarily closing four of its facilities in North Carolina and Virginia and is planning to adjust its shipments and use power generators if necessary; and
  • Novo Nordisk has said it plans to keep its North Carolina plant, which manufactures diabetes medication, open (Samenow, "Capital Weather Gang," Washington Post, 9/12; Baker, "Vitals," Axios, 9/12; Livingston, Modern Healthcare, 9/11; Minch, WBTW, 9/10; WCSC, 9/11; Kawata, WMBF News, 9/11; Cancryn, "Pulse," Politico, 9/12; Koons, Bloomberg, 9/11; Hanna et al., CNN, 9/13; Diamond, "Pulse," Politico, 9/13).

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