Healthcare Ready Hurricane Ian Situation Report #13

Hurricane Ian Situation Report #13

This report provides an assessment of the impacts to healthcare and public health due to Hurricane Ian. After today’s situation report, the cadence for releasing the reports will be every other day. 

Note: Green text indicates new or updated content in this report compared to the previous report.

Healthcare Ready's Posture

Healthcare Ready is ENGAGED for the response to Hurricane Ian. We are tracking potential impacts to healthcare infrastructure and supply chain, sharing information via situation reports, TwitterFacebook, and LinkedIn. Our pharmacy operating status map Rx Open is updated daily (moving to every other day as of 10/7) for pharmacies and dialysis centers in Florida, Georgia, South Carolina, North Carolina, and Puerto Rico

High-Level Situation Summary

Over 7,000 customers remain without power in Florida. Though a dramatic improvement from the 20,000 without power on Sunday, a significant number of residents continue to struggle without power in homes, businesses, schools, and critical community institutions. Disparate delays in restoring critical infrastructure (power, water, internet) in different areas signal a need to consider equity as part of future disaster response and recovery plans. Despite continued challenges, resources (disaster recovery centers, PODS, fuel trucks, Wi-Fi hotspots) are increasing daily and are being made available in areas where support is most needed. These resources have been brought in in many ways, including through innovative sources (via businesses and partnerships). Hurricane Ian, one of the most disastrous events to hit the state of Florida, may very well be an exemplary model for a partner-centered approach to recovery from disasters. As seen throughout this recovery process, public-private sector partnerships in disaster response are a strong tool towards disseminating critical resources, achieving sustainable healthcare infrastructure restoration, and community recovery.

Highlights

  • In Florida, there are 20 pharmacy closures reported on rxopen.org as of 2:00pm EST on 10/11.
  • As of 10/11 there are two dialysis centers closed in Florida.
  • As of 10/11, power restoration continues to improve across Ian-affected counties, with severely hit Lee County now experiencing less than 1,700 outages (down from 17,000 on 10/10).  
  • Parts of 19 counties still remain under boil water advisories as of 10/10.
  • Sanibel Causeway has been habilitated to allow convoys into Sanibel Island to restore power. Full restoration of the causeway is expected to be finished by 10/21.
  • Free telehealth services continue to be available for patients in impacted areas. See the “Healthcare Response Updates and Needs” section for more details. 
  • Public transportation in certain areas is still taking longer to return to normal operations, which may impact residents’ abilities to get access to food, or regular medications.
  • For the latest local updates, including detailed information on fuel, water, and other resource sites, visit the governor’s website and floridadisaster.biz/currentdisasterupdates for more information.
  • Location of POD sites distributing food, water, and ice are updated daily at FLGOV.COM.
  • UPS, FedEx, and USPS are still experiencing service impacts, for communities on Pine and Sanibel Island which were cut off to road access.
  • Federal, state, and local agencies are urging citizens to be aware of the possibility of fraud, scams, and cybersecurity threats following Hurricane Ian.

Assessment of Healthcare and Logistics Impacts

Emergency Declarations and Measures

  • General
    • No changes or updates since 10/11.
    • On 9/28, the Federal Motor Carrier Safety Administration (FMSCA) issued a Regional Emergency Declaration for Alabama, Florida, Georgie, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee. The order will remain in effect until the end of the emergency, or 10/28.
  • Florida
  • South Carolina
  • North Carolina
    • On 9/30, President Biden approved a federal Emergency Declaration for all 100 North Carolina counties and the Eastern Band of Cherokee Indians.
    • On 9/28 North Carolina declared a State of Emergency, which will expire on 10/28.
  • Georgia
  • Virginia

