‘It’s managed chaos’: Western NC hospitals challenged but operational in Helene’s wake
By Rachel Crumpler
Historic rainfall and flooding brought by the remnants of Hurricane Helene have pushed western North Carolina hospitals into “managed chaos.”
Power outages forced many hospitals to rely on backup generators for several days. Widespread water system failures required alternative water supplies for hospitals that use tremendous amounts of water while handwashing, sterilizing surgical equipment and more. Impassable roads blocked by fallen trees and other wreckage disrupted travel for workers and patients alike. Communication disruptions made receiving calls and texts in some areas impossible, straining responses.
But amid these challenges, all western North Carolina hospitals have remained operational throughout Hurricane Helene and its aftermath.
Stephen Lawler, head of the North Carolina Healthcare Association, has stayed in close contact with hospital leaders during the storm and initial days of recovery. He told NC Health News he hasn’t heard of any significant structural damage to the hospitals in the 25 counties and Eastern Band of Cherokee Indians hit hardest by the storm, where a federal major disaster declaration is now in place to facilitate easier aid.
“It’s managed chaos,” Lawler said of hospital operations. “It’s not chaotic within the hospital, but they’re operating in an environment that is supremely dependent on the state’s ability to respond and get roads cleared and supplies in. I think that’s an everyday watch and work to get things done.”
Kody Kinsley, secretary of the state Department of Health and Human Services, told reporters at a briefing Monday afternoon in Asheville that all 22 acute care hospitals in western North Carolina have had their grid power restored, after some using backup generators for days.
“We’ve been in direct — near hourly — contact with those facilities, supporting a number of resource requests,” Kinsley said. Food, water, fuel and other supplies have been delivered to the health care facilities to sustain their operations, he added.
Lawler said emergency management personnel’s steady progress to clear roads and restore power and communication lines is “going to create relief.” The governor’s office issued an update on the storm Monday afternoon in which his administration said travel remains dangerous; more than 400 roads remained closed but were allowing emergency responders to carry out their missions.
“For hospitals, health systems and people, when we are able to clear roads, it makes it easier for everyone just to have the basic necessities to not only survive, but the basic necessities that are required to continue to operate that hospital,” Lawler said.
Lawler added that hospital leaders are working well with their local emergency management teams, state leaders and FEMA to address any need that arises. For example, Lawler said, over the weekend, hospitals requested additional oxygen supplies. The state coordinated the delivery to ensure that there was ample supply to take care of patients.
“Our entire department has rallied every resource to make the difference,” Kinsley said Monday. “We are in this for the long haul and into recovery.”
Challenges persist
The initial days of hurricane response have felt like a furious sprint, said Rob Hudspeth, a senior leader at UNC Health Appalachian, which has three hospitals in western North Carolina. He’s run from hospital incident command meetings to then getting in his car to help with patient transport and other needs in between. In the 15 minutes that he spoke with NC Health News Monday afternoon, his phone kept buzzing with incoming calls.
The biggest ongoing challenge is disruption to communication, he said. That’s made managing logistics and operations all the more complex.
“With COVID — a similar set of circumstances — we could all communicate with each other, and in the absence of communication, it really has made this extra difficult,” Hudspeth said.
Hudspeth said a Starlink satellite phone system was set up at Cannon Memorial Hospital in Avery County Monday afternoon, which has allowed the first calls to go in and out in days.
Greg Lowe, who took over as CEO of Asheville’s Mission Hospital on Sept. 16, got caught up in a storm of planning a week into the job. He started in Helene planning mode on Sept. 25 and moved into crisis protocol as the deluge of rain and wind wreaked havoc throughout the mountain region.
On Sept. 26, before the crux of the storm arrived, they called in staff and told them to plan on sleeping there between shifts, filling the hospital with 1,200 workers in addition to the 700 patients there.
The hospital operated on a backup generator for several days before the power was restored. But water systems across the region have broken down because of the storm. The Asheville municipal system that typically supplies water to Mission Hospital remained inoperable on Monday.
Now, according to Lowe, restoring water and sewer is the hospital’s “most significant priority.” Without pressurized water, the hospital has had a hard time carrying out some of its core functions like hot food preparation, toileting and showering.
“To say that our teams are making the best of rough circumstances in order to keep caring for patients is an understatement,” Lowe said during a briefing by Buncombe County government officials Monday afternoon.
To keep clinical operations going, HCA Healthcare, which acquired Mission Health in 2019, has supplied more than 20 tanker trucks of water daily.
