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Scenes of the Cajun Navy, CNN rescues, Waffle House and other businesses acting decently to great, and basic human decency (even heroism) seem to dominate ‘the’ story as to helping Houstonians amid and after Hurricane Harvey’s (still probably inconceivable for all of us who were under its) 50 inches of rain.

Despite this compelling (and meaningful) stories, a basic truth is that major institutions bear the major brunt and role both in preparing for and dealing with disaster situations.  Amid the serious (and often valid) discussions of how Houston’s free-wheeling land development and Texas political elite’s climate-science denial’s damaging of efforts to reduce vulnerabilities, there are ways in which parts of Houston showed real learning and invested (often with meaningful Federal (both Bush and Obama Administration) support to be better prepared to face climate-driven/enhanced catastrophes like Hurricane Harvey.  Houston’s hospitals and medical system might prove to be the strongest example of how learning from expert analysis (of disasters and risks) and investments based on that learning help society better deal with climate impacts.

Upfront: Before jumping into the discussion of Houston’s hospitals, some basic truth:

• Human-driven climate change (AGW) worsened/amplified Hurricane Harvey
  • Sea-level rise worsened storm surge level
  • Increased temperatures and evaporation added, one scientist estimates, 30% to rainfall levels absent climate change
  • Changing climate might (MIGHT) have fostered conditions for rapid intensification and stalling over Houston
• Investing in mitigation (reduce future human impacts on climate) is preferred over adaptation
  • Though both are necessary — climate is changing and adaptation investments are required even as (much) more should go to mitigation
  • David Roberts’ discussion has this core point: “Mitigation has local costs and egalitarian global benefits; adaptation has local costs and inequitable local benefits.”

• Writ large, Hurricane Harvey’s impacts on Houston show that the city (and, writ large, society) is neither making adequate mitigation nor adequate adaptation investments.
  • Houston has been paving itself ever more with each passing year, making the city more vulnerable to floods.
  • See Greg Laden Is Harvey a failure of the assumption that we’ll adapt to climate change?

Even with news of chemical plant explosions, some news from Houston shows that climate adaptation investments can work and enable resiliency in the face of climate-intensified disasters. Example #1: Houston’s medical system.

Previous storm weather events created havoc in Houston’s medical services.

Houston’s medical complex … was swamped by Tropical Storm Allison in 2001. That storm caused a blackout, inundated medical center streets with up to 9 feet of water, and forced evacuations of patients, some airlifted from rooftops by helicopter. Damage totaled more than $2 billion.

Consider that damage figure.  That is, roughly, one percent of the damage totals being bandied about for Hurricane Harvey’s impacts. (Today, saw estimate of $150B — have to think that this will increase — though perhaps that is solely Federal aid request level.)

Houston’s hospitals and the overall medical system didn’t, however, simply cash disaster-relief checks for $2B (and boost bonuses) but did what good medical professionals do: they considered what had happened, sought to learn lessons, and took action based on recommendations from those evaluations.

After a review of the area’s flood weaknesses, member hospitals moved their electrical vaults and backup generators out of basements to areas above flood level. Scores of existing buildings were fitted with flood gates, and new buildings were built surrounded by berms. Underground tunnels were outfitted with 100 submarine doors, some 12 feet tall. The $756 million bill was paid by the Federal Emergency Management Agency; millions more were spent on the public works projects.

The result? Some hospitals evacuated, but Houston’s medical world mostly withstands Harvey. While hospitals reduced operations (stopped outpatient services), evacuated some patients, and had to deal with challenges like reduced food services,

Disruptive as such changes have been, doctors, health-care administrators, and the leaders of the regional network say Houston’s vaunted web of hospitals has generally come through the storm in far better condition than during the last massive rains to deliver a direct hit.

During Allison, “Memorial Hermann, for one, had no power because its basement-level generator had been flooded, and staff members were working by flashlight and ventilating patients by hand.The pills in hospital pharmacies were wet and ruined. Medical equipment shorted out. The medical center’s research laboratories suffered $2 million in losses.” And, even months later, the hospital warned the community

“Drink milk, not booze, on this Fourth of July weekend, because if you get into a wreck or get in a fight, we have no way to take care of you.”

During the ongoing massive flooding and catastrophe?  The hospital is able to take care of patients — even if stressed by the realities of one of the nation’s largest (climate-enhanced) natural disasters.  As per the view from another hospital’s windows,

when William McKeon, the Texas Medical Center’s president, looked outside during the height of the storm, “We saw the water flowing and the streets looking like rivers when the bayou crested, but the lights were all on,” he said. “The people were inside, were caring for patients as they do every day.”

Without question, the climate adaptation investments have paid for themselves — in this one instance — in terms of reduced damage costs.  It seems quite likely, though harder to calculate with assurance, that they have paid off in terms of saved lives as well.

And, Houston’s medical community already has its eyes on learning from Harvey to better prepare for tomorrow. “Following its protocol, the Catastrophic Medical Operations Center will conduct an after-study to compile evidence of how hospitals weathered the storm.”

In conclusion …

While must emphasize climate mitigation (reducing pollution), the reality is that humanity has driven a changed climate and we are already facing (and will, no matter what, face more) impacts from those changes. Thus, climate adaptation investments are necessary.  Houston’s medical community’s performance during Hurricane Harvey proves that they pay off and provide a real return on investment.

NOTE: If Houston’s Medical System has not already, as part of its investment streams, started investing in climate mitigation (that at least intersects with adaptation), perhaps they will do so.  What are examples of potential investment opportunities that meet this criteria?

• Energy efficiency: cut demands for energy services through, for example, LED lighting and control systems … this can save $s directly, reduce pollution from energy production, while also helping adapt with greater resiliency during stressed power situations/outages.
• On-site renewable energy: such as solar panels over parking lots (yes, they wouldn’t be producing much as the rain fell …) which, again, leads to reduced energy costs and pollution loads while providing on-site generation and resiliency if the grid is disrupted during a climate-driven catastrophe;
• Green roofs and other ‘green’ methods to help reduce energy costs AND absorb rainfall to reduce runoffs. No, such investments wouldn’t soak in a 50 inch rainfall, but widespread green roofing could have reduced by the equivalent of a few inches the runoff from those roofs.
• Etc …