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Wednesday, July 15, 2015

How will the health care system deal with THIS?

Kathryn Schulz, author of one of my favorite books, "Being Wrong: adventures in the margins of error," is now on staff at The New Yorker. She has just written a frightening article about the likely upshot of the looming Big One that may well utterly overwhelm the PacNW health care system (the entire emergency response infrastructure, actually) and render a good bit of the Pacific Northwest uninhabitable for a long time.

I lived in the Seattle area from 1968 -- 1974. Both of my daughters were born there. Wrote my first song there, circa 1969 out in Maple Valley. I absolutely loved living there, and still have numerous dear friends there. This article shook me up. Excerpts from Kathryn's long read:

The Really Big One
An earthquake will destroy a sizable portion of the coastal Northwest. The question is when.


...Just north of the San Andreas ... lies another fault line. Known as the Cascadia subduction zone, it runs for seven hundred miles off the coast of the Pacific Northwest, beginning near Cape Mendocino, California, continuing along Oregon and Washington, and terminating around Vancouver Island, Canada. The “Cascadia” part of its name comes from the Cascade Range, a chain of volcanic mountains that follow the same course a hundred or so miles inland. The “subduction zone” part refers to a region of the planet where one tectonic plate is sliding underneath (subducting) another. Tectonic plates are those slabs of mantle and crust that, in their epochs-long drift, rearrange the earth’s continents and oceans. Most of the time, their movement is slow, harmless, and all but undetectable. Occasionally, at the borders where they meet, it is not.

...Under pressure from Juan de Fuca, the stuck edge of North America is bulging upward and compressing eastward, at the rate of, respectively, three to four millimetres and thirty to forty millimetres a year. It can do so for quite some time, because, as continent stuff goes, it is young, made of rock that is still relatively elastic. (Rocks, like us, get stiffer as they age.) But it cannot do so indefinitely. There is a backstop—the craton, that ancient unbudgeable mass at the center of the continent—and, sooner or later, North America will rebound like a spring. If, on that occasion, only the southern part of the Cascadia subduction zone gives way ... the magnitude of the resulting quake will be somewhere between 8.0 and 8.6. That’s the big one. If the entire zone gives way at once, an event that seismologists call a full-margin rupture, the magnitude will be somewhere between 8.7 and 9.2. That’s the very big one.

When the next very big earthquake hits, the northwest edge of the continent, from California to Canada and the continental shelf to the Cascades, will drop by as much as six feet and rebound thirty to a hundred feet to the west—losing, within minutes, all the elevation and compression it has gained over centuries. Some of that shift will take place beneath the ocean, displacing a colossal quantity of seawater ... The water will surge upward into a huge hill, then promptly collapse. One side will rush west, toward Japan. The other side will rush east, in a seven-hundred-mile liquid wall that will reach the Northwest coast, on average, fifteen minutes after the earthquake begins. By the time the shaking has ceased and the tsunami has receded, the region will be unrecognizable. Kenneth Murphy, who directs FEMA’s Region X, the division responsible for Oregon, Washington, Idaho, and Alaska, says, “Our operating assumption is that everything west of Interstate 5 will be toast.”

In the Pacific Northwest, everything west of Interstate 5 covers some hundred and forty thousand square miles, including Seattle, Tacoma, Portland, Eugene, Salem (the capital city of Oregon), Olympia (the capital of Washington), and some seven million people. When the next full-margin rupture happens, that region will suffer the worst natural disaster in the history of North America. Roughly three thousand people died in San Francisco’s 1906 earthquake. Almost two thousand died in Hurricane Katrina. Almost three hundred died in Hurricane Sandy. FEMA projects that nearly thirteen thousand people will die in the Cascadia earthquake and tsunami. Another twenty-seven thousand will be injured, and the agency expects that it will need to provide shelter for a million displaced people, and food and water for another two and a half million. “This is one time that I’m hoping all the science is wrong, and it won’t happen for another thousand years,” Murphy says.

In fact, the science is robust, and one of the chief scientists behind it is Chris Goldfinger. Thanks to work done by him and his colleagues, we now know that the odds of the big Cascadia earthquake happening in the next fifty years are roughly one in three. The odds of the very big one are roughly one in ten. Even those numbers do not fully reflect the danger—or, more to the point, how unprepared the Pacific Northwest is to face it. The truly worrisome figures in this story are these: Thirty years ago, no one knew that the Cascadia subduction zone had ever produced a major earthquake. Forty-five years ago, no one even knew it existed...


