Hurricane Ian Situation Report #8
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 tracking potential impacts to healthcare infrastructure and supply chain, sharing information via situation reports, Twitter, Facebook, and LinkedIn. Our pharmacy operating status map Rx Open is updated daily for pharmacies and dialysis centers in Florida, Georgia, South Carolina, North Carolina, and Puerto Rico. Healthcare Ready’s Team is on the ground in Florida to support public-private coordination requests.
High-Level Situation Summary
Prolonged power and water outages in certain areas continue to delay the reopening of healthcare operations. Restoring healthcare access for low-income and historically medically underserved communities will require ensuring FQHCs and clinics are supported with the appropriate resources for facilities to operate and for staff to return to work.
In Florida’s Lee, Charlotte, and Sarasota Counties, which sustained significant impacts that forced evacuations, healthcare operations are slowly resuming, with additional reopenings expected throughout the rest of the week. Field hospitals and response teams situated nearby continue to provide resources (water and fuel tankers, etc.), and returning power to facilities via generators. There have been reports of potential long-term implications to electrical infrastructure in the area that may result in long-term or sustained power outages, but details are yet to be determined. While damage assessments continue, pharmacies, clinics, hospitals, and dialysis centers in most areas have started to resume operations. Individuals with medical needs who typically rely on access to water and power at home (to reconstitute medicines, or to operate medical equipment, etc.) are at greatest risk for experiencing impacts from lack of access to water and power. Transportation impacts, including damage to roadways, and delays to resuming public transportation, may continue to threaten the health of communities with medical conditions who rely on regular access to health professionals, medications, water, or power. Healthcare operations in states affected by Ian’s second landfall in South Carolina on 9/30 appear to be stable, overall.
Highlights
- In Florida, there are 50 pharmacy closures reported on rxopen.org as of 2pm EDT on 10/4.
- All 1,304 Dialysis Centers in the impacted states are mapped on rxopen.org, with a total of 5 closed facilities all in Florida – this accounts for 1% of the dialysis facilities in Florida.
- 1 Facility in Bonita Springs
- 3 Facilities in Cape Coral
- 1 Facility in Fort Myers
- While many healthcare facilities are reopening, some locations across impacted areas remain closed due to ongoing water/wastewater restoration and structural damage that will require repairs.
- Boil water advisories are still in effect for parts of 25 counties.
- Nearly 435,000 Florida customers are still without power, with Lee County and surrounding areas experiencing the greatest outages. Areas that experienced the most severe damage may require inspection by licensed electricians before power can be safely restored.
- Many health systems have made their telehealth services available for fee to patients in need of non-emergency medical services.
- Several organizations are offering mental health and emotional support services, including for first responders. See section on “Mental Health.”
- Some hospitals are working to ensure they have adequate staff and resources (with some using mobile units for assistance).
- Location of POD sites distributing food, water, and ice are updated daily at FLGOV.COM.
- Governor DeSantis has shared that a temporary bridge will be built to Sanibel Island where more than 1,000 residents remain stranded. Additionally, Lee County officials are helping to accelerate repairs to be made to transportation to Pine Island to regain accessibility.
- Disaster Recovery Centers, staffed by state, federal, and volunteer organizations, will begin opening today where everyone can access recovery information.
- Homeowners and those in permanently occupied rental properties in Charlotte and Lee counties can sign up for temporary roof reinforcement at blueroof.us or call 1-888-ROOF-BLU (1-888-766-3258).
- Southwest Florida International Airport (RSW) is the only major airport that is still closed due to issues with water and power. RSW is expected to reopen on 10/5 at 8:00am EDT according to the FAA. The airport continues to serve emergency personnel and humanitarian flights.
- Healthcare operations are believed to be relatively stable in other states affected by Ian, though power issues remain. In North Carolina, 667 customers are still without power, 567 in Virginia, and 555 in South Carolina.
