From Cyberattacks to Natural Disasters, NJ Hospitals Stand Ready

On Apr 10, 2025

When hackers infiltrated a subsidiary of a large health insurance company, exposing the personal and financial information of millions of people, hospitals rallied to protect patients and insulate their own critical systems from the data breach.

When a once-a-century storm crashed New Jersey’s utility infrastructure, hospital teams powered up their generators and employees sheltered in place to deliver uninterrupted care to patients.

And, five years ago, when the state’s hospitals experienced an unprecedented surge of patients with a deadly new virus, they mounted an all-systems emergency response that saved lives and kept the doors open for all.

Being prepared has always been a core part of healthcare. It’s a 365-day commitment for hospital leaders and emergency preparedness professionals to ensure they’re equipped to handle any situation, protecting patients, staff and the community.

“Hospitals are the frontlines when disaster strikes,” says Cathy Bennett, president and CEO of the New Jersey Hospital Association (NJHA). “Our communities depend on us to always be there. Think of emergency preparedness as the foundation of a skyscraper. It may not be visible, but it supports our entire healthcare system to ensure stability and safety in times of crisis.”

Through three regional healthcare coalitions, hospitals and other healthcare providers collaborate with local emergency response agencies in coordinated planning efforts. These planning teams utilize an all-hazards approach – a comprehensive strategy focused on supporting capabilities and capacities throughout the healthcare system. It’s built on flexibility and adaptability to address core areas that include: assessing potential risks; developing plans and procedures and testing them through exercises; educating hospital teams; ensuring appropriate resources including staff, equipment and supplies; establishing coordinated communication and information systems; and the ultimate priority in the healthcare system – ensuring continuity of operations to care for patients and community.

Hospitals today must plan for an ever-growing list of threats, including outbreaks, cyberattacks, supply chain interruptions, natural disasters, mass-casualty events and violence and security threats. These challenges make “being ready” more demanding than ever.

Cyberattacks

In February 2024, Change Healthcare, a healthcare technology company owned by health insurance giant UnitedHealth, was the target of a sophisticated cyberattack. Change Healthcare processes 15 billion medical claims each year – accounting for nearly 40% of all claims nationally. The attack knocked those processing systems offline and gave hackers access to the personal information of more than 190 million individuals – more than half of the US population.

Cybercrimes against healthcare systems put lives at risk by attacking vital systems and disrupting patient care. In the case of the Change Healthcare attack, it created a massive, months-long disruption for every hospital in New Jersey. For weeks, hospitals were forced to use workarounds, including manual processes and paper claims, to manage millions of transactions including prescriptions, prior authorizations for patients’ care, and submitting claims to insurance companies.

The Change Healthcare attack revealed unaddressed vulnerabilities in the healthcare sector – including the need for much greater accountability by insurance systems and other third parties in the healthcare delivery system.

“Hospitals were not the cause of this cyberattack, but they incurred multi-million-dollar losses – not to mention the delays and disruptions that hurt patients. Change Healthcare proved to be the single point of responsibility for a threat to millions of people,” Bennett says. “We urge our elected leaders to do more to require third-party entities to meet stringent cybersecurity requirements on par with those placed on hospitals, and to ensure hospitals have the resources they need to provide needed care in the event of such attacks.”

The risk grows as the frequency of these attacks increases. Worldwide ransomware attacks against the healthcare sector have steadily increased and nearly doubled since 2022, reaching a total of 389 claimed victims in 2023 compared with 214 in 2022, according to the U.S. Director of National Intelligence.

“Hackers’ actions are becoming more sophisticated, and the entire healthcare system is challenged to continuously update protections and countermeasures to protect their patients and their operations,” says Brett McCormick, a regional coalition manager for the New Jersey Health Care Coalitions.

Supply Chain Disruptions

The COVID-19 pandemic demonstrated the fragility of the global supply chain. Multiple break points led to the worldwide clamor for personal protective equipment and other critical supplies. These challenges included public health shutdowns that interrupted manufacturing, border restrictions that impacted shipping, staffing shortages, raw material gaps and a reliance on supplies from China, the original COVID hotspot.

Five years later, another disaster would once again buckle the healthcare supply chain – this time domestically when Hurricane Helene decimated a Baxter plant in North Carolina that produces 60% of the US supply of IV solutions. 

For New Jersey hospitals, supported by NJHA, the emergency response included daily statewide surveys to gauge supply availability and potential patient impact, distributing conservation measures to preserve critical supplies, coordinating closely with the Governor’s Office and N.J. Department of Health, and advocating with the U.S. Food and Drug Administration and the congressional delegation to maximize domestic production and increase imports. And, perhaps most importantly, providers worked through NJHA to facilitate in-state transfer of just-in-time supplies to protect patients.

Hospitals strive to innovate with supply chain technology to identify areas for improvement such as visibility, integration, inventory management and vendor relationships that lead to a more resilient supply chain.

Natural Disasters

With 34 fatalities and more than $70 billion in property damage, Superstorm Sandy ranks as the most significant natural disaster in New Jersey history. The storm destroyed 346,000 homes and left more than 2 million households without power for an extended period.

In a testament to the preparedness of New Jersey’s healthcare teams, 100 EMS Task Force units were activated, 137 healthcare facilities lost power, and two hospitals and 11 long-term care facilities were evacuated without incident.

However, the state is increasingly vulnerable to natural disasters that are becoming more severe and frequent – from flooding to wildfires to winter storms. 

From 1980–2024, New Jersey experienced 75 confirmed weather/climate disasters with losses exceeding $1 billion each. That’s an average of $1.7 billion in events annually over a 44-year period, according to the National Centers for Environmental Information. The pace is accelerating, with the most recent five years (2020–2024) recording an average of 5.2 events with a toll of $1 billion or more. 

Experts attribute the rise to a combination of factors including climate change and rising global temperatures, increased exposure with development in disaster-prone areas and an aging infrastructure for critical systems.

Adapting to the growing threat requires updating risk assessment and emergency response plans and upgrading infrastructure and backup systems. These actions require significant investment, and government funding is an essential part of building health system resilience.

Emerging Public Health Threats 

The Spanish Flu of 1918 resulted in 10,000 to 20,000 deaths in New Jersey. A century later, COVID-19 has claimed more than 37,000 lives in New Jersey and 1.2 million across the US.

Are we prepared for the next big outbreak?

“Our public health system was strained to its limits during COVID-19, and I fear for the next emerging health threat,” Bennett says. “Infectious diseases don’t stop at borders.”

Amid high activity in seasonal influenza and growing concerns over measles outbreaks, bird flu continues to spread among flocks, dairy herds and people who come into contact with them. So far, there has been no confirmed human-to-human transmission of the H5NI bird flu, but the virus could mutate to make that leap, Bennett says. 

“If our emergency preparedness doesn’t keep pace, we will once again find ourselves confronting a huge threat,” Bennett says. “That’s why New Jersey’s healthcare providers never rest.”

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