1. Hurricane Sandy: a complex storm of historic size
Sandy’s Minimum Central Pressure: 940 (Irene: 951 (Lower is Stronger))
Sandy’s Hurricane Winds extended 90 miles
Sandy’s Tropical Storm Winds extended 485 miles
1040 Mile Wind Diameter (Irene: 510 Mile)

2. A number of factors contributed to Sandy’s impact
An unusual set of atmospheric conditions steered Sandy west, where other storms typically head east…
Hurricane Sandy was steered between a high pressure system in northern Canada and a low pressure trough over the Southeast US
Coincided with high tides

3. Rising to the Challenge: Superstorm Sandy and the NYC Public Hospital System
Alan Aviles, President & CEO
American Hospital Association – April 29, 2013

4. HHC: The Largest Municipal Healthcare System in the U.S.
1.4 million patients, including 475,000 uninsured NYC residents
11 acute care hospitals, 4 long-term care facilities, 6 diagnostic and treatment centers, and more than 70 community health centers
5 facilities located in flood zones; only one in lowest lying Flood Zone A
Post-storm 2 hospitals fully evacuated, and one skilled nursing facility partially evacuated

5. Preparing for the Worst
3 days before: no elective admissions; cancellation of clinics/elective surgery
Extra food and medical supplies
Testing and topping generators
Extra staffing and cots readied
Precautionary patient transfers
Command centers opened
Staffing of OEM and Healthcare Evacuation Center
Twice daily system-wide conference calls established
Mobile emergency generators positioned

6. Storm Surge Not Forecast

7. NYC Impact
The River in the Basement
Produced by HHC – March 2013

8. NYC Impact (10/28-10/29)
Seawalls breached, flooding to large sections of lower Manhattan
Power lost below 33rd Street, including HHC Central Office and administrative facilities
Coastal sections of Brooklyn and Staten Island flood
Severe devastation by both fire and flood to Queens beach communities
Subways and road tunnels flood
13-foot storm surge occurs
Full moon/high tide coincide
Wind shifts

9. NYC Devastation

10. NYC Devastation

11. NYC Devastation

12. NYC Devastation

13. NYC Devastation

14. Flood Zones 100 and 500-Year Flood Zone (FEMA 1983)
The combination of the precise hour at which Sandy’s surge arrived and the normal tidal cycle increased the storm’s impact on certain areas…
There is a difference in the tidal cycle between the Sound and Ocean
The arrival of Sandy’s storm surge largely coincided with high tide on the Ocean

15. Actual Flooding
The combination of the precise hour at which Sandy’s surge arrived and the normal tidal cycle increased the storm’s impact on certain areas…
There is a difference in the tidal cycle between the Sound and Ocean
The arrival of Sandy’s storm surge largely coincided with high tide on the Ocean

16. Flooding: HHC Facilities
Coler
Actual Hurricane Sandy Flooding Area
--Note the extensive flooding in NJ and LI, outside of NYC, where many of our employees live
Bellevue
Coney Island

17. Coney Island Hospital

18. Bellevue Hospital Center

19. Bellevue Loading Dock

20. Evacuation Down the Stairs

21. Coler-Goldwater Specialty Hospital

22. Coler-Goldwater Specialty Hospital
Loss of power and steam heat
Basement floods
Emergency generator fails
More than 80 medically-vulnerable patients transferred across the island to Goldwater

23. Special Medical Needs Shelters
HHC provides care through 8 Special Medical Needs Shelters (SMNS)

24. Reinforced importance
Lessons Learned
Preparation
Communication
Central Coordination
New Issues when the emergency lasts longer:
Provision of prescription medications to community
Provision of dialysis services
Provision of “walk-in” primary care
Provision of mental health services
Staff redeployment plans
Electronic record access that follows the patient
Supporting all staff
Reinforced importance

25. Our people were awesome!