What Would Your Hospital Do Without Water?

Cyberattacks, natural disasters force us to consider the loss of major public utilities

November 29, 2023

This week, a water treatment plant in Beaver County, Pennsylvania, experienced a cyberattack. Local media reported no impact to the actual facility or the drinking water, but a pump was disabled during the attack, and the impacted equipment was taken offline, resulting in water pressure being monitored manually.

Across our communities, aging infrastructure and antiquated systems are easy targets for nefarious actors who want to disrupt daily living and exploit technology—so, we must be prepared. In a hospital or health care setting, it forces us to consider an uncomfortable question.

“What would you do if your main water source went offline?”

The reality

Cyberattacks are not new, and they aren’t the only threat against our public infrastructure. Everything from old pipes and flooding to clogged drains and car accidents can affect our aging utility systems. We take having water for granted until we lose access to it.

Several recent examples should get us planning. In February 2015, Bradford, Pennsylvania declared a state of emergency when a 24-inch water main ruptured leaving the city and health care facilities without water for weeks. Simple acts like flushing toilets and washing hands became a huge challenge. In 2022, after a loss of water, a Florida hospital recognized significant sanitation concerns when officials noticed a rise in the use of plastic and biowaste bags. Sanitizing critical medical equipment also became a high hurdle.

We know faucets, fountains, and food preparation are affected by the loss of water. Other considerations include bathing patients/residents, cooling for medical gases, dialysis, autoclaves, ice machines, eye-washing stations, laundry, and HAZMAT/decontamination events. The list goes on.

What can I do now?

You need to have a plan to work with community partners and suppliers. Water purification systems and large bladders might be a temporary solution. Also, big box stores have been known to support critical infrastructure during these events by increasing the shipment of bottled water. Good emergency management starts with good partnerships and planning.

You should also consider:

• Messaging:  Accurate, credible messaging is essential to support patients/residents, family members, staff, and local media.
  • Having pre-written or scripted messaging that can be customized or edited to reflect the issues or incident is a very useful strategy.

• Loss of utility/water pressure:  Each facility should complete an assessment of the utility failure and rank the risks associated with it.
  • Once identified and ranked, individuals, teams, and subject matter experts should be assigned to review or develop mitigation strategies.

• Key process:  Each unit and all staff members should identify issues within their department, including fire suppression and the impact on heating and cooling systems.

Practical planning

Your plans must be practical. Many facilities intend to use melted snow to flush toilets. This strategy can work, but it’s time consuming and does not yield high volumes of flushable water. Furthermore, it won’t work in July.

Make an up-to-date water inventory or a current 96-hour plan defining the quantity of available resources. Staff who request bottled water should be specific with their needs. There’s no easy way to transport water, so hand trucks and dollies will be your friend.

Lastly, use external resources. The CDC has developed an Emergency Water Supply Planning Guide. This document is packed with useful information that will help you make a plan that works for your facility.

For additional information about your emergency water plan, contact me or HAP’s emergency management team.