TAMPA — At Tampa General Hospital, Hurricane Irma is requiring preparations that haven't been needed since Hurricane Charley threatened the area 13 years ago.
In a windowless, third-floor conference room Wednesday, high-level administrators set up an Incident Command Center where they will monitor the storm and make critical decisions about patients. It's the first time the center has been used since 2004.
Inside, seven television screens show camera feeds from around the hospital and Davis Islands, on which the hospital sits. Employees will be able to check on any flooding from there, said Tony Venezia, TGH's director of security and emergency management.
Davis Islands are entirely in Evacuation Zone A, where residents are told to leave first. But THG's plan is to keep its patients there.
"It's very hard for us to be able to move the patients," Venezia said. "They're just very sick." Keeping them there is the best way to care for them, he said.
"Not only that, but the regional, state assets just aren't there to be able to move our patients to somewhere else safely."
On Wednesday, the 1,011-bed facility held about 800 patients, he said. TGH is the Tampa Bay area's only Level I trauma center, a facility capable of providing every aspect of care for traumatic injuries.
It's also surrounded by water. The location means that storm surge is a distinct vulnerability, Venezia said. For that reason, its backup generators are about three stories off the ground.
There's enough fuel to power those generators for four days, said Erinn Skiba, the hospital's emergency preparedness manager. That's how much they keep on site every day of the year, storm or no storm. And they have contracts in place to get more if they need it, she said.
"Obviously, we don't want these shutting down," Skiba said.
The plan to elevate the generators came after Hurricane Elena, a 1985 storm that forced evacuations of TGH and several other hospitals and nursing homes.
In 2005, flooding from Hurricane Katrina also affected hospitals. After that storm, Venezia said, TGH administrators visited New Orleans and took notes.
Bad flooding could force patients on the lowest floors to move upstairs, he said, a situation he has prepared for.
"We know that if we get anywhere from about a 10 to 20-foot storm surge come through that we're going to surrender the first and second floors," Venezia said.
Then there's the wind. All the windows have hurricane shutters except for some very new ones that were installed to be hurricane-safe. Still, a major hurricane could pose problems.
"We're pretty comfortable at a Category 3," Skiba said. Winds above that wouldn't likely cause structural damage but could force staff to move patients away from windows. The shutters should withstand a Category 4 storm, Venezia said.
In the worst-case scenario, he knows they won't be able to fly anyone off the island during a hurricane. The plan would be to keep everyone inside and keep working.
"We're very confident that in the event — even if we have to move patients into hallways, and get them away from exterior walls and those type of things — we could still operate as a hospital," Venezia said.
That operation includes feeding patients, doctors and staff. There are five days worth of food available, enough for 11,000 meals per day.
Families and visitors of patients should keep in mind that if an evacuation is ordered, they may not be able to visit the hospital. Decisions will be made on a case-by-case basis, Venezia said.
No patients are being turned away in advance of the storm and there's not yet a push to discharge anyone early, Venezia said. So far, the only difference is in the prep work.
Only a half-dozen administrators worked out of the Incident Command Center on Wednesday but when the storm hits, a couple of dozen hospital leaders will fill the room, Skiba said.
VA hospitals prepared for week without food, water
The Tampa Bay area's two U.S. Department of Veterans Affairs medical centers will have enough food, water and fuel to run for seven days, according to Mary Kay Rutan, spokeswoman for the VA Sunshine Healthcare Network, which oversees facilities in Florida.
The James A. Haley VA Medical Center in Tampa holds more than 530 beds. The C.W. Bill Young VA Medical Center in Pinellas County has 397 beds.
At both, doctors are limiting inpatient admissions and expediting discharges, Rutan said. The hospitals are "discussing" scenarios involving evacuating patients if need be, she said, although they haven't made decisions yet.
"It is too early to activate these contingencies," Rutan said.
She said the hospitals are reaching out to "vulnerable" local veterans, such as those who are homeless or have home-based primary care, but said VA facilities don't typically serve as general population shelters.
Howard Altman contributed to this report. Contact Langston Taylor at email@example.com. Follow @langstonitaylor.