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    <title data-rh="true">Houston’s Hospitals Treat Storm Victims and Become Victims Themselves - The New York Times</title><meta data-rh="true" itemprop="inLanguage" content="en-US"/><meta data-rh="true" name="robots" content="noarchive"/><meta data-rh="true" name="articleid" itemprop="identifier" content="100000005395272"/><meta data-rh="true" name="description" itemprop="description" content="Houston’s world-renowned health care infrastructure found itself battered by Hurricane Harvey, testing whether officials had done enough to prepare."/><meta data-rh="true" name="byl" content="By Sheri Fink and Alan Blinder"/><meta data-rh="true" name="thumbnail" itemprop="thumbnailUrl" content="https://static01.nyt.com/images/2017/08/28/us/29medical1/29medical1-thumbStandard.jpg"/><meta data-rh="true" name="news_keywords" content="Hurricane Harvey,Hurricanes,Emergency medicine,Hospital,Weather,Flood,Nursing home,Evacuation,Houston,Texas"/><meta data-rh="true" name="usageTerms" 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role="group" itemProp="associatedMedia" itemID="https://static01.nyt.com/images/2017/08/28/us/29medical1/29medical1-articleLarge.jpg?quality=30&amp;auto=webp" itemType="http://schema.org/ImageObject"><div class="ResponsiveMedia-container--G2JS6 ResponsiveMedia-toneNews--pMwMi"><span class="accessibility-visuallyHidden--OUeHR">Image</span><img alt="" class="Image-image--2zb04" src="https://static01.nyt.com/images/2017/08/28/us/29medical1/29medical1-articleLarge.jpg?quality=30&amp;auto=webp" srcSet="https://static01.nyt.com/images/2017/08/28/us/29medical1/29medical1-articleLarge.jpg?quality=100&amp;auto=webp 600w,https://static01.nyt.com/images/2017/08/28/us/29medical1/29medical1-jumbo.jpg?quality=100&amp;auto=webp 1024w,https://static01.nyt.com/images/2017/08/28/us/29medical1/29medical1-popup.jpg?quality=100&amp;auto=webp 650w,https://static01.nyt.com/images/2017/08/28/us/29medical1/29medical1-superJumbo.jpg?quality=100&amp;auto=webp 2048w" sizes="((min-width: 600px) and (max-width: 1004px)) 84vw, (min-width: 1005px) 60vw, 100vw"/></div><figcaption class="ResponsiveMedia-caption--1dUVu Media-caption--wlc0l ResponsiveMedia-toneNews--pMwMi" itemProp="caption description"><span class="ResponsiveMedia-captionText--2WFdF Media-captionText--2e27a">Emergency medical technicians transported a patient from the Citizens Medical Center in Victoria, Tex., to another hospital on Saturday.</span><span class="ResponsiveMedia-credit--3F-q_ Media-credit--1ZFho" itemProp="copyrightHolder"><span class="accessibility-visuallyHidden--OUeHR">Credit</span><span>Alyssa Schukar for The New York Times</span></span></figcaption></figure><div class="styles-bylineTimestamp--2J2fe styles-toneNews--29Vp_"><div class="elementStyles-byline--33rWc styles-byline--Dn1Bu styles-toneNews--29Vp_"><div class="Byline-bylineGroup--2XIy_"><p class="">By<!-- --> <a href="http://www.nytimes.com/by/sheri-fink" class="Byline-bylineAuthor--d8i20 elementStyles-authors--voZdU">Sheri Fink</a> and <a href="http://www.nytimes.com/by/alan-blinder" class="Byline-bylineAuthor--d8i20 elementStyles-authors--voZdU">Alan Blinder</a></p></div></div><time class="Timestamp-timestamp--3FJff elementStyles-timestamp--26VGL styles-timestamp--KJFCK" dateTime="2017-08-28" itemProp="datePublished" content="2017 - 08 - 28">Aug. 28, 2017</time></div></header><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">Water poured into hospitals. Ambulances were caught up in roiling floodwaters. Medical transport helicopters were grounded by high winds. Houston’s world-renowned health care infrastructure found itself battered by <a rel="noopener noreferrer" target="_blank" href="https://www.nytimes.com/2017/08/27/us/hurricane-harvey-texas.html?action=click&amp;pgtype=Homepage&amp;clickSource=story-heading&amp;module=span-abc-region&amp;region=span-abc-region&amp;WT.nav=span-abc-region" title="" class="styles-link--1Tap3">Hurricane Harvey</a>, struggling to treat storm victims while becoming a victim itself.