When Republicans and Democrats convene, hospitals shift into high alert
There’s a political cyclone on track for Cleveland; it’s called the Republican National Convention (RNC) and it’s due to make landfall on July 18. Forecasts call for high winds — “hot air” and heated hyperbole — given the expected arrival of presumptive presidential nominee Donald Trump, vocal pro-Trump supporters and antithetical protesters eager to take Trump and his followers to task for their conservative ideologies.
Winds will kick up again in Philadelphia on July 28 when the Democrats arrive for their own party’s “party” – the Democratic National Convention (DNC). Likely not as contentious as the RNC, this gathering — like every national political convention — presents challenges, especially in health and emergency preparedness, simply by virtue of the massive influx of people — and heated opinions — in a concentrated area. Cleveland expects about 2,500 delegates and Philadelphia anticipates 4,769, in addition to some 15,000 media representatives at their respective events. Ancillary support personnel are expected to push city censuses up by an estimated 50,000 people in both locations.1
‘Storm Clouds’ Gather
Both the RNC and DNC (designated National Special Security Events wherein ultimate authority over law enforcement falls to the Secret Service and Department of Homeland Security) could face trouble caused by elements other than the influx of politicos. Public volatility in the wake of recent highly publicized shootings threatens to ignite tinder-like tensions, while the ever-present contemporary threat of terrorism adds yet another layer of fog over public safety.
Michael Fuoco, a Pittsburgh Post-Gazette reporter, offered this take on the climate surrounding the more immediate Republican convention: “Mr. Trump is perhaps the most unorthodox, polarizing and contentious candidate in American history. His controversial comments about Mexicans, Muslims, blacks, women, Jews, abortion, foreign policy, guns, terrorism, free expression, waterboarding and political opponents have produced criticism and demonstrations throughout his campaign. Some protestors at his rallies have been physically assaulted, a practice that critics say he encourages.”2
Even the weather could create additional health and safety concerns next week. Weather.com is calling for a humid 87 degrees on Monday in Cleveland. The Cleveland 2016 Host Committee website cautions, “Transit and events associated with the RNC will potentially require extensive walking and outdoor exposure … this [could]be an above average summer in regards to temperature due to the La Nina. Attendees are encouraged to … make appropriate use of sunscreen, and to stay hydrated by consumption of water and non-caffeinated beverages. Attendees … on medications should bring enough medication for the duration of the visit, and as a precaution, are encouraged to carry the day’s medications with them. Attendees … with medical conditions are encouraged to keep a list containing their medical conditions, medications taken (including dosage and frequency), and physician’s telephone numbers readily identifiable on their cell phone or on their person.”3
Healthcare Stands United
Cleveland healthcare facilities have offered a united and coordinated front in the face of convention-generated health challenges. Healthcare facilities, including Cleveland Clinic, MetroHealth, St. Vincent Charity Medical Center and University Hospitals, reportedly have been meeting regularly for more than a year with city and county officials and Cleveland’s Division of Emergency Medical Services to etch out a health emergency preparedness plan.
Each facility has been assigned a specific area to oversee in the convention locale during convention week, according to Modern Healthcare.4 The Cleveland Clinic, for example, will staff the convention arena. “Normally, for such events, paramedics and/or nurses would be on hand. In mid-July, [the Cleveland Clinic]also will staff the arena with a board-certified emergency physician. They’ll have ambulances on site for quick transport, with an exit that avoids much of the foot traffic,” according to the report. MetroHealth will staff entrances and, with Cleveland EMS, a first aid village. MetroHealth will also support federal elected officials and their healthcare teams. As the closest emergency department to the convention, St. Vincent is expected to see the majority of patient walk-ins. University Hospitals will staff the Global Center for Health Innovation and the Cleveland Convention Center, as well as provide medical care for the large number of law enforcement personnel working at the convention.
“The [health]systems also are providing delegates, media and visitors with a joint nurse triage line, where they can call in with questions about the nearest urgent care, forgotten prescriptions, medical advice and more,” reported Crain’s Cleveland Business in June.5
It has been a grandiose undertaking, requiring teamwork and sacrifice. Bob Wyllie, MD, chief medical operations officer for the Cleveland Clinic, told Crain’s, “We are cooperating as systems around public health, where none of us can solve the problems individually. But we realize that sure, we are competitors in medical care, but there are some things in terms of public health where citizens … would be aided in us joining hands and seeing how we can work together.”
