HOUSTON — Emergency officials along Texas' storm-battered coast have had plenty of practice responding to disasters in recent years, but they've never seen a scenario like this: A destructive hurricane slamming ashore in the midst of a pandemic.
Hurricane Laura intensified to an "extremely dangerous" Category 4 storm Wednesday, the National Hurricane Center said. Laura is forecast to make landfall around the Texas and Louisiana border on the Gulf Coast on Wednesday night or early Thursday.
"It's crazy," said Darrell Pile, CEO of the Southeast Texas Regional Advisory Council, which coordinates emergency medical response in a 25-county region along the state's coast. "You do get to a point where you're like, 'What else do you want to put on us?'"
"You just have to do your best," he added.
Pile said that as Laura approaches, hospitals have the capacity to care for a rush of patients injured in the storm. That said, he and other emergency officials are concerned about how to do it safely in a state with some of the highest known cases of the coronavirus.
Fortunately, he said, the number of people hospitalized for COVID-19 in southeastern Texas has dropped significantly since early July, when a surge of new cases strained hospital systems across the greater Houston region.
Experts worry that emergency shelters or crowded hospitals could become incubators for new COVID-19 outbreaks across the region and are taking steps to mitigate the risk.
"Social distancing will be much more difficult for people who are evacuating," Pile said. "However, they can wear a mask. And they can do their best to minimize being too close to other people."
He said those affected by Laura still need to remember what they've been taught to minimize the spread of COVID-19, the disease caused by the coronavirus.
If Beaumont is slammed, and hospitals there become overwhelmed, plans are in place to move patients elsewhere, like to Houston.
"Our hospitals are prepared for an increase in COVID cases, and the patients transported due to Laura will be taken to hospitals with capacity," Pile said. "Of course, from a disaster standpoint, we are pretty experienced at this point, so there are lots of preparations in place to handle Laura."
All of the hospitals have disaster plans in place which are updated each year, he said.
Texas Gov. Greg Abbott has urged residents along the coast to take evacuation orders seriously and encouraged to seek refuge at hotels or motels, saying they are "a good location" during a pandemic.
"Remember: Just because a hurricane is coming to Texas, does not mean COVID-19 either has or is going to leave Texas," he said at a news conference Tuesday. "COVID-19 is going to be in Texas throughout the course of the hurricane."
After months on the front line of a pandemic, facing the storm
As soon as Dr. Gary Mennie, the chief medical officer at The Medical Center of Southeast Texas, saw the forecast calling for a Category 3 or 4 hurricane cutting a path directly through his town of Beaumont, he knew he and his team needed to act fast.
Mennie said his hospital began preemptively transferring the most critically ill patients Monday morning, shuttling many of them two hours west by ambulance to Houston, which is now expected to avoid the worst of Laura's impact.
That included all of the hospital's COVID-19 intensive care patients.
Now — after months of treating patients on the front lines of the pandemic — Mennie and dozens of his colleagues are preparing to camp out in a mostly empty hospital, waiting for Laura to come ashore.
"It's like, great, 2020," he said. "The perfect storm."
Like many other hospital workers, Mennie sent his wife and children out of town so he could focus on treating patients without having to worry whether his family was safe. But it'll be hard not to think of his own home in Beaumont. It was flooded in 2017 during Hurricane Harvey, and again last year during Tropical Storm Imelda. His family had just got everything pieced back together, just in time for Laura to barrel ashore with what forecasters warn could be devastating winds and storm surge.
It's been a long three years, Mennie said. But he and his colleagues won't have time to worry once storm refugees begin streaming through the hospital doors.
"Everybody that stays are the people who say, 'I want to stay. I'm going to ride it out. We're going to be here for the community,'" he said. "And that's sort of in the blood of front-line workers. It's not even an obligation, but you feel that duty. You've got to be there for the community."
Buckling down with food and supplies for days
Dr. David Callender, the president and CEO of Memorial Hermann, the largest not-for-profit health system in Southeast Texas, said that because of their proximity to the Gulf Coast, they are used to dealing with storms. Their facilities are built to withstand hurricane force winds and the challenges associated with power loss.
"They’re built up high so that they’re relatively immune from flooding," he said.
Memorial Hermann anticipates that transportation could be negatively affected and that there could be dayslong power outages.
Staff will be on hand at the health system's 14 hospitals for the duration of the storm. While the health system has plenty of fuel for generators, it does not expect power to be interrupted.
"We’ve been hit by Harvey and Ike and did not experience any power outages at our hospitals," Memorial Hermann spokeswoman Alex Loessin said Wednesday.
Still, hospitals have food and supplies to last several days for patients and staff.
"Of course with COVID-19, we need to continue the precautions that we’ve been using to eliminate the spread of the disease within the hospitals," Callender said. "So that involves making sure we have plenty of personal protective equipment, particularly masks, on hand. That we can continue to use our social distancing approach."
He added: "So we have a little bit of the COVID-19 overlay to our traditional storm preparations."
Capacity is not a concern for Memorial Hermann. Going into a storm, part of its plan is to discharge patients or release them to an immediate care facility, Callender said.
"So we purposely bring down the capacity in our facilities because it makes it easier to staff the number of beds that we need to staff during the storm, to have the available food and supplies and other resources we need on hand," he said.
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The total number of coronavirus patients across Memorial Hermann is about 430, down more than 60 percent from what it was at its peak, Callender said.
"The numbers continue to come down. We’re very pleased to see that and clearly it’s because the people in our region understand the COVID threat now," he said. "And they’re abiding by the precautions — the wearing of masks, the social distancing, the washing of hands, the avoiding congregating in large groups."
Callender said the biggest challenge as the hurricane nears is not storm related.
"The issue is just to make sure that we continue to practice those behaviors, use those precautions, that stop the spread of COVID-19," he said.