Lauren Caruba, Laura Garcia, Marina Starleaf Riker
San Antonio Express-News
SAN ANTONIO — Severe winter weather conditions and widespread power outages are upending health care services across the San Antonio area, taxing emergency medical providers and forcing some hospitals to rely on backup generators for power.
Emergency calls for service to the San Antonio Fire Department and area ambulance services have skyrocketed in recent days, after much of central Texas was blanketed in several inches of snow. EMS providers are largely transporting patients to whichever is the nearest hospital as they struggle to respond to the large volume of calls and navigate roads that are icy or closed.
The wintry weather has also triggered a cascade of other medical problems for patients, including at-home oxygen shortages, missed dialysis appointments and delayed elective procedures. More than two dozen residents of a Wilson County nursing home were transported to another facility after fire suppression pipes ruptured, causing major flooding.
With freezing rain expected Tuesday night, disruptions to medical services are expected to continue for the next few days. The ongoing power outages could affect critical infrastructure, which includes hospitals, said Melissa Sorola, spokeswoman for CPS Energy.
“The overall health care and emergency services system is stressed,” said Mark Montgomery, assistant fire chief for Bexar County Emergency Services District No. 2, which experienced a 200 percent increase in calls. “We’re still responding and we’re not canceling anything, but we are in that disaster mode.”
The weather chaos comes as hospitals and emergency responders are still responding to the tail-end of San Antonio’s winter coronavirus surge, which is still coming down from its mid-January peak.
The crises are layering on top of each other, said Joe Arrington, SAFD spokesman.
“Everything is just magnified and tripled,” he said.
Typically, SAFD will receive 800 to 900 calls a day. On Monday, it responded to 2,608, many of which were injuries from falls on ice.
As the department contends with a combination of calls related to COVID-19, the weather and power outages, it is prioritizing ambulance units for the most urgent patients. Minor situations are being diverted to a new telemedicine program, which has helped conserve resources during the latest coronavirus spike.
SAFD is also sending trucks with oxygen-filling capabilities to home-bound residents who need refills on their tanks. In some cases, EMS agencies have helped restore power to residents who have oxygen concentrators at their homes.
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‘Organized chaos’
Like other vehicles, ambulances and firetrucks have difficulties gaining traction on ice and have to abide by road closures, complicating their routes. Some ambulances have been involved in minor fender-benders.
Certain hospitals are best equipped to treat serious trauma injuries or strokes, and paramedics are doing everything they can to transport patients to those facilities, said Montgomery, whose department serves the far West and South sides. But EMS agencies also have to consider the safety of their workers, he said.
“If we physically can’t get there because of ice, then we can’t get to it, and we’ll have to go to the closest,” he said.
The conditions are also creating a bottleneck for hospital patients who would normally be transferred to San Antonio from smaller outlying hospitals, said David Rice, director of Wilson County’s Emergency Services District No. 3. In some cases, he said, the risk of transporting them outweighed the benefits.
Some ambulance companies have had to pause their services altogether.
“I couldn’t get anybody in (on Monday) because of the power outages, and we didn’t have power at our main headquarters,” said Andy Schultz, who oversees Superior Mobile Health, one of the largest private ambulance companies in San Antonio. “I have generator power, but the generator was frozen — it wouldn’t run.”
Schultz said many of his employees were scared to leave their families to go to work. Their power had been off for hours, and indoor temperatures had plunged into the 40s and even 30s. He ended up putting them up in hotels so they’d know their children were safe and warm.
He is frustrated by the state’s lack of preparation for such weather.
“Two inches of snow and not even subzero temperatures and you’ve got to shut power off?” he said. “That’s ridiculous. It’s the worst time you can do it.”
The weather has also triggered unusual emergencies, including the rupture of fire suppression pipes at Stockdale Residence and Rehabilitation Center on Monday. When first responders arrived, Rice said, water was pouring from the ceiling, pooling three to four inches deep in two wings.
All 29 residents had to be evacuated — no small feat for Rice’s agency, which called on neighboring departments for help. Medically fragile residents were taken by ambulance to the evacuation site, Floresville Residence and Rehabilitation Center. Those who could walk were transported on a bus provided by a local school district.
“It was organized chaos,” Rice said. “I don’t think anybody was prepared for this, at least over here in Wilson County.”
Broken bones, concussions from falls
San Antonio hospital officials say they have experienced some electricity outages and intermittent low-water pressure, but are equipped to handle them and encourage residents with a medical emergency to come in for treatment.
“Our vital infrastructure, including water, electricity and support for medical care, will not be in jeopardy,” said University Health spokeswoman Shelley Kofler.
Bexar County’s public hospital system has shifted some of its medical units to backup generators to avoid any interruption to critical patient care functions. University Hospital has enough fuel to run the generators for the rest of the week, if needed.
Christus Santa Rosa Hospital-Alamo Heights is also operating on backup generator power.
University Hospital has seen a few cases of frostbite, but since Saturday has already treated at least 100 patients with injuries from falling, said Dr. Ralph Riviello, chair of emergency medicine at University Hospital and UT Health San Antonio.
“At one point on Sunday, 30 to 50 patients in the emergency department were there because they had fallen,” he said. “They injured their ankles, hips, wrists, forearms or ribs when they went down. Some hurt their backs or had closed head injuries and concussions. We had patients who required surgery.”
Baptist officials said they had treated patients for hypothermia and frostbite.
Non-emergency and elective surgeries have been postponed at University Hospital, the Children’s Hospital of San Antonio and Christus Santa Rosa’s five other area hospitals.
But COVID-19 vaccine appointments cannot be easily postponed or risk the medicine goes bad. University Health was open for 12 hours Tuesday at its Wonderland of the Americas site. Patients were asked to come in for their appointments if they could safely drive there.
Disaster for dialysis
Two downtown hospitals, Children’s Hospital of San Antonio and Baptist Medical Center, had trouble with water pressure issues. Baptist officials said it had to close that hospital’s dialysis unit and move those appointments to its other hospitals.
Montgomery said emergency medical providers worry about the large number of renal patients who are going without dialysis.
“The dialysis centers need to have water and power,” he said. “They’re either missing their appointments because they can’t get there because of the ice, or the dialysis center is closed.”
For patients with kidney failure, dialysis manually removes toxins and excess fluids from the body. Depending on the stage of renal disease, patients who miss too many dialysis appointments can end up hospitalized or die, if they are not treated in time.
While emergency management officials are working on a plan to address the dialysis problem, Montgomery said he worries that hospitals will soon see a wave of kidney disease patients and other people who were unable to get medical care due to clinic closures or dangerous road conditions.
If this storm system had visited San Antonio a week or two earlier, when hospitals were treating a greater number of COVID patients from the surge, Montgomery said, it “would have been a whole different story.”
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