Assessment of Healthcare and Logistics Impacts
Emergency Declarations and Measures
- General
- 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.
- Florida
- On 10/1, President Biden approved a Major Disaster Declaration for the Seminole Tribe of Florida.
- On 9/28, the Florida State Surgeon General signed Emergency Order 22-004, which authorizes out-of-state professionals in good standing to practice in Florida for 30 days. Professions include physicians, registered nurses, paramedics, emergency medical technicians, and others.
- On 9/26, HHS Secretary Xavier Becerra Declared a Public Health Emergency for Florida. This declaration includes a Waiver or Modification of Requirements under Section 1135 of the Social Security Act (SSA). An 1135 Waiver waives or modifies requirements under the SSA to increase access to care.
- On 9/24, President Biden approved Florida’s Emergency Declaration and ordered Federal assistance to supplement state, tribal, and local response efforts. On 9/30, FEMA announced that additional Florida counties are able to apply for Individual Assistance.
- As of 9/24, Florida declared a State of Emergency for entire state of Florida.
- On 9/24, Florida’s Department of Highway Safety and Motor Vehicles released Emergency Order 09422 to waive additional registration and hours-of-service requirements for vehicles providing emergency services or supplies in Florida.
- Florida Law, Section 252.358, outlines prescription refills under an Executive Order and allows for early prescription refills.
- South Carolina
- On 9/30, President Biden approved a federal Emergency Declaration for all 46 counties of South Carolina.
- On 9/28, South Carolina declared a State of Emergency.
- 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.
- Georgia
- On 9/29 Georgia declared a State of Emergency.
- Virginia
- On 9/28 Virginia declared a State of Emergency.
Critical Infrastructure Impacts
- Power
- Florida
- As of 10:00am EDT on 10/4, nearly 435,000 Florida customers are without power. This is a decrease of about 175,000 outages since 10/3. Outages are concentrated in southwestern Florida, between Collier County and Manatee County.
- The greatest outage rates are in Lee, Charlotte, and DeSoto, Counties where 60% of customers are without power. Additionally, Sarasota County is experiencing about 30% outage rates, and Manatee, Hardee, Hendry, and Collier Counties are 10% without power.
- Major power providers, including Florida Power and Light Company (FPL), Lee County Electric Cooperative, Jacksonville Electric Authority, and others continue to report high power outages. Across the state, companies continue to restore power for customers who can receive it.
- Long-term outages may be reported across the state for customers who will not be able to receive power due to damage or flooding. In these cases, electrical systems will need to be inspected by licensed electricians to determine if repairs are needed before power can be restored.
- South Carolina
- As of 3:00pm EDT 10/4, about 555 customers are without power in South Carolina.
- Dominion Energy is a major provider in the state and is reporting 345 outages.
- North Carolina
- As of 3:00pm EDT 10/4, about 667 customers are without power in North Carolina, indicating power was restored for about 85% of customers in the last 24 hours. Mecklenburg County is reporting the highest rate of outages, with 287 customers without power.
- Virginia
- As of 3:00pm EDT 10/4, approximately 567 customers are without power in Virginia, indicating power was restored for nearly 75% of customers within the last 24 hours.
- Florida
- Fuel
- As of 10/4, all ports and terminals are open for fuel and many gas stations have begun receiving shipments. Additionally, two residential fueling agencies are open; one in Dunbar, Fort Myers and one in Arcadia. Cars can get up to 10 gallons per day, and trucks can get up to 50 gallons per day.
- As of 10/4, fuel site limitations and outages have slightly improved in some areas of North Fort Myers and Bonita Springs, however Port Charlotte, Punta Gorda, and Cape Coral, Florida are still experiencing severely limited operations. Wait times for gas has been reported to be longer than six hours in some areas.
- Those looking for fuel and gas are encouraged to use Gas Buddy, to search for open stations and providers using crowdsourced information.