...At approximately nine o’ clock at night on January 26, 1700, a magnitude-9.0 earthquake struck the Pacific Northwest, causing sudden land subsidence, drowning coastal forests, and, out in the ocean, lifting up a wave half the length of a continent. It took roughly fifteen minutes for the Eastern half of that wave to strike the Northwest coast. It took ten hours for the other half to cross the ocean. It reached Japan on January 27, 1700: by the local calendar, the eighth day of the twelfth month of the twelfth year of Genroku.

Once scientists had reconstructed the 1700 earthquake, certain previously overlooked accounts also came to seem like clues. In 1964, Chief Louis Nookmis, of the Huu-ay-aht First Nation, in British Columbia, told a story, passed down through seven generations, about the eradication of Vancouver Island’s Pachena Bay people. “I think it was at nighttime that the land shook,” Nookmis recalled. According to another tribal history, “They sank at once, were all drowned; not one survived.” A hundred years earlier, Billy Balch, a leader of the Makah tribe, recounted a similar story. Before his own time, he said, all the water had receded from Washington State’s Neah Bay, then suddenly poured back in, inundating the entire region. Those who survived later found canoes hanging from the trees. In a 2005 study, Ruth Ludwin, then a seismologist at the University of Washington, together with nine colleagues, collected and analyzed Native American reports of earthquakes and saltwater floods. Some of those reports contained enough information to estimate a date range for the events they described. On average, the midpoint of that range was 1701.

It does not speak well of European-Americans that such stories counted as evidence for a proposition only after that proposition had been proved. Still, the reconstruction of the Cascadia earthquake of 1700 is one of those rare natural puzzles whose pieces fit together as tectonic plates do not: perfectly. It is wonderful science. It was wonderful for science. And it was terrible news for the millions of inhabitants of the Pacific Northwest. As Goldfinger put it, “In the late eighties and early nineties, the paradigm shifted to ‘uh-oh.’ ”...


...During subduction-zone earthquakes, torrents of land rush off the continental slope, leaving a permanent deposit on the bottom of the ocean. By counting the number and the size of deposits in each sample, then comparing their extent and consistency along the length of the Cascadia subduction zone, Goldfinger and his colleagues were able to determine how much of the zone has ruptured, how often, and how drastically.

Thanks to that work, we now know that the Pacific Northwest has experienced forty-one subduction-zone earthquakes in the past ten thousand years. If you divide ten thousand by forty-one, you get two hundred and forty-three, which is Cascadia’s recurrence interval: the average amount of time that elapses between earthquakes. That timespan is dangerous both because it is too long—long enough for us to unwittingly build an entire civilization on top of our continent’s worst fault line—and because it is not long enough. Counting from the earthquake of 1700, we are now three hundred and fifteen years into a two-hundred-and-forty-three-year cycle.


t is possible to quibble with that number. Recurrence intervals are averages, and averages are tricky: ten is the average of nine and eleven, but also of eighteen and two. It is not possible, however, to dispute the scale of the problem. The devastation in Japan in 2011 was the result of a discrepancy between what the best science predicted and what the region was prepared to withstand. The same will hold true in the Pacific Northwest—but here the discrepancy is enormous. “The science part is fun,” Goldfinger says. “And I love doing it. But the gap between what we know and what we should do about it is getting bigger and bigger, and the action really needs to turn to responding. Otherwise, we’re going to be hammered...

The first sign that the Cascadia earthquake has begun will be a compressional wave, radiating outward from the fault line. Compressional waves are fast-moving, high-frequency waves, audible to dogs and certain other animals but experienced by humans only as a sudden jolt. They are not very harmful, but they are potentially very useful, since they travel fast enough to be detected by sensors thirty to ninety seconds ahead of other seismic waves. That is enough time for earthquake early-warning systems, such as those in use throughout Japan, to automatically perform a variety of lifesaving functions: shutting down railways and power plants, opening elevators and firehouse doors, alerting hospitals to halt surgeries, and triggering alarms so that the general public can take cover. The Pacific Northwest has no early-warning system. When the Cascadia earthquake begins, there will be, instead, a cacophony of barking dogs and a long, suspended, what-was-that moment before the surface waves arrive. Surface waves are slower, lower-frequency waves that move the ground both up and down and side to side: the shaking, starting in earnest.

