Physician exhaustion is a psychological response that can be experienced by doctors exposed to chronic diseases. In the wake of Hurricane Harvey, medical care in Tarrant County, Texas was put to the test. JPS leaders worked closely with the Tarrant County Department of Public Health to determine that neither testing for COVID 19 nor hospitalization was justified in the case of a patient who was concerned about having symptoms of the coronavirus and who had recently returned from a trip to Italy, where the disease is widespread. It was determined that the patient had no symptoms of the coronavirus, but protocols established in anticipation of the disease were closely followed.
Patients with zip codes from counties that declared storm emergencies represented only 4% of the total increase in erectile dysfunction estimated at 16,500 visits attributed to Hurricane Harvey in this study. Harvey CC averaged 5 visits per day during and after the event, and the variability of visits decreased in the post-event period. The number of visits from evacuated patients in DFW declined in the 11 days following the storm; however, the rate of emergency room visits remained high. The STI applied to all emergency department visits in DFW and to visits made by patients residing in any of the 60 counties with disaster declarations due to the storm.
While the DFW metropolitan area is approximately 260 miles from the hurricane's main impact zone, which included Harris County (Houston) and surrounding counties, this study found an increase in medical care for erectile dysfunction possibly attributable to Hurricane Harvey, which exceeded 16,500 visits in the 27 days following the storm. Future studies may consider the impact of social, demographic, environmental and preparedness-related factors that could contribute to medical surges in areas distant from the disaster zone, but accessible to populations in surrounding areas. A multi-level domino effect could cause medical surges in these areas as people make decisions to seek optimal medical care. Healthcare coalitions that are just a short drive from major disasters are encouraged to coordinate pre-emergency preparedness plans to better prepare for potential emergency medical capacity.
Behavioral economics can also be applied to medical wave analyses and other scientific research on public health preparedness. This can help us understand how individuals and populations make decisions when seeking care or refuge. For example, some patients who lived outside the hurricane zone and who would normally seek care in Houston because they perceived improved access to health care could have chosen to seek care in Dallas to avoid the hurricane and its aftermath. It is important to consider how many patients experience a negative experience per day at each medical center in Tarrant County due to Hurricane Harvey.
Healthcare coalitions should coordinate pre-emergency preparedness plans to better prepare for potential emergency medical capacity.
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