Hurricane Michael made landfall as an unprecedented category 5 hurricane in the Florida panhandle, with maximum sustained wind speeds of 155 mph at 1 p.m. on October 10, 2018. Along the Florida panhandle, the cities of Mexico Beach and Panama City suffered the worst of Michael, with catastrophic damage reported (1).
According to US Renal Data System 2015 data, a total of 468,000 patients were receiving dialysis in the United States (2). Of those patients, 26,382 were in Florida, and about 350 patients were in Bay County. Dialysis patients are a very vulnerable group, and it is necessary to plan how to care for them in special circumstances, such as anticipated natural disasters. Hurricane Michael gave 5 days of warning.
Hurricane Michael brought with it a significant decline in quality of life; loss of infrastructure, including electricity, phones, and the internet; evacuation of medical personnel; a severe shortage of medicines; unavailability of pharmacies; lack of essential supplies; and an increased risk of infectious diseases and mortality in the Panama City area for weeks after it landed. All hospitals in Bay County were severely damaged and were no longer able to provide inpatient care. The only functioning facility was an emergency department, which transferred all patients who needed admission. Inpatient dialysis services were suspended as well.
Accurate figures are lacking, and most of the information in this article is based on observations by the authors—Dr. Oussama Rifai, MD, a practicing nephrologist in the Panama City area, and Dr. Harini Bejjanki, MD, a renal fellow at the University of Florida, Gainesville—who were involved in the care of dialysis patients from Panama City admitted to the University of Florida, Gainesville. Our direct observations revealed that the care of dialysis patients was severely compromised because of a lack of access to outpatient dialysis units, electricity outages, lack of medications and equipment, destruction of healthcare infrastructure, and shortage of medical care providers, including dialysis technicians, patient care technicians, and dialysis nurses.
Kidney Disease Statistics of the United States: https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease
National Kidney Foundation. Planning for Emergencies: A Guide for People with Chronic Kidney Disease. https://www.kidney.org/sites/default/files/docs/disasterbrochure.pdf
Dion E. Panama City News Herald. Remembering Hurricane Michael’s Panhandle victims (PHOTOS). https://www.nwfdailynews.com/news/20181120/remembering-hurricane-michaels-panhandle-victims-photos