Soon after that shaking begins, the electrical grid will fail, likely everywhere west of the Cascades and possibly well beyond. If it happens at night, the ensuing catastrophe will unfold in darkness. In theory, those who are at home when it hits should be safest; it is easy and relatively inexpensive to seismically safeguard a private dwelling. But, lulled into nonchalance by their seemingly benign environment, most people in the Pacific Northwest have not done so. That nonchalance will shatter instantly. So will everything made of glass. Anything indoors and unsecured will lurch across the floor or come crashing down: bookshelves, lamps, computers, cannisters of flour in the pantry. Refrigerators will walk out of kitchens, unplugging themselves and toppling over. Water heaters will fall and smash interior gas lines. Houses that are not bolted to their foundations will slide off—or, rather, they will stay put, obeying inertia, while the foundations, together with the rest of the Northwest, jolt westward. Unmoored on the undulating ground, the homes will begin to collapse.

Across the region, other, larger structures will also start to fail. Until 1974, the state of Oregon had no seismic code, and few places in the Pacific Northwest had one appropriate to a magnitude-9.0 earthquake until 1994. The vast majority of buildings in the region were constructed before then. Ian Madin, who directs the Oregon Department of Geology and Mineral Industries (DOGAMI), estimates that seventy-five per cent of all structures in the state are not designed to withstand a major Cascadia quake. FEMA calculates that, across the region, something on the order of a million buildings—more than three thousand of them schools—will collapse or be compromised in the earthquake. So will half of all highway bridges, fifteen of the seventeen bridges spanning Portland’s two rivers, and two-thirds of railways and airports; also, one-third of all fire stations, half of all police stations, and two-thirds of all hospitals...


...The shaking from the Cascadia quake will set off landslides throughout the region—up to thirty thousand of them in Seattle alone, the city’s emergency-management office estimates. It will also induce a process called liquefaction, whereby seemingly solid ground starts behaving like a liquid, to the detriment of anything on top of it. Fifteen per cent of Seattle is built on liquefiable land, including seventeen day-care centers and the homes of some thirty-four thousand five hundred people. So is Oregon’s critical energy-infrastructure hub, a six-mile stretch of Portland through which flows ninety per cent of the state’s liquid fuel and which houses everything from electrical substations to natural-gas terminals. Together, the sloshing, sliding, and shaking will trigger fires, flooding, pipe failures, dam breaches, and hazardous-material spills. Any one of these second-order disasters could swamp the original earthquake in terms of cost, damage, or casualties—and one of them definitely will. Four to six minutes after the dogs start barking, the shaking will subside. For another few minutes, the region, upended, will continue to fall apart on its own. Then the wave will arrive, and the real destruction will begin.

Among natural disasters, tsunamis may be the closest to being completely unsurvivable. The only likely way to outlive one is not to be there when it happens: to steer clear of the vulnerable area in the first place, or get yourself to high ground as fast as possible. For the seventy-one thousand people who live in Cascadia’s inundation zone, that will mean evacuating in the narrow window after one disaster ends and before another begins. They will be notified to do so only by the earthquake itself—“a vibrate-alert system,” Kevin Cupples, the city planner for the town of Seaside, Oregon, jokes—and they are urged to leave on foot, since the earthquake will render roads impassable. Depending on location, they will have between ten and thirty minutes to get out. That time line does not allow for finding a flashlight, tending to an earthquake injury, hesitating amid the ruins of a home, searching for loved ones, or being a Good Samaritan. “When that tsunami is coming, you run,” Jay Wilson, the chair of the Oregon Seismic Safety Policy Advisory Commission (OSSPAC), says. “You protect yourself, you don’t turn around, you don’t go back to save anybody. You run for your life.”


