When the sun rose over Louisiana on Monday morning, Hurricane Ida’s destruction was apparent.

What’s happening behind shuttered doors and windows is also concerning to physicians, as many residents are crowded together in shelters or stuck in their homes without immediate access to testing or other medical care. Without a doubt, experts say, Covid-19 is spreading.

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Hurricane Ida barreled into Louisiana as the state was battling its biggest surge of Covid-19 to date. The high levels of circulating coronavirus, coupled with the state’s low vaccination rates and the forced close proximity that occurs during a storm, could set the stage for an explosion in cases.

“We’ve got so much Covid in the Southeastern United States,” said Dr. James McDeavitt, senior vice president and dean of clinical affairs at Baylor College of Medicine in Houston. “The pandemic will probably will get worse.”

Aug. 30, 202104:40

Dr. Hugh Cassiere, director of critical care services at Sandra Atlas Bass Heart Hospital at North Shore University Hospital on Long Island, New York, said: “During a storm, you’re not going to keep your windows and doors open, so you’re going to have an environment where not only you’re indoors, but you have stagnant air. That’s the perfect storm for transmitting any respiratory tract infection, let alone the delta variant of Covid-19.”

The potential for infection worries even the vaccinated.

Dr. Joshua Denson, a pulmonary medicine and critical care physician at Tulane University Medical Center in New Orleans, sent his vaccinated family to evacuate during the storm — which put them in close quarters with relatives, as well as other families.

“Everybody’s taking on more risk, including my own family,” Denson said. “Delta doesn’t really care. It still spreads.”

Gov. John Bel Edwards acknowledged the difficulties of responding to a hurricane during a pandemic.

“This is a very challenging situation,” Edwards said Monday on MSNBC. The state intends to get evacuees into hotel rooms as quickly as possible to reduce interactions that could further the spread of Covid-19. State officials are also asking shelters to implement other mitigation measures, including masking and rapid testing.

Louisiana took a similar approach in August 2020, when another major hurricane slammed into the coast during the pandemic: Laura.

Laura didn’t lead to an increase in cases, but doctors are concerned that the combination of the hypertransmissible nature of the delta variant and the high numbers of daily cases Louisiana was reporting before Ida hit could cause cases to surge.

“I expect this is going to be worse just because the caseload is higher,” Denson said.

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The impact on the pandemic goes beyond those who were forced to evacuate, experts say.

Hundreds of thousands of people are without power. Electricity might not be restored in the whole of Orleans Parish and New Orleans for several weeks.

That means no respite in the form of air conditioning from the humid heat of the South.

“Right now, the weather is, like, 90 degrees, and it feels like 100,” Denson said. “If you get someone with a [fever], they’re going to get dehydrated more quickly and end up with more complications.”

Clean drinking water could also be scarce for the foreseeable future, adding to the danger of dehydration, he said.

What’s more, residents of a city in lockdown after a natural disaster are unlikely to venture out for Covid testing.

But experts urged residents to continue mitigation measures, including wearing masks and physically distancing wherever possible.

“When you have a new crisis in front of you, you forget about the old crisis,” McDeavitt said.

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