Hurricane Milton made landfall near Sarasota, Fla., as a Category 3 storm at 8:30 p.m. Wednesday. Here are nine things to know about the storm and its effects on hospitals in the region.
1. The damage. Search-and-rescue operations are underway Thursday morning after Hurricane Milton triggered tornadoes across Florida. Authorities said that once daylight arrives, crews will have a better ability to assess the areas damaged by the tornadoes, though early reports have already confirmed fatalities. St. Lucie County Sheriff Keith Pearson told CNN that fatalities were reported after a tornado ripped through a mobile home retirement community in St. Lucie County.
Local officials are urging Florida residents to stay sheltered in Pinellas County and Tampa as many roads are impassable due to downed power lines, fallen trees, and debris, according to CNN. The damage to public infrastructure is compounded by the existing devastation from Hurricane Helene two weeks ago, complicating travel for staff and patients trying to reach hospitals, according to Mary Mayhew, president and CEO of the Florida Hospital Association.
As Hurricane Milton's center moved into the Atlantic Ocean Thursday morning, more than 3.25 million Floridians were left without power, according to poweroutage.us. The widespread outages pose a critical risk for individuals dependent on power for medical equipment in their homes, requiring transfers to shelters or hospitals for care. Ms. Mayhew said that the Florida Hospital Association is working closely with hospitals statewide to coordinate these transfers.
2. The storm. Milton had top sustained winds of 120 mph after making landfall south of Tampa Bay. It triggered numerous tornadoes in southern and central Florida starting Wednesday, prompting 116 tornado warnings and 19 touchdowns before it made landfall, according to Gov. Ron DeSantis. Tornadoes were reported to have damaged more than a hundred structures around the state, authorities said. Milton lowered to a Category 1 hurricane with top sustained winds of 85 mph as it reached Florida's east coast, according to the National Hurricane Center.
Flooding rain and storm surge continue to hit the state Thursday morning, according to The Weather Channel. Rainfall totals of 10 to 17 inches soaked Pinellas County, Hillsborough County and Manatee County, while St. Petersburg reported more than 5 inches of rain in one hour as parts of the city and downtown Tampa flooded due to up to 17 inches of rain. A storm surge of 3 to 6 feet was recorded from Naples to Charlotte Harbor, with further inundation likely in Manatee and Sarasota counties.
3. Immediate effects on hospitals. All hospitals that remained open before the hurricane are still operational, with the exception of HCA Florida Largo Hospital. HCA Florida Largo Hospital evacuated about 230 patients early Wednesday morning due to flooding in the facility's basement, according to Fox 13 Tampa Bay. The facility remains temporarily closed. Tampa General experienced minor water leaks, but its power, water and supplies are secure, the system said. St. Petersburg was forced to shut down the city's water supply around midnight on Oct. 9 due to a water line break, affecting three hospitals in the area. Flooding and storm damage is expected to disrupt outpatient and community-based services, including pharmacies, which will likely contribute to increased volumes at emergency departments, according to Ms. Mayhew. [Many hospitals' websites and social media channels did not yet have storm updates as of 7 a.m. CT Thursday. Becker's will continue to monitor for new information and updates to this story.]
4. Preparations ahead of landfall. Before the hurricane made landfall, 313 healthcare facilities in the state reported evacuations, including 17 hospitals. The state requested that healthcare providers share information on their patient census, available beds, evacuation status, acceptance of evacuees and generator needs from counties.
HHS Secretary Xavier Becerra declared a public health emergency in Florida Oct. 8, a day after President Joe Biden issued an emergency declaration over the storm. HHS' declaration grants healthcare organizations and suppliers with greater flexibility in responding to the health crisis.
5. Tampa General Hospital is one of the largest hospitals in the country with 1,041 beds and the region's only level 1 trauma center. On its main campus, Tampa General healthcare providers and staff who are trained in emergency management remained on-site throughout the storm to care for patients. The hospital noted Oct. 10 that it did not experience major power outages and plans to resume normal operations on Friday, Oct. 11.
Tampa General's Davis Islands campus is protected by a water-impermeable AquaFence, designed to guard against storm surges up to 15 feet above sea level. Additionally, the campus has access to a Central Energy Plant, built in 2022 at 33 feet above sea level, which secures the power supply and includes boilers capable of generating steam and hot water. TGH proactively activated its on-site power plant to ensure there were no interruptions to operations. It previously noted on Oct. 8 that it had more than five days of supplies stockpiled to support patient care and employees.
6. AdventHealth North Pinellas in Tarpon Springs, Fla., is one hospital that evacuated due to its proximity to the Gulf of Mexico. The hospital began moving 40 patients to other facilities within the AdventHealth system Oct. 7, when Milton's potential storm surge was forecasted at 8 to 12 feet and wind speeds reaching up to 120 mph.
As of Oct. 10, all AdventHealth hospitals and freestanding emergency departments in the Tampa Bay area — with the exception of AdventHealth North Pinellas — are open and accepting patients. The system said some of its facilties experienced minor water intrusion after Hurricane Milton made landfall, but no patient care was affected and no injuries were reported. The AdventHealth system stockpiled thousands of gallons of water and positioned generators on standby.
7. HCA Florida Healthcare was suspending services and transferred about 400 hospital patients to sister facilities due to evacuation orders on Oct. 8. As of Oct. 9, 16 HCA Florida facilities were temporarily closed while 12 remained open. Temporarily closures were in effect for the system's 307-bed Pasadena Hospital, 204-bed Palms West Hospital and 201-bed West Tampa Hospital, among other emergency departments and hospital facilities.
8. Supplies. Health systems stocked up on medical supplies, water and fuel for generators ahead of the hurricane, which threatens to further disrupt an already fragile healthcare supply chain. The recent port workers strike temporarily halted operations and slowed distribution efforts at the Port of Tampa, which supplies nearly half of Florida's gas and fuel supplies.
Hospitals and health systems nationwide are also grappling with a national IV fluid shortage after Hurricane Helene significantly damaged Baxter's plant in North Carolina. Baxter, the nation's largest supplier of IV fluid, resumed some shipments Oct. 8 and is increasing healthcare organizations' allocation from 40% to 60%.
In anticipation of Hurricane Milton, B. Braun Medical, the nation's second largest IV supplier, has temporarily closed its IV solutions manufacturing plant and distribution center in Daytona Beach until Oct. 11. B. Braun is increasing production at its plant in Irvine, Calif., and working with the federal government to transfer IV inventory in Florida to a facility outside the storm's path. The FDA is also considering allowing temporary importation of intravenous fluids from overseas manufacturers to mitigate shortages.
9. Financial and operational implications. Although Hurricane Milton was estimated to cause up to $175 billion in damage, an analyst from Moody’s said nonprofit health systems in Hurricane Milton's path were well-positioned to weather immediate financial disruptions due to their large geographic footprints and good liquidity.
"Most critical in the aftermath of Milton will be assessing the impact to broader communities and the extent to which patient and staff access is impeded, which could lead to more material operational disruptions," Vanessa Chebli, an associate lead analyst with Moody's, said.
Health systems faced similar challenges after Hurricane Helene swept through the Southeast late last month. Sarasota Memorial Health Care's foundation allocated nearly $2 million to provide temporary housing and vehicles for employees affected by the storm, according to The Washington Post.