- Hurricane Maria has left Puerto Rico’s healthcare system in shambles, with hospitals dependent on diesel-fueled generators to power life-saving equipment, lacking air conditioning and running out of of clean water, Reuters reports. To guard against looting, fuel is delivered by armed guards.
- Medical supplies are also scarce. Americares flew in duffel bags of antibiotics and vaccines over the weekend, but with much of the island’s telecommunications down and many roads still impassable, getting them to those in need will be difficult, according to The Wall Street Journal. People in shelters who need insulin and other temperature-sensitive drugs to survive have no way to keep them cool, NPR notes.
- “Our main needs are communications recovery and diesel-fuel distribution,” Nabal Bracero, a reproductive endocrinologist at Centro Medico in San Juan, told the Journal via a text message Tuesday. According to the Federal Emergency Management Agency website, fuel had been delivered to 19 of the island’s hospitals as of Wednesday.
With the flooding come worries of mosquito-borne diseases, too, such as Zika, cholera or Dengue fever. Officials have said it will take months to repair the island’s infrastructure and restore electricity and cell phone communications to all Puerto Ricans.
HHS Secretary Tom Price sought to counter criticism that the Trump administration has not responded to the crisis quickly enough, tweeting on Wednesday morning:
In subsequent tweets, Price noted HHS is working with the Department of Defense and Department of Veterans Affairs to move residents with chronic conditions to safety, and said the agency’s National Disaster Medical System had established a base of operations with medical equipment and supplies in San Juan. Efforts were also underway to transport about 150 dialysis and 130 critical care patients from Puerto Rico and U.S. Virgin Islands to the mainland.
Hurricane Maria tore across Puerto Rico, displacing residents and destroying its already fragile infrastructure just weeks after Hurricanes Harvey and Irma wreaked havoc in Texas and Florida. In southeast Texas, several hospitals had to evacuate patients as flood waters rose, and some will be cleaning up for months to come. Irma forced about three dozen Florida hospitals to close or evacuate.
With CMS’ new emergency preparedness rule set to take effect Nov. 16, all Medicare and Medicaid providers and suppliers must have an emergency plan based on an “all hazards” risk assessment. The rule also calls for them to have policies and procedures for addressing subsistence needs, evacuations and sheltering in place and tracking patients; to develop a communication plan to coordinate care both within the facility and across disparate public and private organizations; and conduct training and drills. These plans and policies need to be updated annually.
While there is clearly room for improving emergency preparedness in healthcare, it’s hard to know what could have saved Puerto Rico’s vulnerable system in the wake of Hurricane Maria’s brutal battering.