- As of 10/1, 49.9% of gas stations in the Fort Myers region, one third of gas stations in Tampa, and 20% of gas stations in Orlando are without fuel due to impact of the hurricane.
- 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 US oil production) in the Gulf of Mexico as Ian headed to Tampa and Florida.
- As of 9/28, Chevron Corp 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.
- Water
- As of 10/4, parts of 25 counties are still under boil water advisories. Residents are encouraged to reach out to local utility or county emergency contacts for the most up-to-date information.
- As of 10/4, the FEMA Daily Ops Brief reports that there still disruptions to water and wastewater services in Lee County. Infrastructure and water assessments are ongoing.
- As of 10/4, the FDEM has identified Points of Distribution (PODs) for water and other supplies across 7 counties.
- As of 10/1, the state of Florida is providing additional resources (water and diesel) to Lee County in order to power water supply to nearby hospitals.
- Governor DeSantis and state officials said restoring water service to the area was a top priority for responders. The outage is impacting a population of about 760,000 residents, who are now reliant on bottled water distribution sites. The U.S. Army Corps of Engineers (USACE) are meeting with county officials, noting that work crews are using water trucks to pressurize critical facilities to locate and repair leaks.
- Communications
- Florida
- According to the Federal Communications Commission (FCC):
- As of 12pm EDT 10/4, FCC reports: 3.1% of cell sites are down. 7 (-3) cell sites are down due to damage, 94 (-34) are due to transport, and 148 (-19) are due to power outages. 245 cell sites are running on back-up power.
- All 911 calls are being answered but some Public Safety Answering Point (PSAP) are being rerouted due to power outages.
- As of 10/4, no TV stations are reported as being out of service, 5 FM stations are reported as being out of service, and 2 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.
- International Bureau grants verbal special Temporary Authority (STA) for two weeks to repair of antennas and other facilities. The purpose of this STA is to allow the provider to operate with facilities that are not covered by their current authorization while they are fixing facilities caused by Hurricane Ian.
- Public Safety and Homeland Security Bureau issue a verbal waiver for Florida public safety officials to use 700 – 800 MHz interoperability channels.
- Wireless Telecommunications Bureau grants the American Radio Relay League (ARRL) an emergency request for a temporary waiver of Section 97.307(f) of the Commission’s Rules.
- Wireless Telecommunications Bureau and the Public Safety and Homeland Security Bureau extend licensing and regulatory deadlines for 30 days following President Biden’s declaration of emergency for the State of Florida.
- Wireless Telecommunications Bureau grants an emergency waiver of sections 96.67(c)(2) and (3) of the Commission’s rules governing the Citizen’s Broadband Radio Service to Federated Wireless, CommScope, Inc., and Google LLC.
- Wireless Telecommunications Bureau and Public Safety and Homeland Security Bureau Extend Filing and Regulatory Deadlines in Additional Areas (SC and GA) Affected by Hurricane Ian.
- Due to damage associated with Hurricane Ian caused to broadcasters in Florida and South Carolina, for these stations, the Media Bureau extends the October 11, 2022 deadline for placing material covering the previous calendar quarter in their public inspection file to December 12, 2022.
- Wireless Telecommunications Bureau issues multiple STAs to Verizon and T-Mobile in Florida to restore communications in the aftermath of Hurricane Ian.
- 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.
- According to the Federal Communications Commission (FCC):
- Florida
- Transportation
- Road Closures and Travel Updates
- Florida
- Uber announced free round-trip rides to Central Florida shelter locations in Orange, Brevard, Seminole, Volusia, and Osceola counties. Uber is also offering round-trips to and from Southwest Florida shelter locations in Hillsborough, Pinellas, Manatee, Pasco, Lee, Charlotte, and Sarasota counties – use code IANRELIEF to redeem a round-trip up to $30.
- Florida 511 has real-time traffic conditions and incident information.
- There are dozens of road closures across southwest Florida. Closures along central and northeast Florida are decreasing as workers continue to clear roadways.
