Most people assume disaster medical response is about the dramatic cases. The injuries sustained during the storm itself. The chainsaw accidents which happen in the first days of debris removal. The heart attacks brought on by the physical and psychological strain of recovery. Those cases are real, and my teams have responded to all of them.
But after running healthcare operations for more than a decade of hurricane seasons, I can tell you the greatest medical need is usually far more simple: access to medication.
When a community is devastated by a major hurricane and doctors’ offices and pharmacies remain closed or damaged for weeks, patients need someone to provide prescription refills and access to daily, and sometimes lifesaving medication. The diabetic who needs insulin. The cardiac patient whose 90-day supply ran out on day 10. The person managing a chronic condition who has no way to reach a provider because the provider’s office is closed, the roads are impassable, and the pharmacy three towns over has a line around the block.
Yes, we have saved lives after storms in the ways people expect. However, daily medical needs become hardest to meet when an entire community is devastated without power and water for weeks at a time. Those needs are which recovery plans most consistently fail to account.
That is the healthcare gap in hurricane recovery. I have spent my career working to close it, and it starts with planning that treats medication access and healthcare continuity as essential infrastructure, not as an afterthought.
The Gap No One Measures
During the COVID-19 response, I served Florida’s COVID-19 Infectious Disease Field Hospital System. We delivered more than three million vaccinations, four million tests, and 150,000 monoclonal antibody treatments. None of that work happens in normal conditions. All of it happens under pressure, with incomplete information, and with systems that were not designed to handle what is being asked of them.
Those operations taught me the metrics people track during a recovery — power restoration percentages, road clearance rates, building inspections completed — can all look strong while the population they represent is still in crisis.
Aggregate numbers hide exactly the population who need the most help. A community can report 95% power restoration while the remaining 5% includes every household running an oxygen concentrator or keeping insulin refrigerated. A county can show 80% of pharmacies operational while the ones still closed happen to be in neighborhoods that sustained the most damage and have the least mobility to seek alternatives.
In every large health operation, the hardest patients to plan for are never the ones who showed up. They are the ones who could not get there. After a hurricane, those are often the same people who most need the most help.
Reopening Is Not Recovery
One of the most consequential mistakes in disaster recovery planning is treating reopening as the finish line.
A building can be structurally sound and fully powered while the people who work there are home managing a medical situation which has nothing to do with the building. A business can be technically open while its workforce is operating at a fraction of capacity, not because of anything visible in an attendance report, but because employees are quietly carrying a family health crisis the storm made worse. A community organization can be staffed and running while the residents it serves still cannot access the care they need to function.
Reopening is a milestone. Recovery is when people can actually function again, and for a significant portion of any affected population, that requires restored access to medication, providers, and care.
This distinction matters for business continuity planning because it changes the question from “when can we reopen” to “when can our people actually perform.” An employee who is managing a parent’s medical crisis at home is not available in any meaningful operational sense, regardless of whether they are physically present. Building flexibility into the second and third week of recovery, rather than just the first days, acknowledges that reality.
The First 72 Hours Are the Beginning, Not the Plan
Emergency planning guidance, for good reason, emphasizes the first 72 hours. That window is dangerous, and structured preparation saves lives during it.
In every large-scale health operation I have run, the strain shows up after the initial response phase ends, when public attention moves on, temporary arrangements expire, and the population’s baseline medical needs fully reassert themselves. Vaccination sites and field hospitals rarely get harder to manage on day one. They get harder on day ten, when supplies are still delayed, staff are exhausted, and the people still coming in are the ones whose situations have been quietly deteriorating the whole time.
Hurricane recovery follows the same curve. By the end of week one, the storm is off the news cycle. For a family managing a medication crisis at home, week one is often when conditions get worse, not better. A borrowed generator runs low on fuel. A week’s emergency supply of medication runs out. The relative who drove in from out of state has to leave. The temporary arrangements that got people through the first few days start failing at precisely the moment outside attention has moved elsewhere.
A resilient recovery plan accounts for this arc. What happens if the disruption lasts two weeks instead of three days? Who is checking on medically vulnerable residents in week two? These are operational questions with operational answers, but only if someone asks them before the storm arrives.
What Closing the Gap Looks Like in Practice
This is not a call for every organization to become a healthcare provider. It is a call for every organization involved in hurricane planning to ask one specific question before the season starts. What happens to the people we are responsible for if normal healthcare access is interrupted for one week? For two?
That question, asked seriously, leads to four practical decisions.
The first is identification. Before the season starts, employers and community organizations should have a working understanding of which employees, residents, or clients have known medical dependencies: powered equipment, medications with cold-chain requirements, recurring treatment schedules. This does not require detailed medical records. It requires asking the question at all and creating a simple way to flag the answer.
The second is specific communication. “Prepare for the storm” does not help someone who depends on refrigerated medication or a daily prescription. A more complex statement — “if you rely on refrigerated medication, here is how to protect your supply for 48 hours without power, and here is what to do if the outage runs longer” — does. The difference between a general reminder and a specific instruction is often the difference between a manageable disruption and a medical emergency that did not have to happen.
The third is a plan for week two, not just the first 72 hours. Someone needs to be responsible for checking on medically vulnerable individuals once the initial response has wound down. In my experience, this is the point where most plans go quiet, exactly when the people most affected are running out of options.
The fourth is cross-organization coordination, built in advance. Healthcare access during a hurricane involves employers, local government, shelters, pharmacies, and transportation providers, none of which typically share a planning table. The operations I have run that performed best under pressure had already worked out, before the season started, who does what when normal systems break down. That coordination is slow to build and unglamorous. It is also the difference between a system that holds and one that doesn’t.
A More Human Measure of Recovery
The metrics I have spent my career managing exist because they tell you whether a system is actually working, not just whether it is technically operational. Hurricane recovery needs the same discipline applied to its human dimension.
Not just whether the power is back on, but whether the people who depend on power for medical equipment made it through the gap. Not just whether the pharmacy is open, but whether the people who needed prescriptions actually got them. Not just whether the building is reopened, but whether the people inside it can function.
A community is not recovered because its infrastructure is restored. It is recovered when the people who live and work inside that infrastructure can actually perform the ordinary functions of their lives, including the ones managing a health crisis the storm made worse.
Healthcare access is core infrastructure. It should be planned for before the season starts, with the same operational discipline we apply to power grids and road clearance, and it should be measured with the same rigor we apply to everything else we say matters. The storm is the easy part to plan for. The morning after is where recovery actually happens or doesn’t. Too often, it is a missed prescription refill that makes the difference.
