Healthcare Ready Hurricane Ian Situation Report #4

Hurricane Ian Situation Report #4

This report provides an assessment of the impacts to healthcare and public health due to Hurricane Ian.

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 closely tracking potential impacts to healthcare infrastructure and supply chain, and will share information frequently via situation reports and TwitterFacebook, and LinkedIn. Our pharmacy operating status map Rx Open will be updated daily for pharmacies in Florida and Puerto Rico. 

High-Level Situation Summary

Since making landfall on 9/28, Hurricane Ian has caused catastrophic damage across Florida. Several hundred healthcare facilities remain affected, with operating status of some facilities likely to remain uncertain until power and communication returns online in some areas. There have been transportation impacts, including damage to connections (causeways, bridges) to several barrier island communities (Sanibel Island, Pine Island) that has resulted in those communities being completely cut off to road travel.

Ian made a second landfall as a Category 1 hurricane near Georgetown, South Carolina at 2:05pm EDT 9/30. The storm is expected to cause further damage as it moves northeast into South Carolina and North Carolina, with the primary hazards being hurricane force winds, flooding, and storm surge (in coastal communities). Some power outages have been reported in South Carolina and North Carolina.


  • 1.9 million in Florida are without power. More than 140,000 in South Carolina are also experiencing outages.   
  • More than 30,000 residents are living in shelters across Florida.
  • As of 9/30, multiple states have declared states of emergency. South Carolina’s Emergency Declaration request to FEMA was approved on 9/30, which will allow provision of emergency measures including direct federal assistance for all 46 counties.
  • On 9/29, the Seminole Tribe of Florida requested a Major Disaster Declaration from FEMA.
  • See further below for the list of info/identification needed to access affected areas, including access and re-entry plans and policies for Florida, North Carolina, and South Carolina.
  • Damage assessments across affected areas in Florida are underway, though it may be some time before power in some areas are restored. Response/recovery crews are standing by and ready to deploy to impacted areas as soon as it is safe to do so (if they haven’t deployed already).
  • Several private insurance companies have lifted restrictions to make it easier for plan members to obtain prescriptions or care via telemedicine.