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">The coming days will inevitably bring more hazards for storm-damaged hospitals and nursing homes, and their patients and staff. The scenes of turmoil across Texas raised the specter of the extreme flooding following Hurricane Katrina in 2005, when dozens of hospital and nursing home patients died, and doctors awaiting rescue at one stranded, powerless hospital became so desperate, <a rel="noopener noreferrer" target="_blank" href="http://www.nytimes.com/2009/08/30/magazine/30doctors.html" title="The Deadly Choices at Memorial" class="styles-link--1Tap3">they intentionally hastened the deaths</a> of their patients.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">The response to Harvey, now a tropical storm but still wreaking havoc over the state, promises answers to whether health officials learned lessons from the catastrophe of Katrina when it comes to the medically vulnerable — in particular whether they did enough to prepare for the disaster and to move patients out of its path.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">“We’ve made significant investments,” Dr. Umair Shah, executive director of Harris County’s public health department, said in a telephone interview on Sunday. “The challenge is until it unfolds there’s so many moving pieces and it’s never the same as the situations you’ve previously encountered.”</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">Responders point to dozens of improvements, from better engineered structures to well-practiced cooperation, that are helping protect lives. Still, sometimes even the soundest plans have been foiled.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">Water rose in the basement of Ben Taub Hospital, a major county trauma center in the vast Texas Medical Center campus that had spent billions of dollars on flood protections after being devastated in Tropical Storm Allison in 2001. Officials announced an evacuation Sunday, but hours later, a hospital spokesman said it had not yet begun because the hospital was surrounded by water and rescuers could not reach its 350 patients. On Monday afternoon, a call went out on local radio for a vendor to provide food for the hospital.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">As of Monday afternoon, 10 to 15 other hospitals and various nursing homes, some in rural communities, have also evacuated or begun evacuating since the storm made landfall, said Darrell Pile, chief executive of the Southeast Texas Regional Advisory Council, which established a catastrophic medical operations center in Houston’s emergency command center. At one hospital in northwest Houston, CHI St. Luke’s Health — the Vintage, patients were transported by airboat to nearby ambulances due to severe flooding from the Cypress Creek. As displaced residents filled the George R. Brown Convention Center, t<a rel="noopener noreferrer" target="_blank" href="https://twitter.com/HoustonTX/status/902283771218558978" title="" class="styles-link--1Tap3">he city sent out a call for </a>licensed health workers to help people with medical needs there.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">While some vulnerable hospitals and nursing homes opted to move their patients out of the region in the hours before the storm, Mr. Pile said, others “did not know to necessarily expect this level of chaos.” A large coalition of medical providers had drilled and planned regularly for catastrophes, he added, “but honestly, not at this epic level.”</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">Most hospitals in Houston continued operating and they reported that they were doing well. But some, ringed by floodwater, were cut off from patients trying to reach them. Hospital staff members had trouble getting to work as well.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">In other parts of the state, Harvey knocked out utilities, forcing hospitals to rely on vulnerable backup systems. The wind and rain were threatening at Citizens Medical Center in Victoria, a city of about 68,000 people roughly 125 miles southwest of Houston, when emergency workers loaded patients onto a mass evacuation ambulance while roads were passable late Saturday night. Amid the stressful scene, one older woman clutched a brown teddy bear while waiting to be taken aboard.