Is there enough medical care?

Ike caused $710 million in losses to UTMB when it came ashore near the island city on Sept. 13. Only about $100 million of the damage was covered by insurance.

The massive damage at UTMB prompted the UT System Board of Regents to lay off 3,000 employees and reduce the number of beds at the medical facility's public hospital from 550 to 200.

Hospital facilities are slowly reopening but its Level 1 trauma center remains closed. It's unknown when it will reopen.

The trauma center's closure is of particular concern for some petrochemical industry leaders, who fear long rides to Houston trauma centers could cost lives.

"Without UTMB's vital facilities for emergency treatment, trauma care and its leading burn center, injured refinery workers and others in Galveston County would need to be conveyed far greater distances for emergency treatment," said Keith Casey, a business unit leader at BP PLC's Texas City plant, in a Nov. 19 letter to UT System officials obtained by The Galveston County Daily News.

Trauma centers are ranked by the surgeons available. Level 1, the highest designation, means a trauma center has every specialty -- neurology, orthopedics, cardiology -- in house at all times.

With UTMB's facility still closed, the only remaining Level 1 trauma centers are at Houston hospitals Memorial Hermann and Ben Taub General, which has no helicopter landing pads.

If a disaster similar to the March 2005 explosion at BP's Texas City refinery that killed 15 people and injured about 170 happened, the question would be where to take patients, said Dr. James H. "Red" Duke Jr., professor of surgery at the University of Texas Medical School at Houston and medical director of Life Flight.

"We may have to have another tragedy before there's public awareness," Duke said.

The shutdown is also straining health care in the Houston area.

For every 1 million people in a region, there should be a Level 1 trauma center, hospital officials said. The Houston area, with a population of more than 4 million people, is now being served by only two trauma centers.

"It's a major concern," said David Lopez, Ben Taub's CEO. "We'll do the best we can. We're busy to begin with; it's hard to absorb the volume from another trauma center. Heaven forbid a major event happens any time soon."