Assessment of Healthcare and Logistics Impacts

Emergency Declarations and Measures

Critical Infrastructure Impacts

  • Power
  • Fuel
    • As of 9/30, 11% of Florida’s gas stations are without fuel or are not operational due to impact of the hurricane.
    • Those looking for fuel and gas can use this link, Gas Buddy, to search for open stations and providers.
    • The Interior Department’s Bureau of Safety and Environmental Enforcement has suspended around 190,000 barrels of oil production (equal to around 2% of total U.S. oil production) in the Gulf of Mexico as Ian headed to Tampa and Florida.
    • As of 9/28/2022, Chevron Corp (CVX.N) removed staff from two offshore Gulf of Mexico platforms, however Occidental Petroleum Corp (OXY.N) and Hess Corp (HES.N) have taken precautions ahead of the storm’s arrival and are implementing storm procedures. This may impact fuel resources getting sent to other areas of the country and could impact medical and other types of manufacturing.
    • Florida officials are also identifying opportunities to safely store fuel and transport equipment as the storm passes. Port impacts pose significant risk to fuel supply for central Florida, and cascading impacts on the movement of goods.
  • Water
    • Water production facilities are not operating in 5 counties, working at reduced capacity in 16 counties, and boiled water notices are in effect in 19 (+8) counties.
  • Communications
    • The Federal Communications Commission (FCC) has begun Hurricane Ian Communications Status Reports.
    • As of 12pm EDT 9/29, FCC reports: 1,552 (10.9%) of cell sites are down, 180 are due to damage, 577 are due to transport, and 795 are due to power outages.
    • As of 9/29, this is impacting 525,966 subscribers in the disaster area.
    • All 911 calls are being answered but some Public Safety Answering Point (PSAP) are being rerouted due to power outages.
    • As of 9/30, six TV stations are reported as being out of service, 15 FM stations are reported as being out of service, and 6 AM stations are reported as being out of service.
    • The (FCC) may grant Special Temporary Authority (STA) to permit immediate or temporary operation of certain radio facilities during emergencies or other urgent conditions, as well as waivers to support emergency communications and service restoration.
    • Comcast has opened Xfinity WiFi hotspots in Central, North, Southwest, and Panhandle of Florida for Xfinity customers, and non-customers, to remain in contact during and after the storm.
    • AT&T has waived talk, text, and data overage charges for Postpaid and Prepaid customers with billing addresses in the Florida zip codes (828) through October 28, 2022, to facilitate customer access to communications before, during, and after major events.
  • Transportation
    • Road closures and Travel Updates
      • Florida
        • Road closures have been reported in the St. Petersburg, Tampa, Orlando, and Daytona Beach, and Jacksonville areas.
        • The SR-78 / Pine Island at Matlacha Draw Bridge, which connects Pine Island to Ft. Myers, is closed in both directions. This is the only road into Pine Island, meaning its residents are cut off from assistance and rescues can only be conducted by water or air.
        • I-275 North is reopened allowing traffic to resume between St. Petersburg to Rubonia across the Tampa Bay.
        • Hurricane Ian destroyed a section of the Sanibel Causeway connecting Sanibel Island and Captiva to mainland Florida, cutting off the only access to the barrier island where roughly 6,300 residents reside. With the bridge compromised, Sanibel-Captiva rescues can only be conducted by water or air.
        • On 9/30, FL DOT repeated their advisory that individual do not drive unless absolutely necessary, noting roadways are still flooded.
      • South Carolina
        • Several news outlets are reporting road closures due to flooding, including areas of downtown Charleston, West Ashley, Summerville, North Charleston, Georgetown, James Island, and Johns Island.
      • North Carolina
        • Several news outlets are reporting road closures due to flooding, including areas of Southport Shalotte, and Carolina Beach.
      • 511 Traffic Information across Impacted States
        • Florida 511 will be providing real-time traffic conditions and incident information.
        • The South Carolina Department of Transportation provides live updates on South Carolina 511. Users can view alerts from the National Weather Service as well as evacuation resources.
        • provides the latest travel information, including how Ian is impacting travel in North Carolina. Additionally, North Carolina’s 511 Information Line is available to motorists throughout the state.
        • Georgia 511 provides information on closures and evacuation routes. Users can also view live alerts in real-time.
    • Airports 
      • Florida
        • According to the Federal Aviation Administration’s airport status map, airports are largely operational in Florida, with the following airports remaining closed as of 9/30:
          • Daytona Beach International (DAB), which is expected to reopen on Wednesday, 10/5.
          • Southwest Florida International Airport (RSW) in Fort Myers will remain closed until further notice pending water and power restoration. The airport continues to serve emergency personnel and humanitarian flights. The FAA states RSW is expected to reopen on 10/7.
          • As of 9/29, North Perry Airport (HWO) in Hollywood Broward County remains closed due to tornado damage.
        • As of 9/30, the following airports are open:
          • Tampa International Airport (TPA)
          • St. Pete-Clearwater International Airport (PIE)
          • Sarasota Bradenton International Airport (SRQ)
          • Orlando International Airport (MCO)
          • Melbourne Orlando International Airport (MLB)
      • South Carolina
    • Port status
      • Florida
        • As of 9/30, some Florida ports have resumed operations. The following ports remain closed:
          • JAXPORT remains closed (Port Condition ZULU) but plans to reopen at 6am EDT Saturday, 10/1.
          • Port Canaveral (no expected reopen date reported)
          • Port of St. Petersburg (estimated to reopen Saturday)
          • Port of Fort Pierce (estimated to reopen Friday)
          • Port Canaveral (estimated to reopen Friday)
          • Port Fernandina (estimated to reopening unknown)
          • Port of Key West (estimated to reopen Thursday)
        • As of 9/29, the Port of Tampa Bay is open both landside and shoreside, and fuel trucks are actively transporting fuel to impacted communities.
        • As of 9/30, SeaPort Manatee is open to shoreside traffic. Port of Palm Beach has also reopened. On 9/29, the Port Everglades and Port Miami reopened.
      • South Carolina
    • Rail
      • Freight activities have slowed (increasing delays) or temporarily stop operations.
      • As of 9/30, FEMA reports that nine (+1) railways have closed with numerous Amtrak and Northern schedule cancellations and changes.
      • As of 9/29, Brightline has resumed commercial trains.
      • As of 9/27, SunRail service has been suspended.