- The SR-78 / Pine Island at Matlacha Draw Bridge, which connects Pine Island to Ft. Myers, remains closed as of 10/4.
- Lee County authorities are aiming to have a temporary bridge to Pine Island in 10 days to allow for residents to relocate their cars to the mainland.
- 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. The Sanibel Causeway bridge remains closed as of 10/4.
- Gov. DeSantis mentioned the state will also build a temporary bridge to Sanibel Island.
- North Carolina
- Current road conditions and road closures in North Carolina are mapped on DriveNC.gov.
- As of 10/4, there are 2 active incidents on secondary roads due to impacts from Hurricane Ian.
- North Carolina’s 511 Information Line is available to motorists throughout the state.
- Florida
- Airports
- According to the Federal Aviation Administration’s airport status map, airports are largely operational in Florida.
- As of 10/4, Allegiant flight operations have resumed at Punta Gorda Airport with several inbound and outbound flights.
- Southwest Florida International Airport (RSW) in Fort Myers is the remaining major airport closure as of 10/2. RSW will remain closed until further notice pending water and power restoration. The FAA states RSW is expected to reopen on 10/5 at 8:00am EDT.
- Rail
- As of 10/4, all SunRail trains are back on schedule.
- Road Closures and Travel Updates
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
- As of 10/4, FEMA reports that some healthcare facilities remain closed due to ongoing water and wastewater restoration and structural damage.
- On 10/3, the Governor’s office reported that 22 healthcare facilities who had previously been evacuated were returned to their centers and are operational.
- Additionally, only 9 of the 26 healthcare facilities who initially evacuated remain evacuated, with the other 17 having reopened.
- As of 10/4, the following Lee Health Primary Care locations have reopened, and are servicing patients from 8:00am-5:00pm (additional 10/4 reopenings for cancer centers, rehabilitation services, neurosciences services, community & women’s health, hospitalist & continuum of care, specialty care, and pediatrics can be found here. A complete list of scheduled reopenings through 10/5 can be found here)
- Bass Rd – 16271 Bass Rd, Fort Meyers, FL 33908
- College Pointe – 9131 College Point Ct, Fort Meyers, FL 33919
- Lee Community Healthcare Cape Coral – 1435 SE 8th Ter, Suite E, Cape Coral, FL 33990
- Plantation – 13782 Plantation Rd Suite 201, Fort Meyers, FL 33912
- GME Internal Medicine Cape Coral, 1138 County Club Blvd, Cape Coral, FL 33990
- As of 10/4 the following sites within the NHC Healthcare System are open: NCH Downtown Baker Hospital’s emergency department, all other NCH emergency departments, and NCH Physician Group Practices and Outpatient Facilities are open.
- Note: As of 10/3, NCH hospitals were open to receive emergency patients only. However, 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”.
- As of 10/3, all Tampa General Hospital locations are open and caring for patients. TGH Virtual Health is also available for patients who have been displaced from their doctors and/or regular routines.
- Other closures and evacuations (updated 10/4):
- As of 10/4, normal visiting hours have resumed at the following Sarasota Memorial Health facilities: SMH-Sarasota, SMH-Venice; all Urgent Care Centers at Heritage Harbour, University Parkway, St. Armands, Bee Ridge, Stickney Point, and Venice; and most Physician Group offices, including the Gulf Gate Family Practice and Newton International Medicine Offices.
- As of 10/4, Sarasota Memorial Hospital 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.
- 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. As of 10/4, they remain closed. However, as of 10/3, HCA announced that the HCA Florida Care Coral Emergency Room, a part of the HCA Florida Fawcett Hospital, has re-opened as a result of repair completions. All emergency services at the Emergency Room are available 24/7.
- As of 10/3, AdventHealth’s home care, hospice, home infusion, and respiratory equipment services returned to normal operations. However, AdventHealth Medical Group Offices will be closed 10/5 and 10/6.