Critical Infrastructure Impacts

Access and Reentry

  • No updates since 9/30.
  • Florida
    • Florida’s access and re-entry plans and policies are managed by local officials, working closely with Florida’s Division of Emergency Management. During a disaster, private sector companies should coordinate with the Division of Emergency Management, in addition to local health departments and local emergency managers to assess whether they are authorized to enter an impacted area, only after it has been deemed safe enough to do so.
    • Individuals who wish to enter the disaster area must have the following on hand:
      • Valid government-issued ID (driver’s license, passport)Proof of employment (employer credentials, document on company letterhead)
      • Demonstrated need to enter the area (work order, inventory list, employer authorization)
      • Note, DHS CISA’s Access Coordination Letter is not an acceptable document to enter any disaster areas in Florida.
  • North Carolina
    • North Carolina requires pre-registration of vendors who provide critical services and goods before they attempt to enter disaster areas. These vendors must apply for a Certificate of Post Disaster Re-entry to be able to enter areas impacted by disasters. Information on applying for this certificate can be found at this North Carolina Business Emergency Operations Center site. Final decisions about entry/re-entry are still under the authority of local governments.
  • South Carolina
    • South Carolina requires business to register for post-disaster reentry certification before they attempt to enter impacted areas. Business can register for the program with the SC Emergency Management Division and SC Department of Commerce. Final decisions about entry/re-entry are still under the authority of local governments.