Wyllie told Crain’s that The Cleveland Clinic has cut back on vacation requests for convention week, and has asked clinicians and other staff “to stay in town; many people are on call, including extra emergency physicians and anesthesiologists.”
The City of Brotherly Love
In Philadelphia, equally vigorous plans are already in place. Having recently hosted a visit by the pope in September, the city can rely on extensive experience in crowd control and super-heightened security.
“The papal visit was the single largest planned National Special Security Event ever held in the U.S.,” said Mark Ross, regional manager, Emergency Preparedness, Hospital & Healthsystem Association of Pennsylvania.
That experience offered tremendous advantages to the city and its healthcare partners, which include “more than 50 acute-care facilities, 12 trauma centers and more than 200 other healthcare entities that participate in these endeavors,” Ross told ADVANCE. He explained that the city had planned for an extremely large impact on healthcare when the Pope was in town. “We had facilities with access issues wherein they would be cut off for five days — unable to get deliveries or get staff or patients in or out. One facility, which normally has 250-300 staff members sleep over during a snowstorm, actually ‘slept over’ 2,000 staffers during the papal visit,” said Ross.
A surprisingly positive lesson learned from the papal visit was: “We simply didn’t have the negative impact we had planned for – and that’s a good thing,” Ross noted. Nevertheless, hospitals have again increased staffing for the DNC period, but not to the extent of the papal visit. Because the convention site is in a stadium complex several miles from the downtown area, and the security zones are much tighter, far fewer access issues are anticipated for this event.
“One of the advantages we have here — and I tout this when I speak across the country about Philadelphia’s preparedness — is the fact that the Office of Emergency Management has included healthcare since day one. We are always at the table,” said Ross. “When an event takes place, we staff a healthcare coordination desk inside the City of Philadelphia’s Emergency Operations Center. We know scope; we know impact; we know what is happening in real time. We relay information to healthcare facilities in the city and keep them updated on situational awareness. We inform EMS of what is taking place within the hospitals — how many beds are available, capacity burdens, for example. So we coordinate in real time, back and forth. We’re all on the same page and we all use the same incident management system. We make it all work under any conditions.”
Asked if terror threats are of concern during the DNC, Ross confirmed, “We plan for the worst and hope for the best. We have plans, alternate plans, contingency plans, and emergency plans. We go so far beyond Plan A, B, and C that we literally get to double digits in the alphabet. We have anticipated any potential contingency and have made a plan of action for each one.”
Ross said there are plans that revolve around each party’s VIPs, as well, although he could not go on the record as to what they are. He did, however, confirm that should some health problem afflict Hillary Clinton or Bernie Sanders, a plan for care is already in place. “We have granular plans that get down to the real nitty-gritty,” said Ross. “Nothing is left to chance.”
When the winds of political conventions calm before the storm of the November election, we will all be able to cast our vote on the effectiveness of the preparations made by Cleveland and Philadelphia. We can only hope that both cities come out tied as winners in that healthcare and public safety race.
- ABC News. Cleveland mayor, safety officials, unveil RNC security plan. http://abcnews.go.com/Politics/cleveland-mayor-safety-officials-unveil-rnc-security-plan/story?id=3950655
- Pittsburgh Post-Gazette. Cleveland will be in the spotlight when it hosts the Republican National Convention. www.post-gazette.com/news/politics-nation/2016/07/10/Cleveland-will-be-in-the-spotlight-when-it-hosts-the-Republican-National-Convention/stories/201607100010
- Cleveland 2016 Host Committee. Health information/guidance. www.2016cle.com/press-releases/security-and-traffic-restrictions
- Modern Healthcare. Cleveland hospitals prepare for Republican National Convention. http://www.modernhealthcare.com/article/20160627/NEWS/160629925
- Crain’s Cleveland Business. Hospitals are ready, will work together during RNC. www.crainscleveland.com/article/20160626/NEWS/160629853/hospitals-are-ready-will-work-together-during-rnc