Texas hospitals are experiencing several disasters at once from a winter storm that compromised the state's electricity and water supply and left at least 31 dead, including 16 Texans, as of Thursday morning.
Extreme winter weather that began last week has brought multiple days of freezing temperatures resulting in dangerously icy roads, millions without power and the loss of drinking water.
The state and federal governments declared a state of emergency for all of Texas' 254 counties over the weekend. Several state agencies are working together to meet healthcare facilities' energy demands, and the Federal Emergency Management Agency has deployed generators to hospitals and is preparing to transport diesel to ensure continuation of backup power.
Yet problems persist, with power outages shuttering outpatient dialysis centers, hospitals operating without tap water for days, and oxygen supplies running thin.
Six things to know today:
1. Hospitals are experiencing a number of water-related problems. Some have no running water, others have low water pressure, and many are operating under boil-water mandates and dealing with burst pipes.
Two hospitals, 216-bed Houston Methodist West and 224-bed Houston Methodist Baytown, have operated without water since Feb. 16 and maintained operations by trucking in water and purchasing bottles from convenience stores. The hospitals continue to meet essential medical needs, and hospitalized patients are safe with adequate water, according to Houston Methodist spokesperson Stefanie Asin.
Several community hospitals within Houston-based St. Luke's Health began experiencing low water pressure Feb. 17, when the city's water systems dropped to emergency pressure levels. The system is relying on water conservation strategies, including asking patients to limit water usage to essential tasks. The 16-hospital system is prepared to transfer patients from facilities if the severity of water supply disruptions worsens.
Texas Children's Hospital and its West campus are also experiencing low water pressure and have water conservation efforts in place. Ice machines, refrigerator water dispensers and coffee machines are not in use, and employees reporting on-site are encouraged to bring water for their own consumption so the hospital can direct the majority of its bottled water to patients and families.
"At this time, we are effectively managing this situation and will continue to closely monitor this impact," a Texas Children's spokesperson told Becker's.
2. Boil-water notices are expected to increase. As of noon Feb. 17, just under 7 million Texans were affected by 276 boil-water notices issued across the state, which cannot be lifted until one of the 135 accredited labs in the state completes a bacteriological sampling for the affected water system that can take up to 24 hours, Toby Baker, executive director of the Texas Commission on Environmental Quality, said during a Feb. 17 news conference.
Mr. Baker said he expects boil-water mandates, which are issued when water pressure falls below levels required by the state for safety, to increase through Feb. 19.
3. Health systems are suspending elective surgeries. The following systems canceled elective medical procedures or patient appointments for storm-related reasons. This list is not exclusive and will be updated:
Baylor College of Medicine and its outpatient clinics are closed Feb. 18.
Houston Methodist: Elective procedures are canceled systemwide for Feb. 17 and 18.
MD Anderson: All in-person appointments scheduled for Feb. 17 through Feb. 19 will be rescheduled. This applies to appointments for outpatient services, radiation therapy treatments and nonemergent procedures.
St. Luke's Health: Most facilities have canceled nonurgent procedures through the end of the week, although cancellations are made on a hospital-by-hospital basis due to differences in weather and the safety of patient travel.
Texas Children's: In-person clinic appointments, procedures and imaging visits scheduled at Texas Children's Hospital and its West campus are converted to a virtual visit or rescheduled through Feb. 19. In-person clinic appointments, procedures and imaging visits scheduled at Texas Children's Hospital The Woodlands are also converted to a virtual visit or rescheduled through Feb. 18.
UT Austin and UT Health Austin are closed Feb. 18. This applies to all COVID-19 testing vaccination appointments. In-person appointments will be rescheduled; telehealth appointments are still available.
4. Patients with dialysis needs are a top concern. Water and electrical problems are fracturing Texas' dialysis network. Houston Methodist spokesperson Stefanie Asin said local dialysis centers were out of operation Feb. 17, leaving patients going to emergency rooms. "These patients should contact their dialysis center for alternative resources," she said.
Nephrologist Tessa Novick, MD, with Dell Medical School in Austin tweeted Feb. 17 that "almost all" outpatient dialysis units were closed due to power outages. "Trying desperately to do as many as we can inpatient. To make matters worse some of our hospitals lost water today (so no [hemodialysis]). Truly a nightmare."
Dialysis centers require a lot of electricity and water, Chief of the Texas Division of Emergency Management Nim Kidd said during a Feb. 17 press conference. Each four-hour dialysis session takes between 120 and 240 liters of filtered water, according to Nature.
"Dialysis is a very important network that we need to continue to work," Mr. Kidd said. "So, we're moving through our emergency medical task force, moving people that need dialysis to places where dialysis can be delivered."
5. Oxygen supplies are thinning. Texas is working with private sector and federal partners to bring additional oxygen tanks to hospitals experiencing shortages, Mr. Kidd said at a Feb. 17 press briefing. Oxygen tanks do not require electricity to operate, unlike oxygen concentrators.
People and families are resorting to at-home oxygen tanks or energy generators to keep oxygen concentrators powered, but the dayslong outage has caused distress and rationing, including for the family of a 5-month old baby born prematurely who needs oxygen and a 59-year-old Amarillo resident with chronic obstructive pulmonary disease whose oxygen concentrator lost power while he was sleeping.
6. When will power return? Feb. 18 will mark the fourth day of power problems for the state. Website PowerOutage.US tracks 12.4 million Texas homes and businesses and shows more than 485,000 were without electricity at the time of publication. Less than 12 hours prior, the number without power exceeded 3.3 million.
On Feb. 17, managers with Electric Reliability Council of Texas declined to say exactly when electricity would be fully restored, saying that the main factor in coming days will be the weather. Rolling outages limited to 30 minutes would be a best-case scenario, they said.
Texas utility companies have said they avoid blackouts for "critical loads," like hospitals. Areas that share a circuit with a "critical load circuit," i.e. a hospital or other essential facility, were more likely to have kept power over the past four days. One hospital in San Antonio, Christus San Rosa Hospital - Alamo Heights, did lose power and was forced to run on a backup generator, according to local NBC affiliate News4SA.