Access and Reentry

  • 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 and Adjacent Facilities
      • On 9/30, FEMA reports 202 of 4,338 healthcare facilities across Florida have evacuated, additional evacuations are being assessed.
      • As of 09/30, nine Lee County hospitals are in the process of evacuation due to water availability issues.
      • ShorePoint Health Port Charlotte reopened on 9/29 for medical emergencies. As of 9/29, it was the only operational ER in Charlotte County.
      • As of 9/30 NCH Downtown Baker Hospital and all other NCH locations remain on lockdown , but are accepting emergency room patients.
      • As of 9/29, Tampa General Hospital’s emergency room is open and caring for patients. All Ambulatory locations remain closed and elective surgeries and procedures are cancelled.
      • Closures and evacuations:
        • HCA Florida Pasadena in Pinellas County evacuated about 40 patients on Monday 9/26. HCA Florida South Tampa Hospital and HCA Florida West Tampa Hospital also reported evacuations.
        • On 9/29, Sarasota Memorial Hospital in North Point closed its emergency room. However, as of 9/30, Sarasota Memorial Healthcare System has reopened their urgent care centers.
        • On 9/28, Kindred Hospital Bay Area – Tampa and Kindred Hospital Bay Area – St. Petersburg announced they safely evacuated all patients to other facilities.
        • On 9/28, Windmoor Healthcare of Clearwater reported it safely evacuated patients and staff.
        • As of 9/27, Encompass Health Rehabilitation Hospital of Cape Coral has evacuated all patients and staff to another Encompass Health area hospital.
        • HCA Florida Fawcett Hospital in Port Charlotte was severely damaged during the hurricane, patients in the ICU were affected by flood waters entering their rooms.
        • Advent Health locations in Central Florida remain closed and hospice care facilities have paused home visits and admissions. Elective surgeries are postponed. AdventHealth North Pinellas also evacuated patients.
        • As of 9/28 60 VA hospitals are closed through at least Thursday (9/29), with many closed through 9/30 or later.
        • As of 9/28 North Plant Bay Hospital operated by BayCare is closed. All urgent cares operated by the company are also closed.
        • 43 nursing homes evacuated in Southwest Florida after Hurricane Ian.
    • Emergency Medical Services
    • Pharmacy
      • Rx Open is activated for Georgia, Florida, and South Carolina, and North Carolina is showing 545 pharmacy closures across the impacted states.
      • Please see the table outlining pharmacy statuses per state:
  • County Statuses:
    • The following counties are reporting fewer than 50% of pharmacies as open:
      • Florida – 20 counties (-18 from 9/29): Baker, Charlotte, Citrus, Collier, DeSoto, Flagler, Gilchrist, Glades, Hardee, Lake, Lee, Marion, Miami-Dade, Orange, Osceloa, Pinellas, Sarasota, Seminole and Volusia
      • Georgia: Baker, Brantley, Butts, Chattahoochee, Clay, Clayton, Decatur, Echols, Fayette, Glascock, Liberty, McIntosh, Quitman, Talbot, Taliaferro, Wayne
      • South Carolina: Bamberg, Calhoun, Charleston, Dorchester, Georgetown, and Jasper
      • North Carolina: No counties
    • Pharmacy deliveries via Express Scripts may arrive late.
  • Dialysis:
    • As of 9/30, many dialysis facilities in Florida are closed. Most of these were planned closures prior to the storm. Most closed facilities plan to reopen by Monday, 10/3.
    • 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. The page includes patient helpline numbers and contacts for End Stage Renal Disease Networks supporting Florida:
      • Network 7: HSAG Florida ESRD Network
        • Helpline: 800.826.3773
      • Network 8: Alliant ESRD Network 8
        • Helpline: 877.936.9260

Public Health Impacts

  • Infectious illnesses
    • With people entering shelters due to the hurricane, there is a higher potential for COVID-19 and other infectious and vector borne diseases to spread without the appropriate precautions and protective measures.
    • As of 9/30, CDC reports 13,444 total COVID cases, 269 new hospital admissions, and 45 deaths in the past seven days in Florida.
    • As of 9/30, there are 2,520 Monkeypox cases in Florida.
  • Mental health
    • The Hurricane Ian disaster recovery hotline is available for mental health needs, disability services, military and veteran assistance, etc.
    • 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 the United States and its territories. Individuals may call or text 1-800-985-5990 to connect with a trained crisis counselor.