</p><figure class="ResponsiveMedia-media--32g1o ResponsiveMedia-toneNews--pMwMi ResponsiveMedia-sizeMedium--3hVlk ResponsiveMedia-toneNews--pMwMi" aria-label="media" role="group" itemProp="associatedMedia" itemID="https://static01.nyt.com/images/2017/08/28/us/29medical3/29medical3-articleLarge.jpg?quality=30&amp;auto=webp" itemType="http://schema.org/ImageObject"><div class="ResponsiveMedia-container--G2JS6 ResponsiveMedia-toneNews--pMwMi"><span class="accessibility-visuallyHidden--OUeHR">Image</span><img alt="" class="Image-image--2zb04" src="https://static01.nyt.com/images/2017/08/28/us/29medical3/29medical3-articleLarge.jpg?quality=30&amp;auto=webp" srcSet="https://static01.nyt.com/images/2017/08/28/us/29medical3/29medical3-articleLarge.jpg?quality=100&amp;auto=webp 600w,https://static01.nyt.com/images/2017/08/28/us/29medical3/29medical3-jumbo.jpg?quality=100&amp;auto=webp 1024w,https://static01.nyt.com/images/2017/08/28/us/29medical3/29medical3-popup.jpg?quality=100&amp;auto=webp 650w,https://static01.nyt.com/images/2017/08/28/us/29medical3/29medical3-superJumbo.jpg?quality=100&amp;auto=webp 2048w" sizes="((min-width: 600px) and (max-width: 1004px)) 84vw, (min-width: 1005px) 60vw, 100vw"/></div><figcaption class="ResponsiveMedia-caption--1dUVu Media-caption--wlc0l ResponsiveMedia-toneNews--pMwMi" itemProp="caption description"><span class="ResponsiveMedia-captionText--2WFdF Media-captionText--2e27a">Lt. Javier Quiroga of the Brownsville Fire Department walking between two ambulance buses, which have the ability to transport up to 20 patients lying down, on Saturday.</span><span class="ResponsiveMedia-credit--3F-q_ Media-credit--1ZFho" itemProp="copyrightHolder"><span class="accessibility-visuallyHidden--OUeHR">Credit</span><span>Alyssa Schukar for The New York Times</span></span></figcaption></figure><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">“As much as we want to help our patients, I know we can help them more by getting them to a safer spot,” said Dr. Daniel Cano, the hospital’s medical director. The hospital’s generators did not power air conditioning and when city power switched it back on after a day without, it took hours for the humidity to seep out of the hospital.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">Hundreds of patients had remained in Victoria’s hospitals during Harvey. But after a power outage and a threat to the running water supply, and with flooding in the area expected to worsen, all were taken to San Antonio and elsewhere across the state, officials said.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">Jennifer Schulte, director of marketing for Citizens, said some critically ill patients had been transferred before Harvey made landfall, when a mandatory evacuation of the city was announced a day before. But the short time window meant that 80 other patients could not be moved. “The roadways there were very clogged up,” she said. “That would require patients to sit and wait. For some, in their condition, it would not be safe.”</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">That was a lesson etched in memories by Hurricane Rita in 2005. A charter bus with an illegal license <a rel="noopener noreferrer" target="_blank" href="http://www.nytimes.com/2005/09/23/national/nationalspecial/bus-carrying-elderly-storm-evacuees-explodes-near.html?mcubz=0&amp;_r=0" title="" class="styles-link--1Tap3">caught fire on its way to Dallas from a nursing home</a> near Houston. Oxygen tanks in the luggage bays exploded. Twenty-three people aboard the bus burned to death. In the end, the storm spared Houston.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">However, decisions not to shut nursing homes for Hurricane Harvey left some residents in peril. In Dickinson on Sunday, rescuers removed about two dozen people from the La Vita Bella assisted living center. <a rel="noopener noreferrer" target="_blank" href="https://twitter.com/dividendsmgr/status/901805509950541825" title="" class="styles-link--1Tap3">An alarming photograph spread across social media</a> of the center’s residents in wheelchairs and lounge chairs, sitting in water to their waists. All survived, officials said.