In the urgent response to the pandemic, healthcare facilities around the country erected temporary triage and overflow facilities to handle a possible surge of patients.

These facilities often required lightning-quick planning and coordination between facilities managers, contractors, government officials, and others. With frigid temperatures lingering throughout the late spring, many of these professionals relied on propane to provide a fast, versatile fuel source for heating and water heating that’s available wherever these temporary structures are located.

Testing and triage tents at Express Care Rutland and Express Care Castleton in Vermont relied on propane heaters with installation provided for free by Proctor Gas.

The experiences of these emergency responders and healthcare providers offer a road map that can guide organizations on how to select and source equipment in future crisis scenarios — including a potential resurgence of the coronavirus later this year.

Testing and triage at small clinics

Like many healthcare providers, the Community Health Centers of the Rutland Region set up tented outdoor facilities early in the COVID-19 pandemic to screen and triage incoming patients. The Vermont organization’s property management and maintenance firm, Miglorie Services, sourced several 20-foot-by-20-foot tents from a rental company, along with propane heaters to keep the tents warm enough for patients and staff. Miglorie contacted local propane provider Proctor Gas to supply the fuel, and less than four hours later, the heat was running.

“It was very quick and very responsive, and I can’t ask for anything better,” says Miglorie contractor Mike Robillard.

That urgent response time demonstrates why propane is often the fuel of choice for emergency situations, says Judy Taranovich, president and owner of Proctor Gas, which supplied the equipment and installation work for free to Community Health Centers. “We’re so portable, we can come to an emergency so much quicker than any other fuel,” she says. “There are certain applications where the flexibility of propane is really advantageous to the community.”

Temporary hospital sites

At the temporary hospitals set up in major metropolitan areas to provide additional healthcare capacity, the energy needs can go beyond just temporary heat. That was the case in two of the cities hit hardest by the pandemic, New York City and New Orleans.

Trailers with support systems set up outside of the temporary hospital at Ernest N. Morial Convention Center in New Orleans included propane water heaters and washers and dryers supplemented by propane.

New Orleans set up a temporary overflow hospital in a nearby state park, outside of the Ernest N. Morial Convention Center, as an isolation site for people who are infected but can’t return home. Government contractors operating the facilities brought in ready-made trailers with support systems including propane water heaters and 20 washers and dryers supplemented by propane.

While the urban setting and scale of the facility is different, it’s still the flexibility and response time of propane that sets it apart as a fuel source, says Seth Johnson, area director for AmeriGas, which provided propane to the New Orleans facilities. Setting up a temporary pole for electric wires could require days of red tape, and huge diesel generators would create unwanted noise and smell in a hospital setting. In contrast, propane is clean, efficient, and available anywhere, Johnson says. “All of these trailers are equipped for propane. The fuel is highly portable and simple to set up, which allows us to get these facilities up and running within a matter of hours.”

In New York City, the Federal Emergency Management Agency used mobile RV units to house personnel working at each of their temporary locations, including the USNS Comfort docked in New York Harbor, the Javits Center in Manhattan, and the New York City Emergency Operations Center in Brooklyn. Propane provides heating for the RVs and for temporary COVID-19 testing centers, as well as hot water for portable showers. Each mobile unit has a built-in propane storage tank supplied by Suburban Propane.

The Federal Emergency Management Agency used propane-fueled mobile RV units to house personnel working at the USNS Comfort docked in New York Harbor and at other sites.

“It has demonstrated the versatility and the flexibility that temporary propane storage offers,” says Nandini Sankara, spokesperson for Suburban Propane. “We’ve been able to mobilize and place tanks very quickly and in small spaces while ensuring all permitting and safety requirements are met.”

Propane’s role in emergency scenarios

Propane’s part in the pandemic response is just the latest chapter in a decades-long history of the propane industry’s role as the go-to energy source during emergencies. Although propane is perhaps best-known for protecting homes, hospitals, and critical infrastructure with standby generators, propane companies are well-equipped to quickly respond to other emergency energy needs. AmeriGas’ New Orleans region, for example, frequently works with FEMA or other government contractors.

“We’re in the line of natural disasters down here, so we’re pretty well-versed in responding to these kinds of situations,” Johnson says. “Everything we’re doing now is what we’ve done previously for hurricanes or floods.” Propane is often used in portable mobile kitchens to feed troops overseas or first responders and displaced families during natural disasters, says Leslie Anderson, president and CEO of the Propane Gas Association of New England. In 1955, propane was federally certified for emergency civil defense use in mass feeding, hospital use, and emergency stockpiling.

Mobile units heated by propane can be used as testing centers, offices, or living quarters.

The response during these emergencies is likely to involve federal, state, or local governments; equipment vendor and rental facilities; disaster recovery and mitigation contractors; and insurance companies. Partnering with these responders, propane companies can consult on tank sizing options, safe placement, and permitting, and they can supply and install the equipment needed to connect the propane fuel source to heaters or other propane-powered equipment.

