Hurricane Florence uprooted dozens of critically ill patients from their hospital beds this week in an uncommon evacuation of large hospitals in the Pee Dee and Grand Strand regions.
About 2,200 patients at health care facilities were moved by Thursday, the state's health department reported, as Florence bore down on the northeastern part of the state. Seven hospitals were ordered to move their patients, save for a few of the very sickest.
In these cases, every patient's care team has to secure a spot at another hospital for them to go. The S.C. Hospital Association helps with that.
Then, the tricky part: Finding transportation.
Any time there is a hurricane, ambulance services are naturally strained, said Aaron Dix, administrator of emergency medical services for Greenville Health System.
Dix said he and his teams of critical care paramedics were standing in the lobby of the Grand Strand Medical Center in Myrtle Beach when a transfer for four patients to Georgia fell through.
Securing those patients a place at Greenville Health System took 15 minutes, Dix said. The transport from Myrtle Beach took four hours.
Patients are usually sedated, he said, and any medical equipment they're hooked up to has to stay in place.
"It's a huge, huge operation to move these patients," Dix said.
While GHS took some of the patients, their ambulances also moved others to regional hospitals, including in Spartanburg, Columbia and Greenwood.
Evacuations of this scale are uncommon. Hospitals prefer to weather in place. But as Hurricane Florence neared, it was clear the Myrtle Beach region could see unprecedented damage.
For hospitals and their patients, evacuation can cost days of time in planning and thousands of dollars per transport, according to a report from the Medical University of South Carolina. Authors of that report noted the Ralph H. Johnson VA Medical Center's decision to evacuate 60 inpatients during Hurricane Matthew in 2016. That was "bold," they wrote.
This will be Tidelands' first time evacuating in its 70-year history, said Carl Lindquist, spokesman for Georgetown-based Tidelands Health.
MUSC has never evacuated, a spokeswoman said Thursday.
Palmetto Health did not clear out during major flooding in Columbia in 2015, said Jay Hamm, chief operating officer at Palmetto Health Richland.
During a mandatory evacuation, hospitals must apply to be exempt. Eight local facilities, including all of Charleston's hospitals, did that successfully.
But the Department of Health and Environmental Control announced seven facilities are closed, including three owned by Tidelands Health and the Grand Strand Medical Center.
Together, those hospitals can hold more than 600 patients. An official count of how many patients actually had to be evacuated from hospitals was not available Thursday.
David Wilson, DHEC's director, said during a press conference that all evacuations would be done by the end of Thursday.
And at least 22 hospitals have stepped in and accepted patients, according to the S.C. Hospital Association. To name a few:
- MUSC took 50 patients, mostly intensive care, said Matt Wain, their chief operations officer.
- Greenville Health System has received roughly 30 patients from hospitals and skilled nursing facilities on the coast, a spokeswoman said.
- Palmetto Health in Columbia has taken 19 patients, a spokeswoman said.
Hamm said hospitals generally prefer to keep their patients in place during storms. Choices about whether to move them, and where, have to take into account how sick the patient is, whether their condition would worsen if they moved, and imminent threats from the storm. Hurricane Florence has been unpredictable, Hamm said.
"There is no black and white," Hamm said. "We’re making decisions on a storm that’s changing every hour."
The 19 patients moved to Palmetto Health were spread over its four facilities, he said.
In his 12 years in his job, Dix said he's never seen an evacuation of hospitals of this scale.
The trucks put thousands of miles on their odometers in the last two days, Dix said. Tires busted. Engine lights came on. The vehicles are now scattered across three service centers, Dix said. And half of his team was asleep at midafternoon Thursday.
They are resting, he said, to prepare for when Florence passes through the Upstate — and afterward, to move all the patients they took back to the coast.