</p><figure class="ResponsiveMedia-media--32g1o ResponsiveMedia-toneNews--pMwMi ResponsiveMedia-sizeMedium--3hVlk ResponsiveMedia-toneNews--pMwMi" aria-label="media" role="group" itemProp="associatedMedia" itemID="https://static01.nyt.com/images/2017/08/28/us/29medical4/29medical4-articleLarge.jpg?quality=30&amp;auto=webp" itemType="http://schema.org/ImageObject"><div class="ResponsiveMedia-container--G2JS6 ResponsiveMedia-toneNews--pMwMi"><span class="accessibility-visuallyHidden--OUeHR">Image</span><div class="LazyImage-imageContainer--26dUd"><img alt="" class="Image-image--2zb04 LazyImage-lazyload--1mWsm" src="https://static01.nyt.com/images/2017/08/28/us/29medical4/29medical4-articleLarge.jpg?quality=30&amp;auto=webp" sizes="((min-width: 600px) and (max-width: 1004px)) 84vw, (min-width: 1005px) 60vw, 100vw" data-srcset="https://static01.nyt.com/images/2017/08/28/us/29medical4/29medical4-articleLarge.jpg?quality=100&amp;auto=webp 600w,https://static01.nyt.com/images/2017/08/28/us/29medical4/29medical4-jumbo.jpg?quality=100&amp;auto=webp 1024w,https://static01.nyt.com/images/2017/08/28/us/29medical4/29medical4-popup.jpg?quality=100&amp;auto=webp 650w,https://static01.nyt.com/images/2017/08/28/us/29medical4/29medical4-superJumbo.jpg?quality=100&amp;auto=webp 2048w"/></div></div><figcaption class="ResponsiveMedia-caption--1dUVu Media-caption--wlc0l ResponsiveMedia-toneNews--pMwMi" itemProp="caption description"><span class="ResponsiveMedia-captionText--2WFdF Media-captionText--2e27a">A nurse at the Citizens Medical Center communicated with colleagues as the center prepared for the medical evacuation of patients.</span><span class="ResponsiveMedia-credit--3F-q_ Media-credit--1ZFho" itemProp="copyrightHolder"><span class="accessibility-visuallyHidden--OUeHR">Credit</span><span>Alyssa Schukar for The New York Times</span></span></figcaption></figure><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">Ideally, hospitals should not only withstand disasters, but also provide safe haven to those injured in them. As of Monday morning, the fortification of the Texas Medical Center in Houston appeared to have paid off for most of its 23 hospitals. Submarine doors were locked on Saturday afternoon, protecting foundations that had flooded catastrophically after Allison in 2001, knocking out power and forcing emergency patient evacuations.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">With ambulance routes flooded, however, potential patients had difficulty reaching the complex. “I’ve never heard so few sirens as I have in the last few days, which is upsetting,” said William McKeon, the center’s president and chief executive. “We can be dry and open but if you can’t deliver patients to the medical center, that’s our biggest concern.” For hours on Sunday, he said, the system’s eight helicopters could not fly to the center because of high winds and tornado warnings.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">“With one of the most devastating hurricanes in Texas, I’m looking out my window now, all the lights are on, the largest medical city in the world is operating today, that’s a feat of engineering that is really amazing,” Mr. McKeon said late Sunday night.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">Law enforcement officials helped identify routes to the hospitals and shared them with emergency medical service agencies. And when water needed to be let out of a reservoir overnight from Sunday to Monday, responders were given advance notice to re-establish a massive staging area for ambulances and medical equipment.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">“That kind of coordination and teamwork has prevented some hardships that might have happened in prior years when people were not communicating and were operating in their own little silos,” Mr. Pile of the Southeast Texas Regional Advisory Council said.</p><figure class="ResponsiveMedia-media--32g1o ResponsiveMedia-toneNews--pMwMi ResponsiveMedia-sizeMedium--3hVlk ResponsiveMedia-toneNews--pMwMi" aria-label="media" role="group" itemProp="associatedMedia" itemID="https://static01.nyt.com/images/2017/08/28/us/29medical2/29medical2-articleLarge.jpg?quality=30&amp;auto=webp" itemType="http://schema.org/ImageObject"><div class="ResponsiveMedia-container--G2JS6 ResponsiveMedia-toneNews--pMwMi"><span class="accessibility-visuallyHidden--OUeHR">Image</span><div class="LazyImage-imageContainer--26dUd"><img alt="" class="Image-image--2zb04 LazyImage-lazyload--1mWsm" src="https://static01.nyt.com/images/2017/08/28/us/29medical2/29medical2-articleLarge.jpg?quality=30&amp;auto=webp" sizes="((min-width: 600px) and (max-width: 1004px)) 84vw, (min-width: 1005px) 60vw, 100vw" data-srcset="https://static01.nyt.com/images/2017/08/28/us/29medical2/29medical2-articleLarge.jpg?quality=100&amp;auto=webp 