In the coming days, Lowe said Mission Hospital will receive 10 more mobile units, including kitchens, bathrooms, handwashing stations and mobile laundry facilities.
Bringing in relief
Hospitals are also working to be mindful of staffing — particularly the people who have worked around the clock the first few days after Helene. Those staffers are just now going home themselves to inspect the damage to their own homes.
To provide relief to hospital staff that have already worked long hours, Lowe said HCA Healthcare colleagues from around the country are coming to western North Carolina to help across Mission Health sites. Two buses of staff members arrived on Sunday from Nashville, South Carolina and Texas, he said.
“A number of our individuals, our caregivers, have no idea about their families or their homes,” Lowe said. “We have not contacted a number of our colleagues. We have had no contact because of communication disruption. And so what we’ve done is bring in hundreds of individuals to assist in that, provide relief for those caregivers so that they can go home, check on their families and then return to care for western North Carolina.”
Mission Health is not the only health system that has asked its staff to hunker down at work instead of going back and forth to homes and families that might be suffering from the storm. Others have been cut off from work by buckled roads and problems at home, leaving holes in staffing.
“Some of our teammates have been dealing with their own problems, with homes being damaged, roads being washed out so they weren’t able to get into work, or they’ve been stuck at work and they’ve been working nonstop,” Alan Wolf, a spokesman for UNC Health, told NC Health News.
Leaning on each other
Amid this fraught time, as medical staff frantically work to fix problems and provide patient care, hospital leaders and health care workers across the state are pooling resources to lend a hand.
Lawler said hospitals in North Carolina have mutual aid agreements in place so they can share resources if a hospital needs help. That has meant that unaffected hospitals in central and eastern North Carolina have sent people and supplies to the aid of their peers in the west.
“We’re all in this for the same reasons — to take care of people and to save lives,” Wolf said, noting that Novant Health and Atrium Health have offered help where they can. “It’s really nice to see that there’s healthy competition when it’s called for, but there’s also times to step up and we all help each other.”
FEMA Administrator Deanne Criswell said at the Monday afternoon briefing in Asheville that she’s mobilizing more federal medical teams to support some of the long-term sustainable needs for running some of the medical facilities.
To address health needs, a 20-bed state medical support center opened in Caldwell County Sunday, and Gov. Roy Cooper said more are planned. UNC Health also announced it will provide free telehealth visits to residents in areas affected by Helene for a wide range of conditions, including fever, cold or flu, insect bites and rashes.
Community organizations are stepping up to fill gaps. Samaritan’s Purse, a Boone-based disaster relief organization, is one that has sprung to action. They set up emergency medical tents Saturday in the parking lots at Cannon Memorial Hospital in Avery County and Watauga Medical Center in Boone to provide oxygen for people who have no power at home.
Elliott Tenpenny, director of the international health unit at Samaritan’s Purse, spoke to NC Health News Monday while taking a brief break from setting up a 20-bed field hospital at Cannon Memorial Hospital to help take some patients from the hospital as it gears up for a likely influx of people seeking care from the flooding.
“We’re just hoping to be able to step into a gap to be able to provide more care here in Avery County. The hospital here is quite small, and we need to be able to provide more care for more people so they can get the hospital care they need,” Tenpenny said.
Alice Salthouse, CEO at High Country Community Health, manages 10 sites and two mobile units across four western North Carolina counties. Less than half the sites were able to open Monday. All other sites had challenges with electricity and water that kept them from opening. Until those resources are restored, any of her staff who can are helping provide care elsewhere in the region, she told NC Health News Sunday while taking a break from cutting up a tree that fell on her house in Morganton.
More to recovery
Hospital leaders recognize there’s a long road to recovery. Emergency workers are still rescuing people; floodwaters stewing with storm debris, runoff and removal of downed trees pose health risks for people as they move around more.
“This is not a one-week, two-week thing,” said Hudspeth of UNC Health Appalachian. “We’re going to be in this for a while.”
“People are rolling in that have lost their homes. A lot of them are muddy, wet and soggy. I just can’t begin to tell you. It’s crazy,” he said.
Do you need Hurricane Helene resources or want to help victims? Look at our resources page.
Another critical concern for Hudspeth is where patients will be able to go once released from the hospital: Will they have homes to go to? Will they be able to return to their health care providers as needed?
“It changes how we discharge patients,” Hudspeth said. “We have to make sure that they have adequate follow-up care. There are a lot of hands on deck making sure that people are getting the resources they need. Not just patients, but people and families who come to the hospital for food or shelter. So just making sure that we have people with ‘boots on the ground,’ sort of directing people to the right resources.”
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