means to do so, and officials knew that the city’s plans to help transport them had significant holes, including a lack of sufficient drivers. Residents who could go on their own were already stuck in traffic on the interstate leading out of town. The Superdome, the giant stadium that hosted the New Orleans Saints football team, was designated as a “shelter of last resort.” New Orleanians who had no way to get out of the city could take a shuttle bus there. Mayor Nagin appealed to one population in particular. “If you have a medical condition, if you’re on dialysis or some other condition, we want you to expeditiously move to the Superdome,” he said. He didn’t mention what kind of help people could expect there.
Many tourists whose flights had been canceled had no ability to flee on their own either, and so Nagin’s evacuation order exempted essential hotel workers to serve them. It also exempted essential criminal sheriff’s office workers, who were needed to keep their eyes on prisoners at the parish jail. They, too, were not being moved.
A questioner at the press conference asked for a clarification: “People should stay put in the hospitals … or what?” The mayor said he had exempted hospitals and their workers. People might get hurt in the hurricane. If hospitals closed and turned them away, that would, he said, create “a very dangerous situation.”
The possibility that a very dangerous situation could develop inside the hospitals if they stayed open had occurred to other officials who were, at that very moment,on a conference call discussing the matter. Louisiana had received more than $17 million from a federal grant program to help prepare its hospitals for bioterrorism and other emergencies after the September 11, 2001, attacks and subsequent anthrax mailings. A FEMA representative on the call wanted to know which hospitals in flood-prone regions of the state had located both their generators and electrical switching gear above ground-floor level. In and around New Orleans, only two out of about a dozen and a half hospitals had. Memorial was not one of them.
An emergency response leader from the US Centers for Disease Control and Prevention alerted several colleagues to the problem in an e-mail hours later. “It is assumed that many of the hospital generators will lose power given the expected height of the water.” He reported that around 2,500 hospital patients remained in New Orleans as Katrina advanced on the city. That should not have been a surprise. Planning sessions had gone on, after lengthy delays, for more than a year for a model “Hurricane Pam.” FEMA had sponsored an emergency exercise in New Orleans earlier that very week. The scenario assumed the presence of more than 2,000 hospital patients in New Orleans during a catastrophichurricane. No one had yet figured out how so many patients might be moved to safety in a flood, and federal health officials had not participated in the latest planning sessions.
Dispatchers for the region’s largest ambulance company, Acadian, were swamped with calls to transport patients from threatened hospitals, nursing homes, and houses. Many of the roughly two dozen ambulances the company made available were frozen on the jammed interstate. To save time, some ambulances began delivering patients to the Superdome instead of taking them out of town.
The main hospital in St. Bernard Parish, Chalmette Medical Center, managed to begin evacuating, but after the first round of critically ill patients left, ambulances never returned. Administrators from one New Orleans hospital wanted to move nine of their sickest patients to western Louisiana. But unless they could arrange an urgent, costly airlift, it seemed to be too late. The roadways were now so clogged with evacuees, the vulnerable patients could be trapped for up to a day in an ambulance before arriving. One nursing home had, before hurricane season, retained a New Orleans tour company at
Jennifer Salvato Doktorski
Erin McCarthy, Donna Kauffman, Kate Angell