- 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 10/4, 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”.
- According to the Governor’s Office, as of 10/3, 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, normal visiting hours have resumed at the following Sarasota Memorial Health facilities: SMH-Sarasota, SMH-Venice; all Urgent Care Centers at Heritage Harbour, University Parkway, St. Armands, Bee Ridge, Stickney Point, and Venice; and most Physician Group offices, including the Gulf Gate Family Practice and Newton International Medicine Offices.
- 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 10/4, 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:
- Kissimmee, FL Store 2881, 904 B Cypress Pkwy, Kissimmee, FL
Walmart Health is open Mon. – Fri. from 7:30am – 7:30pm; Sat. from 9am – 5pm; Sun. telehealth only* - Sanford, FL Store 857, 3647 S Orlando Dr, Sanford, FL
Walmart Health is open Mon. – Fri. from 7:30am – 7:30pm; Sat. from 9am – 5pm; Sun. telehealth only* - Wesley Chapel, FL, Store 3418, 28516 State Road 54, Wesley Chapel, FL
Walmart Health is open Mon. – Fri. from 7:30am – 7:30pm; Sat. from 9am – 5pm; Sun. telehealth only* - Brandon, FL, Store 2387, 11108 Causeway Blvd, Brandon, FL
Walmart Health is open Mon. – Fri. from 7:30am – 7:30pm; Sat. from 9am – 5pm; Sun. telehealth only*
- Emergency Medical Services
- Disaster Medical Assistance Team’s (DMATs) are setting up in Lee County to supplement the hospitals’ emergency departments by providing emergency and urgent care. As of 10/4, a DMAT is currently in place at Cape Coral Hospital and will be setting at Lee Memorial Hospital on 10/5.
- The Florida Department of Health has provided an additional 40 ambulances to local emergency county EMS providers. In total over 450 emergency medical service vehicles have been provided to impacted counties to assist with community needs.
- Florida Department of Health’s Division of Emergency Preparedness and Community Support continues to support patient movement requests and special need shelter requests.
- Members of the Chesapeake Fire Department deployed to Florida. Additionally, California, Ohio, Tennessee, and other states deployed emergency management personnel and mass care specialists to Florida.
- There are several units prepositioned and on standby for Hurricane Ian response, including: Firefighters, Cadets, and other EMS providers; Members of Virginia and Ohio’s taskforces, including fire departments and organizations from various counties and cities; USF volunteers in conjunction with the Florida Department of Health; and Medical Response Unit’s Specialized Disaster Response Team on standby to assist with high-needs shelters as needed.
- Pharmacy
- Rx Open is activated for Georgia, Florida, South Carolina, and North Carolina. It was last updated on 10/4 at 2:00pm EDT and is showing 51 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 – Baker, Charlotte and Glades counties.
- Georgia – Baker, Butts, Chattahoochee, Clay, Clayton, Decatur, Echols, Fayette, Glascock, Quitman, Teliaferro, Wilcox and Wilkinson counties.
- These counties have less than 50% pharmacies as open primarily due to Unknown Statuses, and not confirmed closures.
- North Carolina – Camden county.
- As of 10/2, OptumRx provided guidance to customers for rerouting existing prescription deliveries to new addresses.
- Pharmacy deliveries via Express Scripts may arrive late.
- Dialysis
- No changes since 10/1.
- As of 10/1, many dialysis facilities impacted by Ian have reopened, though closures remain in Florida. 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
- Network 7: HSAG Florida ESRD Network
Public Health Impacts
- Infectious illnesses
- No updates since 10/3.
- 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 10/3, CDC is still reporting 10,627 total COVID cases, 218 new hospital admissions, and 20 deaths in the past seven days in Florida.
- As of 10/3, there are still 2,543 Monkeypox cases in Florida.
- 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.
