“Execute Condition Gray!” blared over the intercom at St. John’s Regional Medical Center in Joplin, Mo., in the late afternoon three years ago on Thursday.
Panic in the hospital operator’s voice told emergency room nurse Tracy Hernandez that this tornado warning was different.
“We had heard sirens and stuff before, but we had never had a threatening storm like this while I was on duty,” said Hernandez, who had worked there five years.
Within minutes one of the worst twisters in U.S. history was wrecking the nine-story building. Nearly every window shattered, doors were blown off, the roof caved and interior walls collapsed. The hospital lost all power, even the emergency generators.
“The tornado gathered up everything in its path and threw it straight at us,” Hernandez said. “The building couldn’t match what Mother Nature had thrown at it.”
With any luck, Joplin will never have another tragedy like the mile-wide, 200-mph twister that killed 158 people, including six at the battered hospital.
But with southwest Missouri often in the crosshairs during storm season, the team building the new hospital isn’t taking chances.
“It’s designed to withstand a tornado,” said Ryan Felton, project director with McCarthy Building Companies, the firm constructing the new facility, which will be known as Mercy Hospital Joplin.
How do you tornado-proof a hospital?
The most visible and costliest upgrade will be Mercy’s windows. The only ones to survive the 2011 storm were the reinforced windows in the behavioral health unit. So hospital officials and McCarthy worked with a manufacturer to assemble breakage-resistant windows. Fifteen-pound wooden studs were shot at the glass to see if the windows would hold up. Windows in the new patient rooms will be able to withstand winds of 140 mph. Even stronger windows, designed to endure winds up to 250 mph, will be used in intensive care units.
“The Mercy Joplin hospital team’s goal was to design and construct a facility that provided a safe environment for patients, staff and visitors from a direct hit by an EF-3 or greater tornado,” Felton said.
About $11 million of Mercy’s $350 million in construction costs is being spent on storm-hardening upgrades.
When the hospital is complete next March, there will be two lines of power, water and data communications coming from different directions in case one fails. A concrete tunnel, the length of one-and-a-half football fields, will protect utility lines from severe weather. The electrical plant and backup generators will be housed in a bunkerlike structure away from the main building.
A blanket of rock, with some pieces the size of a golf ball, was used to weigh down the roof on the old hospital, which was built in 1965.
“Those actually turned into projectiles during the tornado,” Felton said of the gravel. “They were being shot right through the patient room windows.”
The damaged exterior resulted in a “complete loss of control over the interior environment,” investigators with the National Institute of Standards and Technology wrote in a recent report examining the 2011 tornado.
Rubble, toppled furniture and flooded hallways created hazards for more than 200 patients, visitors and staff trying to evacuate in total darkness, wrote the NIST, an agency within the Commerce Department.
“There was debris on top of people, on top of us, walls in, doors in, door frames in…” one survivor told investigators. “You can’t imagine the shattering that goes on when you have materials exposed to that kind of wind.”
Injured Joplin residents were arriving in the parking lot, but St. John’s, a regional hospital that served nearly 700,000 people before the storm, was inoperable.
“In medical circles, there is a lot of talk about ‘never’ events — referring to things that should never happen in a hospital, like a surgeon operating on the wrong limb,” Felton said. “But there is one ‘never’ event that is harder to control: A hospital full of patients should never be reduced to rubble in a matter of minutes. That is the motivation behind our efforts in Joplin, which aim to not only keep occupants alive during an EF-5 tornado, but actually keep the hospital operational after the event.”
There will be no rocks on Mercy’s new roof, but a protective layer of lightweight concrete is being incorporated into the roofing scheme. Hurricane-rated precast concrete exterior walls will make the facade of Mercy sturdier than most brick, metal or plastered walls.
Each floor of the hospital will have special hallways designated as safe zones, with reinforced walls, ceilings and lighting. Emergency grab bags with crucial supplies will be strategically stashed throughout the 880,000-square-foot campus.
Mercy’s aggressive tornado-proofing comes at a time when U.S. health care facilities are being urged to hone their disaster plans. The federal government has described emergency preparedness as an “urgent public health issue,” and proposed exhaustive regulations aimed at preventing disruptions after natural disasters like Hurricane Katrina.
The NIST report recommends that U.S. model building codes be developed and adopted to protect hospitals against tornado threats. Current building codes address hazards like hurricanes, earthquakes and floods, but not tornadoes.
But for an industry already under mounting pressure to reduce costs, what price will be put on tornado-proofing?
Last month, a twister heavily damaged the only hospital in Winston County, Miss. A tent city is being used until repairs are completed sometime next year. The catastrophic tornado that struck Moore, Okla., a year ago destroyed its relatively new 45-bed hospital. Moore broke ground this week with plans to rebuild by 2016.
“We’ve had quite a few people reach out and ask about the things that we’ve incorporated here,” Felton said.
Three years later, Hernandez, the ER nurse, still looks for the nearest concrete wall “anytime the wind blows.” The new Mercy can’t open fast enough.
“Just knowing that you’re safer there than you ever could be in the other building is going to be pretty comforting,” she said.
Watch engineers test tornado-resistant windows:
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