HJBR Nov/Dec 2021

DIALOGUE 20 NOV / DEC 2021 I  HEALTHCARE JOURNAL OF BATON ROUGE past, not what we experienced with Ida. Because, it not only put the lights out, it took the grid out — the entire grid — elec- tricity, cable, water, gas, all public services. It destroyed the grid, including the internet. That unto itself set a new, if I may use the term, high watermark. When we look at the category of the storm and the preparedness and the resiliency of the grid, we must take that into account. Based on what we knew frompast experi- ence, the proper measures were taken with the exception of: are we evacuating early all the vulnerable population, and where are they going?Which was not well done, as you know. And, do we encourage people who are at risk even for 12 hours, if the power goes out?That vulnerable population. While the city may be protected from flooding, which was the Katrina event, what happened if the grid goes out? I think we will be looking at that in after- action reports, and we should in our plan- ning and preparedness. Maybe we do need to do selected mandatory evacuation for the elderly and the vulnerable based on pre- dicted power outages. We hadn’t thought that way before. We always looked at water and wind alone, but we hadn’t experienced that level wind in Northern Jefferson and Orleans Parish and the North Shore in the past. The coastal parishes evacuated. Very few people were left there other than the diehards who were first responders and a handful of people. The coastal parishes evacuation was an A+. That being said, in Louisiana, it is well inside our culture and in the procedures of the parishes and the state to prepare. The state had the entire National Guard mobi- lized, had trucks loaded with water and food to move in. The state had requested and received search and rescue teams from FEMA, from out of state that were pre-posi- tioned, ready to come in. FEMA had pre- positioned trucks ready to come in. The challenge was, as we know, when the grid went down, the streets were closed, and the magnificent work of the Louisiana National after the storm. We need to do that for our elders. A sheriff in every one that has not elected to evacuate, with communications. It’s a simple fix. So, if they don’t evacuate, there’s a sheriff there. We still got to give politicians the freedom to exercise judgment. That’s why we elect them. After the storm, as is in the saying, “Mother Nature can break anything built by man,” we’re working on predictions. We’re certainly not going to evacuate with every Category 1 hurricane unless you’re along the coast, because the level one hurricane can cause surge water along the coast and flood everything there, so that’s the threat of flooding. But, when you have the threat of flooding and a Category 3 or higher, then you got wind. Few homes along the coast have been built to handle Category 3 winds, let alone four as Ida did. So, it’s evacuation in context. It’s an A for planning, a C in execution. It was well- planned, and the most vulnerable parishes along the coast, they planned and they exe- cuted. In North Jeff, Orleans, St. Bernard, Plaquemines, St. John, St. Charles, we had elective evacuation based on what the pre- dictions were. As a result of that, we had more people exposed, particularly the vul- nerable population — the elderly and the people living in the older homes not built to current hurricane code — so it caused extensive damage. Editor Available shelter? Honoré Each of the parishes had an assem- bly point for shelter. Then, people were transferred north to shelter designated by the state. I think that’s a B+ plan. They knew where to go, space was available, but they used local shelters in Jeff, Orleans, St. John to collect people and move them north to state shelters in Alexandria and Monroe. Can’t ask for better than that. The ques- tion is the loop. The doughnut hole was the nursing homes who are underregulated and get to select their own shelter. I think that’s going to have to be fixed based on what we learned from that one nursing home. And Guard to clear all roads ... they have spe- cific units in the Louisiana National Guard designed to go clear roads. No other state has that. They’re not organized. They’re not trained to do that. Our National Guard is. Planning and preparation, A+. But even with an A+ in planning and preparation, we are reminded that Mother Nature can break anything, so you have a good game plan and still lose. In essence, a category storm like Ida wins and broke the infrastructure and broke the grid. So, everything that we say is in context. Editor On evacuation? Honoré We have one of the best evacuation plans; it was executed in the lower parishes. The leadership in North Jeff, Orleans, St. Bernard and the North Shore was to shel- ter in place, because we were looking at best at Category 2 — the levees would hold, we wouldn’t have a repeat of Katrina. And the storm rapidly exercised to a category of four upon approach. So, in retrospect, there’ll be many leaders that say that we made the right decision. We didn’t evacuate. That’s not so for the people. Most people who stayed here and expe- rienced that, I’ve talked to and I have talked toomany, that they would evacuate, because now they know the vulnerability of the grid. They know the vulnerability of a Category 3 wind and what it can do. On the North Shore, North Jeff, St. John Parish and where the eye of the storm in St. Charles came through — those people, more and more people, the next time are not going to worry about evacuating based on, not necessar- ily the threat of flooding, but the threat of wind when you’ve got an above Category 2 storm coming. Evacuation, I think, has to be tailored. It has to be tailored to the vulner- able population to include nursing homes. Every nursing home needs to have a sher- iff on-site if they’re not evacuated; because we had nursing homes that everybody thought somebody else was doing it, and we ended up with large groups of people being stranded and not evacuated until days