When a tornado strikes a hospital

NOAA investigates what makes hospitals vulnerable when severe weather strikes

Contact: John Ewald, 240-429-6127

A NOAA scientist and Exploratorium staff perform indoor tests on the new “Remote Rains” exhibit.

The exhibit was developed in cooperation with researchers from NOAA’s Hydrometeorology Testbed. Credit: Exploratorium

Creston, Iowa, did not lose any lives to the tornado that struck on Saturday, April 14, but it did lose a lifeline. A twister hit the town’s only hospital, tearing away its roof, breaking windows, and leaving it without power.

Because tornadoes, hurricanes, and other severe storms can destroy hospitals as indiscriminately as anything in their path, NOAA is funding research to better understand what makes hospital buildings vulnerable and how weather warnings are used in short- and long-term planning within a facility’s chain of command.

"Socio-economic studies on weather vulnerabilities and preparedness, like this one, are an important component of building a weather-ready nation," says John Cortinas, Ph.D., director of the Office of Weather and Air Quality in the NOAA Office of Oceanic and Atmospheric Research. "This project is a good example of how the research we fund through our U.S. Weather Research Program contributes to the protection of lives and property."

News reports indicate that the 10 patients who were in the 25-bed Greater Regional Medical Center Saturday were transferred to a hospital in Corning, Iowa, about 30 miles away. The hospital had provided an emergency room, birthing center, and cancer center, along with surgical, rehabilitation, radiology and other medical services. It is unknown how long Creston, a town of nearly 8,000 about 75 miles southwest of Des Moines, will be without a hospital.

"Hospitals are unique in being both a hub of commerce within a community and a critical component of a community’s emergency response system," explains Wendy Thomas, a policy analyst and meteorologist with the American Meteorological Society’s Policy Program. She is leading the five-year NOAA-funded research project on how hospitals can better prepare for severe weather.

"Hospitals provide a service that isn’t duplicated elsewhere in the community. When the building itself becomes a patient, then part of the response and recovery effort has to be diverted in order to get the hospital up and going again," she says.

Map showing Koppen-Geiger climate zone classification system.

Public domain image from Wikimedia commons

Creston's hospital is now one of several that have suffered significant and costly weather damage in the past decade. In May 2011, St. John's Mercy Hospital in Joplin, Mo., lost windows and suffered damage to its roof and electrical systems to an exceptionally strong tornado. Rebuilding of the 367-bed facility is estimated to be complete in 2014 at a cost of nearly $1 billion. In March 2007, the 143-bed Sumter Regional Hospital in Sumter, Ga., lost windows and the building façade in a tornado. Rebuilding and merging with another hospital cost more than $100 million, while a temporary facility cost $9.3 million.

Hurricane Katrina caused a great deal of damage to health care facilities as well as innumerable challenges related to evacuation and patient care before, during, and after the storm along Louisiana and Mississippi Gulf of Mexico coastal areas in 2005. The toll exacted by Katrina put a light on the need for health care facilities to be as well prepared as possible for extreme weather, Thomas explains.

The NOAA-funded AMS research is looking at ways to lessen hospital building vulnerabilities and improve emergency response planning. AMS has gathered input from engineers, architects, hospital administrators, insurance industry representatives, private sector weather service providers, and public health and emergency response managers on steps that could strengthen hospitals' weather preparedness.

So far, they've learned that hospitals tend to be constructed in "cookie-cutter" fashion from coast-to-coast, and therefore tend to experience similar failings. For example, large window surface areas and elevator penthouses located on roofs can be damaged by debris in high velocity winds. Backup generators, as well as large diagnostic instruments, are often located on lower floors where they are vulnerable to flooding.

AMS researchers have also identified communication issues that hampered quick action by hospital staff when severe weather was threatening. For example, humidity, temperature and air pressure data points in weather reports generally do not help hospital staff make weather planning decisions. Forecasts intended for decision-making use by health care professionals need to clearly associate potential risks with predicted weather events, Thomas says. Explaining uncertainty in forecasts and providing as much lead time as possible would also be helpful.

The AMS research effort has opened communication between weather forecasters – including NOAA and private sector weather forecasters – and hospital administrators and others with a voice in emergency planning for hospitals, including insurance companies, public health officials, and local emergency managers. The effort, continuing through 2013, is expected to help hospitals face severe weather threats with the best possible plans in hand. For more details on the NOAA-funded AMS research, see reports on the AMS Rising Above the Weather forum.

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