Supply Chain

  • Manufacturing
    • Florida has a relatively large pharmaceutical and medical devices manufacturing footprint, with most companies concentrated in northeast Florida (near Jacksonville). Though not anticipated to have direct impacts from the, the region is still expected to experience heavy rainfall with the possibility of flash flooding.
    • Florida has a moderate plastics manufacturing presence. Should the state be unable to supply power to these manufacturers due to impacts to critical infrastructure caused by Ian, it is possible upstream medical supply could be impacted in the coming months. This analysis of potential impacts is based on the observed impacts to plastics following the severe winter weather that affected Texas in 2021.
    • No major disruptions to PPE manufacturing, or downstream impacts across the US are anticipated from this event.
  • Distribution
    • As of 9/29, retailers, such as Inc., have about 10 fulfillment centers in Florida and have paused operations at these sites. Walmart Inc. (WMT.N) and Sam Club have closed at least 100 stores and Target Corp (TGT.N) temporarily closed stores. Costco Wholesale Corp closed 9 stores in Florida.
    • Many of the medical product distributors as well as third party logistics providers have operations and/or distribution centers in Florida. We will be closely tracking any impacts to facilities or centers to determine any downstream supply chain impacts.

Resource Staging

Information for: Florida, Georgia, South Carolina, Alabama, North Carolina

  • Florida
    • As of 9/29, Florida Emergency Operation Center (EOC) and Georgia EOC have fully activated. Alabama EOC is monitoring and South Carolina EOC is expected to activate on 9/30.
      • Incident Management Teams are in Tallahassee, Miami, and Atlanta. Mobile Emergency Response Support teams are present in Tallahassee and Orlando, with support teams located in Alabama and Georgia.
      • More than 2,000 personnel are supporting the response throughout the Southeast with more than 3,200 reservist personnel and more than 7,500 Surge Capacity Force members standing by for deployment. FEMA is establishing a personnel mobilization center to expedite deployments when critical.
    • As of 9/29, FEMA reports that more than 32,000 mutual assistance power crew personnel will begin assessing damages and making repairs. Crews are on standby for Hurricane Ian’s landfall in Georgia and South Carolina.
      • As of 9/28, a US Army Corp of Engineers team will deploy to Craig Field in Alabama ahead of the storm to provide power restoration services.
    • As of 9/29, FEMA teams have delivered over 1million meals and liters of water to impacted areas. More supplies are expected to follow once conditions are deemed safe for transport. FEMA is currently procuring additional water and meals.
      • As of 9/28, FEMA has been preparing and staging supplies in strategic locations in Alabama and Florida. One location is Maxwell Airforce Base in Alabama. Supplies being staged at Maxwell Airforce Base include four Mobile Communications Operation Vehicles, 3.5 million liters of water and 3.6 million meals. Supplies in Alabama include more than a million liters of water, more than 480,000 meals and more than 7,200 cots.
    • As of 9/29, US Department of Health and Human Services deployed a National Disaster Medical System (DMAT) personnel to Miami and two other teams to Robins Air Force Base in Georgia. Additionally, health and medical task forces and pharmacists were deployed to Atlanta. Additional DMAT teams are on standby if needed.
    • As of 9/30, FDEM has received more than 1,500 resource requests for Hurricane Ian. Over 1,300 of these requests are currently being processed and are either en route or being mobilized. This includes the coordination of resources such as: trucks of food and water, generators, and water pumps.
      • FDEM has over 3.5 million meals and over 1.8 million gallons of bottled water in preparation for distribution to impacted areas.
      • FDEM is in constant communication with all 67 county emergency management offices and state agencies to coordinate protective actions and needed resources ahead of potential storm impacts.\FDEM has activated the State Assistance Information Line (SAIL) to provide an additional resource for Floridians to receive up-to-date information regarding Hurricane Ian. Residents and visitors can call this toll-free hotline at 1-800-342-3557.
    • As of 9/29, Florida Emergency Operation Center (EOC) is fully activated.
      • Incident Management Teams are in Tallahassee, Miami, and Atlanta. Mobile Emergency Response Support teams are present in Tallahassee and Orlando, with support teams located in Alabama and Georgia.
      • More than 2,000 personnel are supporting the response throughout the Southeast with more than 3,200 reservist personnel and more than 7,500 Surge Capacity Force members standing by for deployment. FEMA is establishing a personnel mobilization center to expedite deployments when critical.
  • Georgia
    • As of 9/29, the Georgia EOC has fully activated.
  • South Carolina
    • As of 9/30, the South Carolina EOC is fully activated.
  • North Carolina
    • As of 9/30, Governor Cooper has assured that crews in North Carolina have checked necessary equipment to ensure that we already, we have had more than 2200 employees statewide help us prepare this week for this event. We have about 1500 chainsaws, 11,000 barricades, emergency signs and ample fuel supply to respond. We have also specialized equipment ready to clear debris in about 1400 trucks, 400 backhoes and loaders and more than 200 motor graders ready to respond. 