“If it is a U.S. government entity, they usually have predetermined specifications contingent on their respective needs,” Sankara says. “When it involves local governments and businesses such as hospitals, their maintenance and support structure staff partner with our operations team to determine an optimal solution that best fits their needs.”

Specifying heating for temporary applications

The sophistication of the heating systems used in temporary structures can vary depending on the application. Some drive-through testing sites required only simple patio-style propane heaters to provide warmth in open tents. Others required more-sophisticated engineering and ventilation to meet the air-quality needs of a healthcare setting. That was the case for a series of triage tents at 30 hospital sites for two healthcare networks in Illinois and Wisconsin.

Each tent included 6–10 exam rooms sectioned off by temporary walls. Mike Bacchi, senior technical field representative at Sunbelt Rentals, helped to design the heating solution in coordination with a local mechanical contractor and general contractor. To meet the air-quality requirements, the facilities required a higher-grade filtration system and a minimum of six air changes per hour. To meet that level of airflow, Bacchi switched from the typical flexible vinyl duct to a more-elaborate inflatable duct that runs along the pitch of the roof to distribute the heat and cooling.

The final design includes ductwork running from an air conditioner into and out of the tent with a bypass loop that includes an indirect-fired propane heater. The system runs on two thermostats to control the cooling and heating, and a fan runs continuously to provide even heating. Based on the size of the tent, the number of occupants, and the expected temperature, Bacchi used one or two heaters with a total heating capacity ranging from 400,000 to 1.2 million Btus.

Of the 30 sites Bacchi served, all but two ran on propane; those two used natural gas. “The plus for propane for this type of application is you could place the tents almost anywhere,” Bacchi says. “We obviously go through permits being pulled for certain locations that require them. But what’s nice about them, we could put the pegs in, put jersey barriers up to protect the tanks, and then the propane companies just put them on a schedule to fill them.”

Indirect-fire heaters such as this Foreman unit are commonly used for tightly enclosed spaces where a heat source without combustion byproducts is needed.

Natural gas and electric alternatives each carry downsides. Many of these tents are set up in parking lots, so there’s no easy way to run a pipe for natural gas. Even if gas is available, running these large heaters can quickly create capacity issues for an existing hospital’s pipe or meter. And because many of these sites are powered by diesel generators, electric heating would require much larger diesel fuel pods and a higher operating cost than propane heat.

Direct or indirect propane heaters

Beyond size, pros should also decide whether a direct- or indirect-fired heater is the best choice for their application. Heater manufacturer L.B. White offers both types. The Premier line of enclosed direct-fired heaters, also known as box-style or tent-style heaters, is the most common choice for temporary tented applications, says April Gnadt, L.B. White’s product manager for the temporary-heat market. The line has an enclosed flame, making the heaters safe and ductable. Because they’re direct-fired, they’re 99 percent fuel-efficient, but they do require exchange air.

For more tightly enclosed spaces, such as hospitals, schools, or remodels in inhabited spaces, indirect-fired heaters are usually preferred. In L.B. White’s Foreman line, the combustion takes place within an enclosed heat exchanger and a fan pushes air over the heat exchanger without coming into contact with the byproducts of combustion.

For temporary tents, the vast majority of heaters are set up to be propane-only, but L.B. White also offers dual-fuel units that can run on natural gas or propane, a popular choice for rental fleets or on construction sites where natural gas may become available later in a project.

The heart of the community

A thank-you note to Proctor Gas from the Community Health Centers of the Rutland Region.

The most inspiring aspects of the pandemic response have involved the focused response and coordination by all parties involved. Bacchi, for instance, received his request at 8:30 p.m. on a Wednesday; put together preliminary numbers for a phone call at 6:30 a.m. on Thursday morning; and had his team working Friday, Saturday, and Sunday to implement the first phase of the project. “I’ve been doing this 27 years, and I was just amazed with the timeframe and turnaround,” he says.

Companies like Proctor Gas and others throughout the propane industry are providing not only immediate response time but are going further to provide free or reduced-cost labor and services to facilities responding to the pandemic.

“The propane industry, over and over again, is willing to answer the call,” says Proctor Gas’ Taranovich. “Whether it be something like the quick response to this pandemic or simply a sponsorship to the Little League team. We are some of the most community-minded people and are much more likely to say ‘How can we help?’ rather than ‘Sorry, no.’ For this reason and so many more, we are not only a vital part of the community, but the heart of it.”

Top photo: U.S. Air Force Gen. Terrence J. O’Shaughnessy, commander of U.S. Northern Command, addresses media during his visit to the hospital ship USNS Comfort. (U.S. Navy photo by Mass Communication Specialist 1st Class Kleynia R. McKnight)