Iowa hospitals reflect on lessons learned from pandemic, derecho

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Cathy Hafsi stands on her porch in August 2020 looking at the derecho damage in her front yard in Cedar Rapids. Hafsi has cerebral palsy and cares for a roommate who also suffers from cerebral palsy. Both of them, especially Hafsi’s roommate, rely on power chairs for getting around and struggle to keep them charged without power after the storm ravaged parts of eastern Iowa. (Andy Abeyta / The Gazette)

Garret Frey, who is on the city’s ADA advisory board, leans on an electric wheelchair and ventilator. When the power went out on August 10, 2020, he relied on a friend’s generator to power the chair before realizing that generators aren’t recommended for motorized wheelchairs like his. Eventually, her family had to pack their bags and stay with a relative in Missouri for several days until the power came back on. (Jim Slosiarek / The Gazette)

Emergency preparedness plans take into account unrelated disasters occurring at the same time.

But the confluence of derecho and pandemic – and the need to follow public health measures that at times collided with a typical response to natural disasters – have placed an additional burden on hospitals in Cedar Rapids.

As a result, he highlighted the need for medical centers, running on emergency power, to be able to handle an influx of vulnerable residents.

After more than a year of emergencies, officials from hospitals and other healthcare organizations who serve as first responders look to the future, discussing what improvements can be made to emergency operations plans who serve as a guide during unprecedented events – such as a pandemic and a hurricane – high winds and civil unrest.

“Experience is the best teacher,” said Mike Hartley, emergency management coordinator at University of Iowa hospitals and clinics.

“A community shelter was something we really needed because we were already taxed as a hospital,” said Casey Greene, COO at UnityPoint Health-Cedar Rapids.

Thousands of residents were without power following the devastating derecho that swept through parts of seven Midwestern states on August 10, 2020. In some cases, power was cut for more than two weeks.

For Cedar Rapids residents like Garret Frey, the lack of electricity wasn’t just an ordeal, it was a matter of life and death.

Frey, 39, is a quadriplegic who relies on a ventilator to breathe. After the storm, the first priority was to find a way to charge his wheelchair and the attached ventilator, which had around 36 hours of battery life left.

Even after several phone calls, no aid organization was able to help. A friend brought him a generator that night, but Frey’s family couldn’t find gas to power him.

After two days, they left Cedar Rapids to stay with family members in Missouri.

“Even when we came back, we heard much worse stories than ours,” said Charlene Frey, Garret’s mother. “We had a safe place to go, but there were people in much more difficult circumstances than us. “

These kinds of circumstances have forced many people to turn to a hospital.

Cedar Rapids hospital officials said dozens of people came to their emergency rooms – not because they needed medical attention, but because they needed a place to recharge medical devices or receive oxygen.

“We had to figure out how to deal with these types of community members who aren’t patients and need power sources,” said Chris Williams, safety and emergency management specialist at Mercy Medical Center. Cedar Rapids. “How do we fit them into the organization, especially in a pandemic when we’re trying to distance ourselves? “

The COVID-19 patient volume at the start of August was at a manageable level, and hospitals were able to find space in conference rooms and other areas to house these healthy non-critical patients.

“I hope it’s a lesson learned for our community to prepare for something like this and stand up for these types of community shelters with a greater sense of urgency in the future as it was a challenge for us here at the hospital, ”Greene said. “We were happy to support these community members and of course we would do it again, but it’s something we could have used a little earlier.”

According to state emergency management officials, the COVID-19 restrictions presented a challenge for local responders as they worked to create emergency shelters.

As a result, organizations such as the Red Cross have relied on “non-collective shelters,” such as hotels, to house the displaced residents. Charging stations and overnight shelters were then established throughout the county.

Responding to a natural disaster in the midst of a pandemic has also shown state and local authorities the need to adapt to a hybrid operating environment.

“Historically, state emergency operations have taken place in a face-to-face environment, but with COVID being superimposed on the derecho, a large majority of these operations have taken place in a virtual environment,” said John Benson , chief of staff for the Iowa Department. internal security and emergency management.

At the local level, the pandemic has added complexity in terms of the ability of officials to coordinate face-to-face response and recovery. They have had to balance infection control strategies to ensure their workers stay healthy, while also struggling with faulty communication systems.

“If we had passed COVID-19 through the staff, we wouldn’t have an (emergency response center) to be able to respond to the derecho,” said Steve O’Konek, county emergency management coordinator from Linn. “But we had to get together. You had to answer. “

Hospital challenges

Hospitals have emergency operating plans in place to respond to an incident of any magnitude that could affect a facility’s operations. This includes events like the protests against police brutality that took place over the summer.

At one point, when protesters took to the campus of University of Iowa hospitals and clinics, officials had to find alternate routes for ambulances and staff, Hartley said.

While hospitals in the corridor were prepared to scale up operations to house large numbers of COVID-19 patients if the need arose, they were unprepared for the challenges of obtaining personal protective equipment. .

At the onset of the pandemic, as the first COVID-19-related hospitalizations were reported in Iowa, hospitals faced significant gaps in the global supply of masks, gowns and other equipment used by professionals health care to reduce the risk of infection. Hospitals in Iowa asked staff to reuse PPE and relied on handmade masks donated by community members.

This challenge has been felt nationwide.

Some researchers argue that this is the result of the country’s unprepared emergency management system. Analysis found that the United States had not adequately invested in pandemic preparedness efforts – despite years of warnings about the risk of infectious disease outbreaks – which hampered its ability “to prepare, detect and respond ”to the new coronavirus.

The report was released late last year by the Council on Foreign Relations, a US-based think tank specializing in foreign policy and international affairs.

“Over the past two decades, federal support for state and local government public health emergency preparedness and response has declined by hundreds of millions of dollars,” the report said.

Look ahead

Hospital officials agree that a stronger stockpile of PPE and other medical supplies is needed for future emergencies. However, Hartley said the efforts should be supported by state and federal governments that maintain strategic storage programs, such as the national stockpile managed by the US Department of Health and Human Services.

Not all hospitals have the funding or the capacity to store supplies for the long term, he said.

“The shopping lists of things we need to store are going to grow longer, and it’s hard for hospitals to do,” Hartley said.

According to hospital officials, this is just one of the topics emergency responders will be discussing over the next few months as they review what worked and what didn’t work over the course of the year. pandemic and related events.

“One of the most fundamental principles of emergency management,” said Benson, “is to conduct an honest review of any operation and apply the lessons learned not only to existing plans, but also to future efforts. training and exercise. “

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