Healthcare Response Updates and Needs

  • Healthcare Facilities
    • On 10/4, the Governor’s office confirmed that only 9 of the 26 healthcare facilities who initially evacuated remain evacuated, with the other 17 having reopened. No new updates as of 10/7.
    • FACHC asks Florida’s Health Centers to report their status and resources needed using the Live Response Tool or by contacting 850-591-1832 or gianna@fachc.org.
    • The Agency for Health Care Administration for the State of Florida is collecting health facility status. All licensees providing residential or inpatient services are asked to update status via the Health Facility Reporting System.
    • As of 10/7, Sarasota Memorial’s freestanding Emergency Department in North Port remains closed due to damages, and the North Port Family Practice and Venice Medical Office Building also remain closed due to power outages.
    • As of 10/7, while the HCA Florida Fawcett Hospital in Port Charlotte remains temporarily closed, the HCA Florida Care Coral Emergency Room, a part of the HCA Florida Fawcett Hospital, has re-opened, and emergency services at the Emergency Room are available 24/7.
    • As of 10/5, AdventHealth’s home care, hospice, home infusion, and respiratory equipment services returned to normal operations. However, AdventHealth reports the following closures:
      • Hospitals:
        • AdventHealth Sebring is open, but as of 10/7, outpatient services are currently unavailable.
        • AdventHealth North Pinellas has reopened, but some services may still be unavailable.
      • AdventHealth Medical Group: As of 10/7, all AdventHealth Medical Group Practices in Flagler and Volusia Counties are closed for both in-person and virtual care.
      • Urgent Care: Centra Care Locations with no reported opening hours: Titusville, Lake Mary, Daytona, Port Orange, and Brandon, Centra Care Kids Lake Mary.
      • Sports Med and Rehab: As of 10/7, locations with no reported opening hours: Daytona, DeLand Stetson, Fish Memorial/Orange Park, Horizon West, Innovation Tower, Kissimmee, Wekiva, New Smyrna Beach Campus, Orange Ave (SoDo), Palm Coast Parkway, Pediatrics Winter Park, Port Orange Health Park, West Lakes Early Learning Center, and Winter Park.
      • Primary Care: As of 10/7, locations with no reported opening hours: Lakeland and Orlando – Training Center.
      • Orthopedics: no locations reporting opening hours as of 10/5.
    • As of 10/5, NCH status updates on services and open locations are posted online.
      • NCH Virtual Care is accessible to anyone in the community at no cost, 24-hours per day, 7 days a week for two weeks following Ian. Use the coupon code “NCH”.
      • For patients who do not have internet access, the NHC Employee Medical Center in the Greentree Plaza is open from 7:00am-7:00pm for patients to use Wi-Fi.
    • CentraCare will remain open for free video visits for non-emergency patients. Use promo code “Ian” to access free visits on the AdventHealth app.
    • As of 10/5, the following Lee Health locations reopened, and are servicing patients from 8:00am-5:00pm (a full list of reopenings can be found here).
    • As of 10/4, all hospitals and non-hospitals operated by BayCare are open.
      • Assistance is available for patients who are in need of durable medical equipment, including oxygen, walkers, wheelchairs, or CPAP. Patients should call 1-800-940-5151, option 3.
      • BayCare is offering 1 free telehealth visit for all registered users of BayCareAnywhere though 10/12. Initiate a telehealth visit in the BayCareAnywhere app and use the code “IAN”.
    • GoodRx is offering free telehealth appointments to Florida residents affected by Hurricane Ian through 10/17.
    • According to the Governor’s Office, as of 10/4, the Lee County Healthcare Center, VA Outpatient Clinic in Daytona Beach, and the Naples and Port Charlotte VA Clinics are closed until further notice.
    • As of 10/4, Walmart Health Centers in Tampa and Orlando continue to offer complimentary sick or injury exams. Make appointments at walmarthealth.com or walk-in. Health and Wellness Service Locations can be found at this link.
  • Emergency Medical Services
    • No updates as of 10/7.
    • As of 10/5, Disaster Medical Assistance Team’s (DMATs) are currently in place at Cape Coral Hospital and Lee Memorial Hospital.
    • Florida Department of Health’s Division of Emergency Preparedness and Community Support continues to support patient movement requests and special need shelter requests.
    • Several emergency response organizations, including fire departments, mass care specialists, and other volunteers or task forces, deployed to Florida (and remain on the ground) to assist with emergency medical services in response to Ian.
  • Pharmacy
    • Rx Open is activated for Georgia, Florida, South Carolina, and North Carolina. It was last updated on 10/7 at 2:00pm EDT and is showing 19 pharmacy closures across the impacted states, with closures primarily in Florida.
    • Please see the table outlining pharmacy statuses per state below:
    • The following counties are reporting less than 50% pharmacies as operational:
      • Florida – Glades, Miami-Dade, and Baker Counties
      • Georgia – Baker, Butts, Chattahoochee, Clay, Clayton, Decatur, Echols, Fayette, Glascock, Quitman, Talbot, and Taliaferro Counties
        • These counties have less than 50% pharmacies as open primarily due to Unknown Statuses, and not confirmed closures.
      • North Carolina – Camden county.
        • This county has less than 50% pharmacies as open primarily due to Unknown Statuses, and not confirmed closures.
    • OptumRx provided guidance to customers for rerouting existing prescription deliveries to new addresses. 
    • Pharmacy deliveries via Express Scripts may arrive late as recovery operations continue.  
  • Dialysis
    • As of 10/7, three dialysis centers remain closed in Florida.
    • In Florida, several facilities are on generator power and/or connected to water tankers. Damage has been reported at some facilities, but overall damage is minimal.
    • See Kidney Community Emergency Response (KCER’s) Hurricane Ian webpage to share information with the dialysis community.