The time to save people from a tsunami is before it happens, but the region has not yet taken serious steps toward doing so. Hotels and businesses are not required to post evacuation routes or to provide employees with evacuation training. In Oregon, it has been illegal since 1995 to build hospitals, schools, firehouses, and police stations in the inundation zone, but those which are already in it can stay, and any other new construction is permissible: energy facilities, hotels, retirement homes. In those cases, builders are required only to consult with DOGAMI about evacuation plans. “So you come in and sit down,” Ian Madin says. “And I say, ‘That’s a stupid idea.’ And you say, ‘Thanks. Now we’ve consulted.’ ”

These lax safety policies guarantee that many people inside the inundation zone will not get out. Twenty-two per cent of Oregon’s coastal population is sixty-five or older. Twenty-nine per cent of the state’s population is disabled, and that figure rises in many coastal counties. “We can’t save them,” Kevin Cupples says. “I’m not going to sugarcoat it and say, ‘Oh, yeah, we’ll go around and check on the elderly.’ No. We won’t.” Nor will anyone save the tourists. Washington State Park properties within the inundation zone see an average of seventeen thousand and twenty-nine guests a day. Madin estimates that up to a hundred and fifty thousand people visit Oregon’s beaches on summer weekends. “Most of them won’t have a clue as to how to evacuate,” he says. “And the beaches are the hardest place to evacuate from.”

Those who cannot get out of the inundation zone under their own power will quickly be overtaken by a greater one. A grown man is knocked over by ankle-deep water moving at 6.7 miles an hour. The tsunami will be moving more than twice that fast when it arrives. Its height will vary with the contours of the coast, from twenty feet to more than a hundred feet. It will not look like a Hokusai-style wave, rising up from the surface of the sea and breaking from above. It will look like the whole ocean, elevated, overtaking land. Nor will it be made only of water—not once it reaches the shore. It will be a five-story deluge of pickup trucks and doorframes and cinder blocks and fishing boats and utility poles and everything else that once constituted the coastal towns of the Pacific Northwest...


...The inundation zone will be scoured of structures from California to Canada. The earthquake will have wrought its worst havoc west of the Cascades but caused damage as far away as Sacramento, California—as distant from the worst-hit areas as Fort Wayne, Indiana, is from New York. FEMA expects to coördinate search-and-rescue operations across a hundred thousand square miles and in the waters off four hundred and fifty-three miles of coastline. As for casualties: the figures I cited earlier—twenty-seven thousand injured, almost thirteen thousand dead—are based on the agency’s official planning scenario, which has the earthquake striking at 9:41 A.M. on February 6th. If, instead, it strikes in the summer, when the beaches are full, those numbers could be off by a horrifying margin...

...OSSPAC estimates that in the I-5 corridor it will take between one and three months after the earthquake to restore electricity, a month to a year to restore drinking water and sewer service, six months to a year to restore major highways, and eighteen months to restore health-care facilities. On the coast, those numbers go up. Whoever chooses or has no choice but to stay there will spend three to six months without electricity, one to three years without drinking water and sewage systems, and three or more years without hospitals. Those estimates do not apply to the tsunami-inundation zone, which will remain all but uninhabitable for years...
Wow. Read the entire piece. How can you even plan for something like this?


Here in the Bay Area, while we wrestle with how to deal with our extreme drought, we too fret over the next California Big One. It may pale in comparison with that which inexorably awaits the PacNW.


My wife is Corporate Director of QA/QC for Gilbane Federal. As I was telling her about the Schulz article and this post, she reminded me of the substantial military infrastructure up in the PacNW. Her company does a ton of construction, repair, and maintenance work for the U.S. military world-wide, including the U.S. northwest.

Have to wonder whether they have any contingency response/mitigation planning going on.

Schulz concludes:
All day long, just out of sight, the ocean rises up and collapses, spilling foamy overlapping ovals onto the shore. Eighty miles farther out, ten thousand feet below the surface of the sea, the hand of a geological clock is somewhere in its slow sweep. All across the region, seismologists are looking at their watches, wondering how long we have, and what we will do, before geological time catches up to our own.
___

ADDITIONAL READING

PDF link here.

UPDATE

See also
The Five Scariest Takeaways From the New Yorker Article About the Earthquake That Will "Devastate" Seattle
by Kathleen Richards • Jul 14, 2015

Could a Catastrophic Earthquake Really Destroy Seattle?
Worried Pacific Northwesterners seek reassurance from geologists, who are the worst people to ask for reassurance.
By Eric Holthaus
Nine Questions for Sandi Doughton, Author of Full-Rip 9.0: The Next Big Earthquake in the Pacific Northwest
by Dan Savage • Jul 15, 2015
Again, how can you truly prepare for something of this magnitude? Again, kinda makes our drought problem seem trivial in comparison.

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