As Sally – now downgraded from hurricane to tropical storm – continues its slow crawl through the southern United States, people are moving. They’re just not moving quite the way they usually do.

In the area of Florida most affected by wind shear, there are about 2.8% fewer people than usual, said Andrew Schroeder, Direct Relief’s vice president of research and analysis.

Evacuees have dispersed widely, from San Antonio, Texas in the west to Birmingham, Alabama in the north, according to Facebook data.

But what sets evacuees of the current storm – and its immediate predecessor, Hurricane Laura – apart is one striking fact: remarkably few of them are showing up in shelters.

As of September 14, Schroeder said, only a handful of people in Florida and Alabama had popped up in shelters. About 120 appeared in shelters in Mississippi.

More typically, for a Category 1 or Category 2 hurricane, Schroeder said he would expect to see about 5,000 people appear at shelters. A Category 4 storm might top out at 35,000 shelter residents. “We’re not even in the ballpark of that,” Schroeder said.

There’s a likely culprit – and it’s the most obvious one.

“It’s probably Covid,” Schroeder said. “It’s probably that people are choosing to avoid sleeping in shelters unless they really don’t have other options.” It’s likely, he suggested, that people are opting to stay in hotels, RVs, cars, and family members’ residences instead.

In part because the storm has cut such a slow path, the extent of its effects is just beginning to emerge. That’s the case for safety net health care providers – which are among the organizations Direct Relief supports during and after a disaster such as a hurricane – as well.

“Obviously, they’re in the middle of it right now, so they don’t necessarily know what the impact will be,” said Leighton Jones, Direct Relief’s director of emergency response.

But a few things have emerged from Jones’s conversations with health care organizations. “It’s the rainfall that’s the challenge, and the storm surge. It’s a flooding event [even] more than a wind event,” he explained.

In preparation for storms like this one, Direct Relief has stationed Hurricane Prep Packs at health care organizations throughout the southern United States – including packs distributed to 19 organizations in Mississippi, Alabama, and Florida that serve low-income and medically fragile patients every day and will be where they go for care when the storm passes

The packs, developed with consultation from health care experts after Hurricane Katrina and improved upon in the years since, contain a wide variety of medications and supplies, from first aid supplies to chronic care medications, that are widely requested after a hurricane or tropical storm.

In addition to the pre-staged packs, “what we usually do at this point is open the lines of communication with our partners in the area… just to say ‘We’re here if you need us,’” Jones said. “A couple of days after the storm, we usually get asked” for other essential medicines and needed supples.

Although it’s too soon to tell what the long-term effects from Sally will be, Schroeder noted some developments in the wake of Hurricane Laura that he’ll be watching closely in the weeks after Sally.

For one thing, although Facebook’s users are slightly more likely to be women than men, Schroeder said that the number of long-term displaced people from Laura are disproportionately female. Two weeks after the storm, 63.2% of those still displaced were female.

In addition, Schroeder said, people are returning much more slowly overall. Although about 18,000 evacuees were identified as leaving the areas that Laura endangered, only about 400 people a day have been returning.

“At that rate of return, it’s going to take quite a while for people to get back to their homes,” Schroeder said.