- Mosquito-borne illnesses
- Stagnant water that pools and develops in the aftermath of hurricanes can promote an increase in mosquitos and other insects that carry illnesses. Flooding from hurricanes can cause mosquito eggs laid in the soil to hatch. This results in a large population of floodwater mosquitos. If the flood waters to not recede, then the buildup of mosquitos becomes much larger than is typical.
- Some mosquitoes, Aedes Aegypti, yellow fever mosquitos, can transmit viruses including: Dengue Fever, West Nile Virus, Chikungunya Virus, Zika Virus.
- There are several key methods for protection, including: wear long sleeve shirts and pants, use EPA-registered insect repellant, and drain water from outdoor containers when possible.
- Stagnant water that pools and develops in the aftermath of hurricanes can promote an increase in mosquitos and other insects that carry illnesses. Flooding from hurricanes can cause mosquito eggs laid in the soil to hatch. This results in a large population of floodwater mosquitos. If the flood waters to not recede, then the buildup of mosquitos becomes much larger than is typical.
- 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.
- Leptospirosis
- Cholera – Cholera was less common in Florida before Hurricane Ian, so it will remain less common even in the flooding aftermath.
- 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.
- Mental health
- 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 residents 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 hours a day, seven days a week with a trained counselor. 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, 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.
- Royal Park Hospital Patients experiencing behavioral health crisis are encouraged to call the National Suicide and Crisis hotline at 988.
- Other
- Website 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.
Supply Chain
- Manufacturing
- No updates as of 10/4.
- 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 10/4, UPS is continuing to report that most UPS facilities are providing pickup and delivery services as conditions permit. There will still be no pickups or deliveries today in the following zip codes: 33924, 33957, 33931, 33908, 33901.
- As of 10/4, FedEx is reporting delays and disruptions for inbound and outbound shipments across impacted areas. FedEx Express, Ground, and Freight have temporarily suspended service in a number of cities in Florida which can be found here.
- No changes to US Postal Service status. As of 10/3, US Postal Service reports that 14 facilities remain temporarily suspended until further notice. Each of the 14 facilities have an alternate location provided.
- Localized healthcare supply chain disruptions are likely, however damage to distribution centers has been minor.
Resource Staging
- General resource staging
- FEMA and state search and rescue operations continue in Florida with a priority on hospitals, healthcare facilities, and barrier island communities. More than 100 FEMA Disaster Survivor Assistance Team staff are working in the hardest hit communities to help survivors apply for assistance and identify immediate and emerging threats.
- As of 10/4, FEMA has approved more than $70 million for recovery efforts for Florida residents.
- Disaster Survivor Assistance Teams will check on survivors, assist with federal disaster assistance applications, and answer questions about types of federal assistance available.
- Teams are visiting shelters now to help survivors apply for assistance.
- FEMA Administrator Deanne Criswell will travel with President Biden to Florida on 10/5 to survey heavily damaged areas and meet with response officials about ongoing efforts to help survivors and hard-hit communities.
- Disaster Recovery Centers, staffed by state, federal, and volunteer organizations, will begin opening today where everyone can access recovery information.
- Operation Blue Roof is now available to homeowners in Charlotte and Lee counties. Homeowners can sign up online at blueroof.us or call 1-888-ROOF-BLU (1-888-766-3258) for more information.
- Florida
- Florida Department of Emergency Management (FDEM) is identifying locations and resource needs for Points of Distribution (POD) in Charlotte, Collier, DeSoto, Hardee, Highlands, Lee, and Sarasota counties.
- 28 POD sites have distributed:
- 2,099 pallets of water
- 1,776 pallets of food
- 438 pallets of ice
- 67 pallets of tarps
- POD locations are open today in the following counties: Charlotte, Collier, DeSoto, Hardee, Highlands, Lee, and Sarasota. The exact locations can be found here.
- 28 POD sites have distributed:
- 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.
- FDEM has received more than 3,700 resource requests for Hurricane Ian and fulfilled. Over 3,100 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.