600w,https://static01.nyt.com/images/2017/08/28/us/29medical2/29medical2-jumbo.jpg?quality=100&amp;auto=webp 1024w,https://static01.nyt.com/images/2017/08/28/us/29medical2/29medical2-popup.jpg?quality=100&amp;auto=webp 650w,https://static01.nyt.com/images/2017/08/28/us/29medical2/29medical2-superJumbo.jpg?quality=100&amp;auto=webp 2048w"/></div></div><figcaption class="ResponsiveMedia-caption--1dUVu Media-caption--wlc0l ResponsiveMedia-toneNews--pMwMi" itemProp="caption description"><span class="ResponsiveMedia-captionText--2WFdF Media-captionText--2e27a">Ambulances arrived at Citizens Medical Center on Saturday to evacuate patients.</span><span class="ResponsiveMedia-credit--3F-q_ Media-credit--1ZFho" itemProp="copyrightHolder"><span class="accessibility-visuallyHidden--OUeHR">Credit</span><span>Alyssa Schukar for The New York Times</span></span></figcaption></figure><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">He and others also said that a new federal rule stemming from Katrina — which requires a wide range of health providers to establish emergency plans — had led to significantly better preparedness among nursing homes.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">Federal health officials also analyzed Medicare claims to <a rel="noopener noreferrer" target="_blank" href="https://www.phe.gov/Preparedness/news/events/anniversary/Pages/empower.aspx" title="" class="styles-link--1Tap3">provide Texas officials</a> with the likely addresses of homebound people who rely on power-dependent ventilators, oxygen concentrators and electric wheelchairs, among other needs. Responders also used the <a rel="noopener noreferrer" target="_blank" href="https://www.dps.texas.gov/dem/stear/public.htm" title="" class="styles-link--1Tap3">state’s voluntary</a> registry to locate them and offer assistance.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">Mr. Pile and his colleagues said that organizations and assets funded by the federal hospital preparedness program had boosted their efforts.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">President Trump has proposed <a rel="noopener noreferrer" target="_blank" href="https://www.hhs.gov/sites/default/files/Consolidated%20BIB_ONLINE_remediated.pdf" title="The President’s Budget request for Health and Human Services" class="styles-link--1Tap3">cutbacks</a> to that program and two other medical preparedness programs overseen by the Federal Emergency Management Agency and the Department of Health and Human Services.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">Those programs helped establish emergency medical task forces that have dispatched ambulances, personnel and equipment from across the state.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">Hilary Watt, executive director of the Coastal Bend Regional Advisory Council, also used those federal funds to purchase special sleds and stretchers that allow extremely overweight people to be transported, after she read about the death of one heavy man at a hospital after Katrina when doctors could not figure out how to move him. Ms. Watt spread those stretchers strategically through ambulance services in her region.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">As Harvey approached, she called on those ambulance teams. Five patients were moved from Rockport and Aransas Pass in the hours before the storm, likely saving the patients’ lives when the hurricane roared ashore there as a Category 4.</p><p class="Paragraph-paragraph--2eXNE elementStyles-paragraph--3EIcW elementStyles-toneNews--sRTft">“We’ve definitely learned from the unfortunate outcomes in other areas,” Ms. Watt said.</p><div class="bottom-of-article"><div class="elementStyles-addendums--1S4tV elementStyles-toneNews--sRTft"></div><div class="elementStyles-extendedInformation--3NG2u elementStyles-toneNews--sRTft"><p>Alan Blinder reported from Victoria, Tex.</p> </div><div class="elementStyles-printInformation--2VtfI elementStyles-toneNews--sRTft">A version of this article appears in print on <!-- -->, on Page <!-- -->A<!-- -->1<!-- --> of the New York edition<!-- --> with the headline: <!-- -->As Waters Rise, The Caregivers Need Help, Too<span>. <a href="http://www.nytreprints.com/">Order Reprints</a> | <a 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