Public Health Impacts

  • Infectious illnesses
    • With people entering and/or remaining in shelters due to the hurricane, there is an increased risk of transmission of COVID-19 and other infectious diseases.
      • As of 10/11, CDC reports 10,793 total COVID-19 cases (higher than 10/6), an average of 218 new hospital admissions (lower than 10/6), and 49 deaths over the past seven days in Florida.
      • As of 10/11, there are 2,572 confirmed Monkeypox cases in Florida (higher than reported on 10/6).
  • Chemicals/Flood Water
    • Gas and diesel can generate carbon monoxide when generators are not properly used. This can cause dizziness, headaches, and other negative health effects. Breathing can also be impacted by mold and pollutants in the air. Practice safe generator usage to decrease risk of health implications.
  • Mosquito-borne illnesses
  • Waterborne hazards
    • Waterborne hazards are common after a hurricane because of the high amounts of water that buildup post storm and flood. Experts recommend avoiding drinking tap water, using water filters when possible, and to refrain from walking through flood waters when possible.
      • According to the Governor’s office, Florida Department of Health’s Division of Medical Quality Assurance has been informing health care providers about the increase in vibrio vulnificus infections due to exposure to flood and standing waters caused by Hurricane Ian.
      • Leptospirosis – Leptospirosis is a bacterial disease caused by animal urine contaminating water sources. Avoiding exposure to contaminated is the best way to prevent the bacterial disease.
      • Waterborne diseases, like Cholera, are not expected to threaten impacted areas due to low prevalence prior to Ian.
  • Mental health
    • Mental health resources for individuals and communities are available at MyFLFamilies.com/HurricaneIan. The state has compiled a list of mental health resources at https://www.floridadisaster.org/dem/recovery/disaster-mental-health-resources/.
    • The Crisis Center of Tampa Bay offers a free mental health helpline for first responders and their loved ones. The program focuses on Charlotte, Collier, DeSoto, Glades, Hendry, Hillsborough, Lee, Manatee, Pasco, Pinellas and Sarasota counties. Firefighters, police officers, emergency care providers and other first responders can reach the program by filling out a web form at lasttoask.com and can receive confidential support by calling 1-866-435-4376 (1-866-4FL-HERO).
    • Florida Blue is offering free virtual doctors’ visits and a bilingual emotional support helpline for Floridians impacted by Ian at 855-225-5032 for visits, and the helpline at 833-848-1764 for emotional support. Both lines are available 24/7.
    • The Florida Behavioral Health Association provides a list of helplines offered to Floridians in various counties, including an Aspire Health Partners helpline that residents of Orange, Osceola, Lake and Seminole counties can call at 407-875-3700, ext. 2.
    • The Veterans Crisis Line is a free, confidential resource that is available to veterans 24/7. The service is available to all veterans, even if you are not registered with the VA or enrolled in VA healthcare. You can call 800-273-8255 ext. 1, text 838255, contact the veterans crisis chat, or dial 988 ext.1
    • The Hurricane Ian disaster recovery hotline is available for mental health needs, disability services, military and veteran assistance, and other needs.
    • Individuals may call or text 211 to be connected with help for physical and mental health needs and assistance in the aftermath of Hurricane Ian.
    • The SAMSHA Disaster Distress Helpline 1-800-985-5990 is open 24/7 to provide immediate crisis counseling for people who are experiencing emotional distress. The Helpline is toll-free, multilingual, and confidential and is available to all residents in US and its territories via phone or text. Deaf or hard of hearing callers can utilize a videophone or ASL Now.
  • Other
    • Persons found and reported safe can be reported at safe.fl.gov.
    • This website is for reporting missing persons related to Hurricane Ian.
    • US government agencies have shared that routine non-criminal immigration enforcement operations will not be conducted at evacuation sites or assistance centers.
    • Disaster Unemployment Assistance (DUA) is available to Florida businesses and residents in FEMA disaster-declared counties whose employment or self-employment was lost or interrupted as a direct result of Hurricane Ian.

Supply Chain

  • Manufacturing
    • No updates as of 10/11.
    • Manufacturers in Florida have not reported any major impacts. There are no expected impacts to Georgia, South Carolina, and North Carolina supply chain.
  • Distribution
    • As of 10/11, UPS is continuing to report that most UPS facilities are operational as conditions permit. There will still be no pickups or deliveries today in zip codes listed below . Disruptions in service to Pine Island may decrease soon as a temporary bridge restoring road access to the island has been established as of 10/6.
      • 33924 – Captiva
      • 33957 – Sanibel
      • 33931 – Fort Myers
      • 33956 – St. James
      • 33922 – Bokeelia
    • As of 10/11, FedEx is reporting delays and disruptions for inbound and outbound shipments in the following zip codes below. Much like UPS, the service areas affected are in barrier island counties and along the southwest coast of Florida which is where Hurricane Ian did the most damage to critical infrastructure and roadways. As temporary bridges and roadways clear, we expect the disruption to services areas to decrease.
      • 33924 – Captiva
      • 33957 – Sanibel
      • 33931 – Fort Myers
      • 33956 – St. James
      • 33952 – Bokeelia
      • 33993 – Cape Coral
    • As of 10/10, US Postal Service reports that 11 facilities remain temporarily closed until further notice. Each of the 11 facilities have an alternate location provided.