- Florida Department of Emergency Management (FDEM) is identifying locations and resource needs for Points of Distribution (POD) in Charlotte, Collier, DeSoto, Hardee, Highlands, Lee, and Sarasota counties.
Emergency Prescription Refills
- Florida
- As of 9/24, early prescription refills are permitted under the State of Emergency. Opioids are considered a controlled substance, and therefore excluded from emergency prescription refill laws.
- You can obtain a 30-day refill of your prescription medication – even if you have just refilled it – if you reside in a county that:
- Is under a hurricane warning issued by the National Weather Service;
- Is under a state of emergency executive order declared by the Governor; or
- Has activated its emergency operations center/emergency management plan.
- About 13% of Florida’s population is uninsured. The Emergency Prescription Assistance Program (EPAP) is the federal program that provides medication coverage for uninsured patients, but the program has not yet been activated. The uninsured population under age 65 in areas impacted by Ian is especially high:
- Lee County: 19.3%
- Collier County: 17.9%
- Charlotte County: 16.9%
- Hendry County: 27.6%
- Centers for Medicare & Medicaid Services (CMS) implemented the 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.
- Patients can call 855-225-5032 to reach doctors 24/7 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.
- North Carolina
- In the event of a disaster, if a prescriber is unable to provide medical services, Board Rule .1815 states that a pharmacist can issue up to a 90-day supply emergency refill.
- Starting 9/29 through the end of the state of emergency, NC Medicaid Direct and NC Medicaid Managed Care will reimburse providers for medically necessary drugs and services. Additionally, NC Medicaid enrolled pharmacy providers are approved to override prior approval requirements during the state of emergency to ensure all beneficiaries have access to medications.
- Blue Cross Blue Shield of North Carolina is allowing early prescription refills to North Carolina customers through 10/28.
- Members of Anthem whose plan covers prescription medications that are taken on a regular basis can receive a 30-day emergency refill at any pharmacy through 10/28.
- South Carolina
- According to South Carolina Law, if a pharmacist is unable to reach a prescriber for refill authorization of a non-controlled substance, under certain circumstances they are permitted to issue an emergency refill of up to a 14-day supply once within a 12-month period.
- On 9/30, Blue Cross Blue Shield announced that effective immediately, for the next 90 days, members can access early refills of any prescription medicine, and use Well Connection (telehealth platform) with no copayments or deductibles. Use code “BCBSMA126”.
Evacuations and Curfews
- No changes since 10/3.
- As of 10/3, the following Florida counties have issued mandatory evacuation orders: Lee County, Osceola County, and Sarasota County.
- As of 10/3, the following Florida Counties have issued voluntary evacuation orders: Seminole County.
- As of 10/3, Lee County’s evacuation and curfew have not been lifted.
- As of 10/3, the City of Kissimmee has a mandatory curfew from 9pm to 6am until further notice.
- As of 10/3, Collier County and the city of Naples have a curfew from 12am to 6am until 10/4.
- As of 9/30, multiple areas in Florida had issued stay at home orders or curfews. It is unclear if these curfews remain in effect.
- As of 10/2, North Carolina does not have any evacuation orders or curfews.
- As of 10/2, South Carolina has not issued any evacuation orders or curfews.
Sheltering
- The FEMA Daily Ops Brief from 10/3 reports 39 open shelters with 3,418 residents. A slight decrease in sheltered residence from 10/2 (3,607).
- As of 10/4, Florida Disaster Maps shows there are 14 open shelters and 5 Special Needs Shelters in the state.
- Full list and map of shelters open in Florida can be found on the Florida SERT site.
- List of open American Red Cross shelters can be found here.
- On 10/2, Airbnb rolled out urgent hurricane accommodations, info at airbnb.com/hurricaneianflorida. For displaced residents of Lee and Charlotte counties, Airbnb is also working with nonprofit partners to offer vouchers for temporary housing at Airbnb properties. To learn more, see Airbnb’s full press release.
- 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.