Hospitals in Oakland prepare for the next earthquake

When a 6.0 magnitude earthquake—the biggest in 25 years—woke Napa Valley residents early on August 24, it alerted all Bay Area health agencies to be prepared.

Hospitals here remember all too well the 6.9 magnitude Loma Prieta earthquake in 1989 that surprised the San Francisco Bay Area, collapsing Oakland’s Cypress freeway structure and a section of the Bay Bridge, and causing 63 deaths and more than 3,000 injuries. To be ready for the future, Oakland hospitals have been conducting emergency drills, retrofitting buildings to strengthen seismic safety, and constructing brand-new structures to withstand the next big shake.

Oakland’s Highland Hospital conducts drills and reviews its Emergency Operation Plan every year, said safety officer Sandra Williams. It is also an active participant in the statewide drill, the Great California ShakeOut, she added in an email interview.

“We are able to respond to any type of event by employing the HICS,” said Williams, referring to the Hospital Incident Command System, which is used both nationally and internationally. HICS is a detailed system of disaster planning protocols and logistics that was developed in 1991 and updated in May 2014 by the California Emergency Medical Services Authority (EMSA) with support from federal, state and local partners including Oakland-based Kaiser Permanente. The guidelines are covered 156-page guidebook available at agency’s website.

The California Office of Emergency Services (OES) says a hospital “not only needs to care for its existing patients but also needs to prepare for the potential of thousands of people needing critical care as a result of the disaster,” according to a statement on the agency website. Guidelines for hospitals are provided by several entities, including the California Hospitals Association, California Department of Public Health , the Federal Emergency Management Agency, and the EMSA.

Licensed for 236 beds, Highland Hospital is one of the largest hospitals in the Alameda Health System. It can treat and care for around 85,000 people a year. Highland Hospital also has several “surge tents” that can be deployed for use when triaging patients, as did the Queen of the Valley Medical Center in Napa to handle the high volume of injured people who descended on its emergency department on the morning of August 24.

Approximately 2,000 employees work at Highland Hospital on a regular basis. But should it need additional staff, the hospital can call back off-duty staff to respond “to any type of disaster,” Williams said. “Drop, Cover and Hold On” are the personal safety steps recommended by the Earthquake Country Alliance, and that is what they teach to Highland Hospital’s staff, said Williams, adding, “We are prepared.”

UCSF Benioff Children’s Hospital Oakland trains personnel in those three basics steps and also participates in the Great California ShakeOut. It also reviews its emergency plan annually and updates it regularly, said Michelle Heckle, a certified healthcare emergency professional at Children’s.

Children’s is licensed for 190 inpatient beds and can flex during a surge event to add another 19, said Heckle. “We have both triage and, separately, decontamination tents available,” she said.

Measures like triaging outside the emergency department area are not only needed to handle overflow of patients, but could also be used in case the integrity of the building is in question, said Carolyn Kemp, a spokesperson for Sutter Health East Bay Region and Alta Bates Summit Medical Center in Oakland. For that reason, Alta Bates stores emergency supplies in a large container outside the building. “We are prepared to respond appropriately to what happens in the community,” she said, adding, “We hope we don’t have to put our experience into effect.”

California Senate Bill 1953, passed in 1994, required seismic retrofitting or rebuilding of hospitals, triggering “mass construction,” Kemp said. After the sizeable Northridge quake in 1994, all acute care hospital buildings were rated for seismic resistance, and 40 percent of California’s hospital buildings were deemed at risk, she said. As a result, hospitals have to retrofit or rebuild by 2030.

“The deadline is coming,” Kemp said. In fact, Alta Bates’ Oakland campus just finished a new building, the Merritt Pavilion, which “meets and exceeds the seismic safety requirements of Senate Bill 1953,” according to the hospital’s website.

Meanwhile, Heckle said, Children’s also tests the building’s resistance and makes engineering assessments. “We also recognize we have improvements to be made and UCSF Benioff Children’s Hospital Oakland is in the midst of an aggressive master planning [build] program now,” she said in the email.

Children’s Hospital, Heckle said, now knows “so much more” from an emergency management perspective, and is “clearly better prepared” today than 25 years ago in terms of its own infrastructure. Heckle also urged community members to be prepared at home for disasters, adding, “1) Make a plan, 2) build a kit, 3) stay informed, and 4) stay involved!”

As for Highland Hospital, staffers are in the process of retrofitting the entire facility. “As we expand and build for the future, we are in the process of constructing a new state of the art facility that will be ready to serve the community in 2017. This facility is designed to meet California’s strict seismic standards,” Williams said.

Looking northward, the Napa quake response so far suggests that preparation works, officials said. The emergency department at Queen of the Valley Medical Center in Napa absorbed 172 injured patients after the earthquake, more than twice its capacity of 80 beds, using the triage tents set up outside. According to EMSA, the Napa hospital activated its emergency command system. An EMSA spokesperson said in an email that its review process for the response to the Napa earthquake “is still underway,” but that actions taken “in accordance with the Public Health and Medical Emergency Coordination System worked well.”

Read more about how local homeowners are also preparing here.