Resource Staging

  • More than 13.7 million MREs and 49.2 million bottles of water have been distributed thanks to the Points of Distribution (POD) locations set up by the Florida Department of Emergency Management (FDEM).There are 8 POD locations open today across 3 counties. Those 3 counties are:
    • DeSoto, Lee, and Charlotte
  • As of 10/10 FDEM has opened an additional fuel depot on Pine Island for a total of 13 fuel depots across Central and Southwest Florida to provide fuel for first responders. A public, mobile fuel depot is open in the Harlem Heights community to provide fuel for vehicles and gas cans for generators to impacted residents.
  • Florida’s Department of Children and Families (DCF) has created a First Responder Support Line (407-823-1657) that all first responders throughout the impacted areas can contact. This line combines current resources into a single point of contact that will connect first responders with mental health professionals.
  • On 10/8 Governor DeSantis announced a new Disaster Recovery Center opened in Collier County. These centers are operated by the Department of Economic Opportunity, in conjunction with more than 10 agencies, to provide a one-stop shop for individuals or businesses that need help recovering from Ian. Locations are listed below:
    • Charlotte County
      • Home Deport (Mobile DRC): 12621 S. McCall Road, Port Charlotte, FL 33981
    • Collier County
      • Veterans Community Park: 1895 Veterans Drive, Naples, FL 34109
    • Sarasota County
      • Shannon Staub Library: 4675 Career Lane; North Port, FL 34289
    • Lee County
      • Joseph P.D Alessandro Office Complex: 2295 Victoria Ave.; Ft. Myers, FL 33901
      • Lakes Regional Library: 15290 Bass Road; Fort Myers, FL 33919
  • Counties eligible for FEMA Individual Assistance include Charlotte, Collier, DeSoto, Flagler, Hardee, Highlands, Hillsborough, Lake, Lee, Manatee, Orange, Osceola, Palm Beach, Pinellas, Polk, Putnam, Sarasota, Seminole, St. Johns and Volusia. Impacted residents can apply at DisasterAssistance.gov.
  • The USACE has activated Operation Blue Roof to provide temporary tarp-like covering to help reduce further damage to property until permanent repairs can be made. This service is free to homeowners, and the initial sign-up period is set for 21 days, ending on October 23. Five counties are currently eligible: Lee, Charlotte, Sarasota, Collier, DeSoto.

Emergency Prescription Refills

Evacuations and Curfews

  • Evacuations:
  • Curfews:
    • Since 10/11 in Lee county, a daily curfew remains in place from 6pm to 6am.
    • As of 10/11, Sanibel has a curfew of 7pm-7am.
    • As of 10/11, Fort Myers Beach access is closed for residents, however, access for residents between Times Square and Bowditch is 7am-5pm.
    • Beginning the evening of 10/6, the City of Sanibel transitions to a 7:00pm-7:00am mandatory curfew. During curfew hours, residents should not be on the island, even in their homes.
    • As of 10/9, the City of Kissimmee in Osceola County has issued a mandatory curfew from 9pm to 6am.
    • From local news sources:
      • Cape Coral’s curfew remains in effect from 9pm-6am.
      • The City of Bonita Spring has rescinded the citywide curfew. The Bonita Beach area curfew, including the areas in Big Hickory Island and Little Hickory Island, is still in place from 7pm-7am.
      • A mandatory curfew is in place for all unincorporated Collier County from 12am-6am. City of Naples curfew begins at 10pm-6am. for residential neighborhoods until further notice.
      • The curfew for Charlotte County has been amended to 10pm-6am, effective immediately.

Sheltering

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