Although we all feel the impact of the pandemic, it is our most vulnerable populations that are the hardest hit. You know this, and you have a good plan for COVID-19, and now hurricane season is here, having begun on June 1 in the Atlantic/Caribbean. Governmental entities, including health departments and health care providers throughout South Florida, are analyzing what impact the COVID-19 pandemic will have on this year’s natural disaster planning and response efforts. Hurricane activity is predicted to be slightly higher in intensity compared to last year, with 16 named storms and 8 hurricanes predicted, 4 of which are expected to be classified as major hurricanes; the probability of major hurricanes making landfall on the Florida peninsula is 45 percent. As our localities open up and the hurricane threat approaches, we are planning for the likelihood of two emergencies hitting at once – a COVID-19 surge and a hurricane.

The nationwide death toll related to COVID-19 reminds us that disasters do not affect people equally, and the threat of a hurricane exposes the vulnerabilities in emergency planning for our vulnerable populations. For this reason, our disaster planning must be especially robust, now, and we must take into account the likelihood of having to make difficult decisions around the allocation of resources in vulnerable patient populations. Plans must provide clarity on thedistribution of supplies among those being served, and allocation details must be preplanned to avoid discrimination in decision-making, actual or perceived. The threat of COVID-19 spread also requires that our plans consider and address physical space limitations and social distancing needs presented by an outbreak in close quarters during a natural disaster.
 
We should also clearly set out our organization’s ethical principles and how those principles will be applied in times of scarcity to support those in our care that are especially vulnerable to the threats presented. Specifically, plans should consider religious, cultural, social, economic, geographic, and ethnic backgrounds of patient populations, in an effort to avoid discrimination toward any group or diagnosis and to avoid potential disparity in treatment. We must expect that ideal staffing levels may not be possible, at times, and that staff will have to provide more “triaged” services during a natural disaster coupled with a COVID-19 threat, compared to “normal” times. Healthcare staff should be trained on what will be expected in providing for the basic needs of all patients, on a non-discriminatory basis, under all foreseeable circumstances.
 
Healthcare employers must also consider how they can provide for the basic needs of staff members to ensure that staff can continue to provide care to patients, such as providing staff meals, protection from illness and shelter. For instance, can staffing quarters be provided in close vicinity to the provider’s location? How would this work with little to no notice?
 
Disaster planning this year also needs to take into account the availability of personal protective equipment (PPE), such as masks, gloves and gowns, in times of disconnectedness from suppliers, along with the availability of essential equipment and supplies, such as medication and oxygen. Healthcare providers should be aware of the current need for advanced stockpiling of resources and the costs associated with such planning.
 
Providing for continued COVID-19 testing and quarantines, in the case of a local outbreak, will be another a major consideration that providers will have to address as we move into this hurricane season, including how quarantining and testing will be continued as disasters hit and providers experience the aftermath of a disaster.
 
In this post-Katrina world, the public expects transparency in our actions, and our actions will be judged in the court of public opinion. How well we plan, how robustly we respond and how quickly we are able to recover from any disaster will be measured by how we care for those who are most vulnerable. We, in South Florida, have always been at the forefront of disaster planning and our first responders and healthcare providers are among the best in the nation. We will be ready.