September 15, 2018 - Just over a year ago, Hurricanes Harvey, Irma, and Maria devastated parts of the US. In doing so, these storms taught those of us in emergency management some hard lessons while exposing vulnerabilities in how we plan for and respond to disasters. Both Hurricanes Harvey and Maria were considered to be once in a lifetime events. Yet, as the deluge from a stalled Hurricane Florence brings record-breaking flooding to the eastern US, in ways eerily reminiscent of Harvey, we are reminded that these events will continue to occur, and we must be prepared to respond. The potential for severe healthcare disruptions from hurricanes and other disasters demands our diligence to protect patients. Hurricane Maria stands out as one of the worst natural disasters in the country’s history, with the death toll recently being officially recognized by the government on the island as just shy of 3,000 people.
Like many major disasters, Hurricane Maria saw a range of cross-sector challenges arise and threaten human health. These challenges require creative partnerships for effective response and recovery. Many solutions to problems faced in Maria’s wake were forged through forward-thinking partnerships between the private and public sector. For example, ride-sharing platforms partnered with patient groups to provide rides for patients to and from shelters to healthcare appointments. We know countless other partnerships, at the community level all the way up to national level, were formed and tapped to protect healthcare.
With their knowledge of the islands, corporations with local footprints in Puerto Rico and the USVI were a source of critical information for the response. We know that across the pharmaceutical industry, companies came together to share information and resources and these intra-sector collaborations were pivotal for coordination efforts. Trade associations like our partners the Biotechnology Innovation Organization (BIO), Pharmaceutical Research and Manufacturers of America (PhRMA), and the Healthcare Distribution Alliance (HDA) played a vital role as central nodes of information, connecting members, facilitating coordination calls, and sharing resources.
Healthcare Ready and our non-governmental organizations partners contributed in a variety of ways, helping to address patient needs and creating new cross-sector linkages at all stages of the health and medical supply chain. Throughout the 2017 hurricane season, we provided critical coordination services to patients and our partners in the government and private sectors. For 81 consecutive days, we triaged patients, helped procure medical care and supplies for those in need, coordinated countless patient transports, and fostered partnerships across a wide range of emergency operations. Large numbers of vulnerable and chronically ill patients were hit particularly hard in Puerto Rico and the USVI during Maria. This situation was exacerbated by a relief effort complicated by physical geography and rigid legislation.
To protect vulnerable patients before and after events, we must integrate the hard lessons learned from last year’s hurricane season and previous events. These lessons have been visible throughout the last week as the Southeast US prepared for Hurricane Florence. Topics like fuel re-supply for generators and oxygen availability for oxygen-dependent patients came up in the earliest coordination calls. Forward-leaning emergency declarations included emergency refill and “refill too soon” permissions in a number of states, granting patients the ability to stock up on necessary medications and affording them prescription assistance days in advance of the storm.
Hurricane Maria will be remembered as a humanitarian crisis well into the future as the recovery continues. Yet, as we continue to see, these disasters are far from once in a lifetime. To avoid facing costly and deadly calamity caused by Maria, we must make sustainable investments into resilient policies and infrastructure. We know these events will come, likely more than “once in a lifetime”, but we have an opportunity to build better, stronger infrastructure to withstand these events.
As Hurricane Maria taught us all too well, excessive strain on the healthcare system will lead to illness and death long after a disaster strikes. It is of critical importance that we develop training for state and local leaders, first responders, and health officials to be able to handle sustained public health emergencies with their own resources and expertise. We must also adopt emergency response policies which put greater emphasis on populations with chronic health conditions and those of low socioeconomic status – a demographic which faced a nearly 50% increase in mortality risk after the storm. Only when health equity extends to our most vulnerable populations will we have a secure and resilient population.
The work to be done in this field is as important as it is prudent. Almost a year since Maria, Puerto Rico and the USVI remain in a state of recovery and will continue to rebuild for decades to come. The time for us to turn the hard lessons we learned last year into working policies that elevate our health readiness is now – we simply cannot afford to wait any longer.
Healthcare Ready remains committed to fostering partnerships among stakeholders in healthcare and supply chain, with the goal of helping patients in crisis. Our mission to build and enhance the resiliency of communities before, during and after disasters through partnerships is as relevant now as it was when we were founded after Hurricane Katrina.