Emergency Prescription Refills

  • No updates since 9/29.
  • Centers for Medicare & Medicaid Services (CMS) implemented 1812 Waiver and 1135 Waiver in response to the Public Health Emergency (PHE) declaration. These waivers and modifications are intended to ensure individual pharmaceutical and medical needs are met during emergency and disaster situations.
  • As of 9/29, individuals that live in one of the 67 impacted counties who have Blue Cross Blue Shield of Florida (Florida Blue and Truli) memberships can access early prescription refills for maintenance medications through 10/24/2022.
    • People impacted can receive a 30-day supply.
    • Teledoc, the virtual healthcare system is available for $0 cost to those impacted by Hurricane Ian.
    • This hotline number, 855-225-5032, will help to reach doctors 24/7 through this network for basic care and prescriptions and prescription refills that are not controlled substances.
  • As of 9/29, Humana Healthy Horizons™ in Florida will provide special accommodations for prescription access until the PHE declaration has ended, and or, 30 days has passed since the initial event.
  • As of 9/28, Cigna has lifted certain medical and benefit pharmacy restrictions.
  • As of 9/28, Molina Healthcare of Florida is suspending all prior authorization requirements for prescription refills until the state of emergency is lifted.
  • As of 9/24/2022, early prescription refills are permitted under State of Emergency. All health insurers, managed care organizations, and other entities licensed by the Office of Insurance Regulation and provide prescription medication coverage as part of a policy or contract will waive time restrictions on prescription medication refills.
  • Opioids are considered a controlled substance, and therefore excluded from emergency prescription refill laws. According to the CDC, there was a rate of 43.4 retail opioid prescriptions dispensed per 100 persons in Florida in 2020.
  • About 13% of Florida’s population is uninsured. Emergency Prescription Assistance Program (EPAP) is the federal program that provides medication coverage for uninsured patients, but the program has not yet been activated.
  • Healthcare Ready will be closely tracking the activation status of the Emergency Prescription Assistance Program (EPAP) to understand what resources may be available to uninsured individuals in disaster areas.

Evacuations and Curfews

  • Strikethrough indicates removal from evacuation category or warning.
  • As of 9/29, the following Florida counties have issued mandatory evacuation orders: Charlotte County, Citrus County, Clay County, Collier County, Flagler County, Hillsborough County Lee County, Levy County, Pasco County, Sarasota County, St. Johns County, Pinellas County, and Sarasota County.
    • Mandatory evacuations are in effect for most of the West coast of Florida and portions of northeast Florida.
  • As of 9/29, the following Florida Counties have issued voluntary evacuation orders: Clay County, Franklin County, Gilchrist County, Glades County, Highlands County, Manatee County, Nassau County, Orange County, Osceola County, Polk County, Putnam County, Orange CountySeminole County, Sumter County, Taylor County, and Volusia County.
  • Information about evacuations, resources, and explanations of warnings can be found here.
  • As of 9/30, multiple areas in Florida have issued stay at home orders or curfews. Lee County has a curfew in effect through at least 6pm Friday 9/30. Collier County and Naples also have a curfew until at least 6pm Friday 9/30.
  • As of 9/30 North Carolina does not have any evacuation orders or curfews
  • As of 9/30 South Carolina has not issued any evacuation orders or curfews.
  • As of 9/30 Georgia does not have any evacuation orders or curfews


  • As of 9/30, FEMA reports 257 shelters (+61) are open with 33,386 (+22,786) residents and 13 Special Needs Shelters (-14) are open.
  • Full list and map of shelters, including special needs shelters, open in Florida can be found on the Florida SERT site.
  • List of open American Red Cross shelters can be found here.
  • Florida SERT and Florida Tourism Department have partnered with Expedia to launch an emergency accommodations page. Expedia has reached out to accommodation partners and encouraged them to waive cancellation fees and pet restrictions for evacuees.  



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