As Hurricane Harvey moves inland after making landfall along the Texas Coast, physicians could be called upon to help with disaster preparedness or with injuries and other public health concerns in the aftermath of the storm.

The state of Texas learned some important lessons about public health response and disaster medical care during hurricanes Katrina, Rita, and Allison. Now that Harvey is upon us, Texas is putting those lessons to use.

UPDATE 1 : U.S. Health and Human Services Secretary Tom Price, MD, Saturday declared a public health emergency in Texas in response to the storm. "Many Medicare beneficiaries have been evacuated to neighboring communities where receiving hospitals and nursing homes may have no health care records, information on current health status or even verification of the person’s status as a Medicare beneficiary. Due to the emergency declaration and other actions taken by HHS, CMS is able to waive certain documentation requirements to help ensure facilities can deliver care," the department said in announcing the declaration.

: U.S. Health and Human Services Secretary Tom Price, MD, Saturday declared a public health emergency in Texas in response to the storm. "Many Medicare beneficiaries have been evacuated to neighboring communities where receiving hospitals and nursing homes may have no health care records, information on current health status or even verification of the person’s status as a Medicare beneficiary. Due to the emergency declaration and other actions taken by HHS, CMS is able to waive certain documentation requirements to help ensure facilities can deliver care," the department said in announcing the declaration. UPDATE 2 (Revised again) : Gov. Greg Abbott has temporarily suspends all necessary statutes and rules to allow health care providers employed by a hospital and licensed and in good standing in another state to practice in Texas to help with Harvey disaster response. E-mail health care provider information (provider's name, provider type, state of license, and license identification number) to: TMBtransition[at]tmb[dot]state[dot]tx[dot]us.

Expedited permit information for out-of-state physicians not affiliated with a hospital.

: Gov. Greg Abbott has temporarily suspends all necessary statutes and rules to allow health care providers employed by a hospital and licensed and in good standing in another state to practice in Texas to help with Harvey disaster response. E-mail health care provider information (provider's name, provider type, state of license, and license identification number) to: TMBtransition[at]tmb[dot]state[dot]tx[dot]us. Expedited permit information for out-of-state physicians not affiliated with a hospital. UPDATE 3 : Pharmacies open in and around the Houston area: Open pharmacies in ZIP codes 77000 through 77099 Open pharmacies in ZIP codes 77400 through 77499 Open pharmacies in ZIP codes 77500 through 77599

: Pharmacies open in and around the Houston area:

Harvey made landfall near Rockport late Friday, bringing with it a strong storm surge, rainfall, and wind hazards, the National Hurricane Center said. It continues to bring large amounts of rain and heavy flooding to communities along its path.

A Message from TMA to Texas Physicians:



Harvey is having an unprecedented and catastrophic impact on Texans and Texas physicians. This event is not over and will continue to impact more of our friends and families.



Senior TMA staff Monday morning reached out to board and delegation members in Houston, Beaumont, and along the Gulf Coast. The question is, “What can TMA do to help?” The answer universally has been, “We don’t know yet.” The flooding has not only made transportation difficult if not impossible in many parts of Houston, it’s also made it almost impossible for anyone who wants to help to be able to get to the city. To avoid adding to the confusion, we are reminded not to arrive unannounced or unrequested.



We have been contacted by several other AMA friends and AMA Board members around the nation saying their thoughts and prayers are with us and they stand ready to help and assist. We also have received an outpouring of support and concern from our friends at the Georgia, Florida, North Carolina, California, and Connecticut state medical societies plus other organizations with whom we work. All want to know how they can help.



As TMA did after Hurricane Ike in 2008, we are looking into ways we can provide long-term help to the practices that have been hit hard (or demolished) by this storm. We will have a plan for the Harvey Relief Fund shortly and will present it to the Board of Trustees for approval.



For all our TMA family involved, please know that the rest of us are praying for you, for your families, and for your communities. If there is anything we can do, please do not hesitate to ask.

Gov. Greg Abbott requested a presidential disaster declaration, which would provide individual and public assistance as well as hazard mitigation to Texas counties in the affected areas.

State public health preparations under way

Staff from the various state agencies that provide public health and medical services are working on a coordinated response to the storm. Regional health and medical operations centers in Harris County and the eastern Rio Grande Valley have been activated, according to the Texas Department of State Health Services (DSHS), which is responsible for planning and preparedness for public health emergencies. Hospitals in those areas are on alert, while others have been put on standby.

DSHS is establishing an evacuation center in San Antonio that has a 500-bed capacity. Some emergency medical centers in San Antonio are being activated, and others are on standby. In Brazoria County southeast of Houston, local health departments have not been activated, though vaccines are being moved to locations with generators, and nursing homes and hospitals will shelter in place. Meanwhile, DSHS is supporting the coordination of ambulances and ambulance buses (or AMBUS) for medical evacuations in the Corpus Christi area.

Protect yourself along with your patients

If you are in an area likely to be affected by the storm, there are several steps you should take to protect yourself, your family, and patients.

According to David Lakey, MD, chair of TMA’s Council on Science and Public Health and a former DSHS commissioner, physicians should remember these things during an emergency and evacuation scenario:

Physicians like everyone else need to take care of themselves and their families first. This includes evacuations where indicated.

Next they need to take care of their current patients. Many patients will evacuate but forget their medications and supplies. This is especially important for diabetics, who will need to be able to contact their physician or be able to access their medical records.

Stay tuned to how the storm and response plays out.

Do not underestimate the impact the storm will have on people’s mental health. This includes not only those with diagnosed mental illness, but also the first-responders and the general public.

No response goes perfectly according to a plan, and there will be surprises. If you want to be involved in the response, you must be flexible and expect many changes.

Talk to your local health department or county medical society to let it know you are interested in helping. But do not be offended if it doesn’t have a role for you initially. Most importantly, do not just show up unannounced, as you may impede the response.

Most people are injured after the hurricane as the try to return home to clean up. This includes chain saw accidents and carbon monoxide poisoning.

Fill your car with gas now and make sure you have cash on hand.

If you are evacuating, make sure you have plenty of water and food in the car.

For physicians in the impact zone, be sure to protect the equipment, paper records, and supplies in your office. Vaccines are especially sensitive to loss of refrigeration.

If you do evacuate, remember that you might have limited access to your home or practice for a while after the storm. Search and rescue efforts will begin as soon as the storm is over and before residents are allowed to return home. Once an area is cleared for re-entry, residents who live in those areas may face varying requirements, which are set up by local officials or law enforcement. Physicians trying to enter should be prepared to provide documentation as requested.

TMA has a wealth of resources available at its Disaster Preparedness Resource Center, including preparedness information for patients, response resources, and ways to volunteer.

Updated Aug. 29, 2017, 10 am CT