How a Louisiana Medical Team Protected COVID-19 Patients as Hurricane Laura Ravaged Lake Charles

Louisianians woke up Wednesday, Aug. 26 to news that Laura would be arriving as a Category 4 hurricane. The storm was expected to hit Lake Charles early Thursday morning.   Throughout the day, doctors, nurses, maintenance and cafeteria workers filled Lake Charles Memorial Hospital. The plan was for several shifts of employees to be ready once the winds picked up that night. Whole floors were designated as sleeping areas for off-duty staff. Dr. Gary Kohler, a pulmonary critical care physician, arrived for his shift at 6:30 a.m. He remembered sensing how nervous everyone was in those hours before the storm. 
 “No one wanted to be alone,” he said. “When we were on break, a lot of us would sit around a table together. It was a shared fear of not knowing what was coming.”    In 2005, the hospital was evacuated before Hurricane Rita arrived and devastated the city. Hurricane Laura was predicted to be more ferocious. But this time, there were no plans to leave.    “You can’t help but wonder what’s going to hold and what isn’t, both at the hospital, but also at your home,” Kohler said.The calm before   A headshot of Dr. Gary Kohler, who works at Lake Charles Memorial Hospital in Louisiana. (Photo courtesy/Lake Charles Memorial Hospital)As the strengthening hurricane headed for the Louisiana-Texas border, 1.5 million residents were ordered to evacuate.    Most chose to heed the warning, particularly residents in Lake Charles, a city of 80,000 that bore the brunt of the storm.   Tens of thousands of the city’s residents evacuated to areas north, east and west on Wednesday.  But some were asked to stay. “Our families left town,” Kohler told VOA. “But as long as there were patients at the hospital, we were going to be there.”    Kohler works in the intensive care unit (ICU) treating the critically ill. During a normal year, patients in the ICU might include those with heart, lung and kidney ailments, or those who suffered strokes or are battling major infections. But this year, a separate wing is reserved for patients who tested positive for the coronavirus. “Our patients tend to be the sickest in the hospital — that’s why they’re in the ICU,” Kohler explained. “And we’ve been hit pretty hard by COVID patients this year, which has made the work a lot more challenging.” Louisiana has the highest number of cumulative coronavirus cases per capita of any state in the U.S. Kohler said Lake Charles Memorial had so many patients this summer from a second wave of the virus that multiple patients were placed in a single room.   “That’s a lot of very sick patients we’re taking care of,” he said. “And when it became clear how strong Hurricane Laura was going to be when it hit us, I knew it had the potential to be a long night.”  Nagging fears   A storm surge of nine feet was predicted for parts of Lake Charles. Everyone at the hospital knew that if the building lost water, they would not be able to properly sanitize themselves or their patients. And if the power went out and the generators did not operate, they would have to manually sustain patients on ventilators.  Shannon Williams, an ICU registered nurse, arrived Wednesday at 5:45 a.m. She called the storm the scariest moment of her life. 
 
“To be honest, my biggest fear was that the building was going to collapse on us, and that all that would be left of my co-workers, patients and me was a very sad story,” she said.A photo of three nurses, including Shannon Williams, are at work at Lake Charles Memorial Hospital in Louisiana. (Photo courtesy/Shannon Williams)Laura hits Kohler and Williams said the wind began to pick up around 8:30 p.m. Shortly after that, the hospital lost its main power source.   “I was concerned we lost power so early and before the main part of the storm arrived,” Kohler said. “But fortunately, the generators kicked on.” The generators are only meant to keep the essential functions of the hospital running, which does not include air conditioning. The lack of air conditioning is a serious problem in southern Louisiana, where temperatures and humidity climb to unbearable heights during summer months. Kohler recalled the uncomfortable situation.   “I was soaked with sweat,” he said. “But the nurses — they’re dressed for hours in their PPEs (personal protective equipment), and they looked like they had just come in from a rainstorm.”  Kohler said it was so humid in the hospital, the flooring was slick from condensation. The windows leaked from the rainfall. Around 1 a.m. Thursday, Williams said the wind sounded like a train speeding past the east side of the building where she was trying to sleep.  A maintenance worker checked the situation. The news was not good.  “These are six-foot-tall windows, so you could see some random debris smashing against them,” she said. “And the maintenance guy said it’s because the window was warped — you could see them flexing in and out — which is why water was also leaking in.” The storm caused many of the windows in the hospital to warp, including those in the ICU. The immediate danger was that the windows would shatter, leaving no protection from the storm outside.  Williams said the nurses frantically thought of ways to protect the patients and themselves should the windows burst. One window did collapse, creating a noisy wind tunnel in the ICU. But the remaining windows managed to hold.   “You had patients crying, and just generally really afraid,” Kohler said. “They were so hot and uncomfortable, and it was a scary experience. Plus, who knows when they saw their family last — family members aren’t allowed to visit COVID patients.” Kohler said the toughest moment of the night for him was when the hospital’s water stopped running.   “You can’t stay sterile if you can’t wash your hands,” he said. “We couldn’t even flush toilets anymore, let alone think about doing a procedure. At that point, you just hope a patient doesn’t require anything big.”   The aftermath   For the remainder of the night, the phones were not working, and employees had no idea what was happening outside.    “Our focus was on making our patients as comfortable as possible, and our nurses did an incredible job,” Kohler said. He explained that in the middle of the storm, some nurses took a device designed to heat patients and repurposed it to keep them cool. “They did everything they could to keep our patients comfortable,” Kohler said. “Our nurses are the real heroes of this hurricane.” Kohler said he woke up at 6 a.m. Thursday and could see outside for the first time since Laura made landfall. “I could see a neighborhood across the street from our hospital, and it was hard to find a home that didn’t have a tree through their roof,” he said. “Trees on roofs. Roofs gone. Trees inside houses. Electrical poles down. Debris all over the street. It’s hard to imagine my city ever being the same.”   But there was no time to think about the future. The staff still had work to do.    “I’m just extremely proud of our resilience,” Williams said. “The next day, we still had no air conditioning and no water. We still had no idea what was happening in the outside world, or what happened to our homes. But we kept working for our patients.”    Williams said the moment when the winds died down, and she realized everyone would survive, was when she finally breathed a sigh of relief.  Kohler’s moment came Thursday afternoon, when ambulances from Mississippi, Georgia and Kentucky arrived to transport critically ill patients to other hospitals.  “That’s where you felt the collective sigh of relief,” he said. “That’s when it felt like we made it. We had never lost the ability to give medication. We had never lost the ability to give blood. And we had never lost the ability to give antibiotics. We did a good job.” On Friday, when it became clear that the city might not have water or electricity for three weeks or more, the announcement was made that the hospital would be completely evacuated.    Patients were evacuated that day. The staff stayed until the last one left.   “I saw heroes,” Kohler said. “The nurses, the maintenance workers, the cafeteria workers. They sacrificed themselves for the patients at this hospital. They’re heroes, and they’ll be ready to get back to work when it’s time.” 



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