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Superstorm Sandy -- Lessons for Health Care in a Changing Climate

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By Gary Cohen, President of Health Care Without Harm; and Robin Guenther, FAIA, LEED® AP, Principal, Perkins + Will, New York, NY

It has been a year since Superstorm Sandy pummeled the New Jersey shoreline and New York City, knocking out the grid, trapping millions in their homes without power and forcing the evacuation of several critical care hospitals. The estimated ongoing clean-up cost is $70 billion.

The international scientific consensus is that with climate change, such extreme weather events will continue to intensify and increase in frequency. Despite whatever cynical and manipulative storytelling continues to emerge from fossil fuel defenders, we need to change our frame of reference and create inherently resilient buildings and communities, capable of withstanding extreme weather impacts while at the same time mitigating the causes of climate chaos

A year after Sandy, what have we learned? At a community health level, we learned that the loss of 15 percent of the total bed capacity in New York City, alongside 5000 nursing home beds, tested the limits of the regional health care system for weeks and months beyond the event itself.

We learned that if hospitals do not have on-site power generation that they are incredibly vulnerable to electrical grid failure. Moreover, if the core electrical backup systems are below the ground floor level, an entire hospital could be completely knocked out and would need to be evacuated, while restoring the facility could take months at massive cost.

The hospitals in New York that were evacuated -- NYU Langone and Bellevue -- did not have on-site power generation, and critical components of their backup diesel generating systems, such as fuel pumps, were located below flood elevation. Once the lower floors of the hospitals flooded, there was no way to stay in operation.

By contrast, South Oaks Hospital, located in Long Island, had invested $3 million in on-site power generation called Combined Heat and Power (CHP) and was able to operate during and after the storm even though the grid was down. This investment yielded additional dividends as the hospital has been saving an estimated $500,000 a year in energy costs due to CHP's energy efficiency, and they have also significantly reduced their greenhouse gas emissions.

Superstorm Sandy was a critical wake up call for the hospital sector. Leading health care institutions are beginning to name "climate change" as one of their core business risks -- unheard of merely two years ago. Moreover, the notion of climate resilience is beginning to infiltrate into the sector with the urgency it deserves. Before Superstorm Sandy, NYU Langone Hospital's CHP plant was in the design stage; it is now nearing completion.

Spaulding Rehabilitation Hospital, located on the Boston Harbor and designed using lessons learned from Hurricane Katrina, has a CHP facility on its roof and has raised critical patient care functions off the lower floors. Texas Medical Center, which suffered significant losses due to storm flooding in 2011, has redefined its 1.5 square mile campus as an eco-district, with a plan to remove acres of impervious paving, thereby constructing an inherently more resilient storm water management system.

New York City is further incentivizing green roofs and extended rainwater capture, which has been difficult to financially justify in the past. Other hospitals are thinking about installing on-site water filtration systems to address the potential for the spread of water-borne diseases in climate change related flooding events.

In the age of climate change, our cities must be able to provide critical health care services and important public health infrastructure in times of need. We must design our critical infrastructure services so they can withstand grid failure, flooding and other consequences of climate change. We also need to integrate resiliency with sustainability concerns, since we are learning that a host of sustainable design and operations strategies can also dramatically improve the resilience of the healthcare sector.

The health care sector represents almost 20 percent of the entire US economy. It should lead by example and become the early adopters of technologies and practices that mitigate their own substantial climate footprint and support the transition to a renewable energy economy. We know that climate change is bringing increased health impacts along with it -- asthma, dengue fever, heat stroke and waterborne diseases -- so health care also has a mission-related imperative to address its own contribution to our nation's fossil fuel addiction. The health care sector will be on the front lines of treating the uptick in these health problems.

On this anniversary of Sandy, let's hope for the gift of foresight and boldness that will help us fully embrace resiliency for our health care system and accelerate the transition to an energy future that is healthy for our people and healthy for the planet. The ability of our communities to withstand the impact of climate change depends on it.

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This post contains a correction to a previous version regarding the status of Bellevue's generators at the time of Sandy.