By: Inderpal Chhabra, MD, FACP
The New York metropolitan area endured a unique experience through the weather related damages from Super Storm Sandy. While normalcy has returned for most of us, some hard-hit areas are still recovering. As such, this is a perfect time to reflect on the happenings of that week, what worked, and what lessons were learned from my own personal experience. I have borrowed from the American Academy of Pediatrics Disaster Preparedness presentation and will focus on communications aspects of a medical practice, since that is the key to maintaining contact with the outside world.
An effective disaster plan should incorporate the following basic principles:
- Prepare in advance
- Anticipate the worst: loss of infrastructure, isolation and chaos
- Take what will be most needed
- Find the safest place for expensive or irreplaceable items
- Minimize the risk to the remaining practice structure
- Improvise with the resources on hand
- Adapt to changing conditions and demands
The first thing that happened with the howling winds was loss of power to more than 8 million people regionally. As a result, many lost ability to communicate through phones, internet, TV, cable/FIOS. Fortunately, Cablevision offers a battery backup for their Optimum Voice cable modem to provide standby power during a power outage (though it lasts for hours, not days).
Similarly, FIOS offers a Battery Back-up Unit (BBU) that is located inside the garage or house which will provide power for voice service for up to 8 hours. For those with traditional landline phone service, power outage is not an issue (provided you have a non-cordless phone).
Another option for telephone communication is via cellular service. In addition to using your cellular phone (provided the towers are functioning), all major service providers offer home phone service via a cellular device. These plans offer a battery-powered device that is portable and based on cellular service. Plug the device into a regular phone or plug the device into your existing PBX (private branch exchange telephone system) – though it may be restricted based on your equipment. Your phone number travels with you and with a battery back up. These also offer web management tools, such as call forwarding and checking on voice mails.
See links below for specific carriers.
- AT&T http://tinyurl.com/aedrd33
- Verizon http://tinyurl.com/a58lovg
- Sprint http://tinyurl.com/a2u2c8j
- T-Mobile http://tinyurl.com/axbbobg
Another cellular based device available is a MiFi device (wireless routers that act as mobile Wi-Fi hotspots). MiFi devices can provide cellular based Wi-Fi to up to 5 devices, such as laptops or smart phones and these have batteries that usually last a few hours. Some services can be bundled for additional savings.
- AT&T http://tinyurl.com/b94g2ho
- Sprint http://tinyurl.com/azmcjbn
- T-Mobile http://tinyurl.com/bh2bqsu
- Verizon http://tinyurl.com/b382hbv
Another device which kept people informed during the power outage, and is invaluable: a radio! Though widely replaced by mp3 players and iPads, a battery-powered or crank powered radio was a lifesaver to keep abreast of the latest news and service announcements.
As medical providers, we have an additional obligation to be available to communicate with our patients. The power outages and other hardships Super Storm Sandy provided us have given us an opportunity to improve our back-up systems and be more prepared for future challenges.
Preparing the Office
Computer equipment, diagnostic instruments, and lab tests are usually among the most expensive items in a Medical office, and should be placed as high or as safe as possible. Office and patient files are often irreplaceable and thus should be moved as well, to the extent practical. In my office, most desktops are kept at least three feet off the ground. The tops of file cabinets, bookcases, and wall cabinets are much safer in the event of flooding or storm surge.
Windows should be boarded up, locks secured, and computer equipment shut down in an orderly and planned manner. Preexisting vulnerabilities, such as a cracked or leaky wall, door, or window, should be addressed and nearby objects moved accordingly. The surrounding area should be cleared of loose debris, which might otherwise become ballistic projectiles in high winds. Consider turning off the building’s water supply, if possible.
Physicians should utilize a written checklist to ensure an efficient disaster preparation. With the stress and anxiety of an impending disaster, it can be all too easy to overlook important items or procedures.
Vaccines deserve special consideration, as they represent a significant financial investment, requiring special storage.
Some regional facilities or organizations with robust generator capabilities—such as a local hospital or health department—may agree to store vaccines for physicians.
Physicians evacuating the area may prefer to take the vaccines with them, in insulated shipping boxes or coolers, for refrigerated storage at their eventual destination. Alternatively, a medium or large generator at a physician’s home may enable transfer of vaccines from the office to the home refrigerator. With all disaster planning—but particularly for vaccines—it is important for Physicians to realize that no plan is foolproof. Any disaster involves risk of loss and destruction, no matter how good the planning, and unexpected contingencies will inevitably arise. The physician must make an individual assessment and choose the measures that appear to present the least amount of risk, or at least an acceptable risk of loss.
If vaccines do spoil, Physicians should still retain them for possible replacement or reimbursement. Vaccine manufacturers may offer credit or partial credit for spoiled vaccines after a major disaster.
- Sample Checklist
- American Academy of Pediatrics : http://tinyurl.com/a5nk95b
- FEMA Ready.gov
- Center for Disease Control (CDC) http://tinyurl.com/37jo5dd
This post is the personal opinion of the author and does not necessarily reflect the official policy or position of the New York Chapter American College of Physicians (NYACP).