How Disaster-Ready Are We?

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San Franciscans are prepared — at least psychologically — for the next big earthquake they know will someday hit their city. But how ready is the rest of the country for the other disasters — natural and manmade — waiting to strike? Not very, according to a survey by TIME's Amanda Bower.

The Bay Area is not the only region threatened by quakes. The greatest risk outside the West Coast is found along the New Madrid fault zone, a 120-mile-long system named after a little town in Arkansas. This is where a series of 2,000 earthquakes struck over a five-month period between 1811 and 1812; five of the quakes registered magnitude 8.0 or more. Eighteen of them caused church bells to ring on the East Coast.

The U.S. Geological Survey predicts there is up to a 40% chance that a quake of magnitude 6.0 or greater will hit here in the next 50 years, causing serious damage to communities from Memphis to St. Louis. That's especially bad news for Memphis, the biggest urban center in the region. In January, Memphis was ranked second least-prepared (after Louisville, Ky.) among 30 big cities studied by the American Disaster Preparedness Foundation. "Memphis has an aging infrastructure and many of its large buildings, including unreinforced schools and fire and police stations, are particularly fragile," U.S.Geological Survey geologist Eugene Schweig testified at the Capitol in February. "Very few buildings were built using modern building codes."

Next year, the federal government and 13 states will conduct a two-week exercise focusing on how to cope with a New Madrid zone earthquake. They'll have a lot to plan for. Two government studies conducted in the wake of Katrina predicted that a 7.7 quake could kill up to 4,200 Memphis residents and injure another 70,000; destroy or damage 200,000 homes in the city of 1 million people; render one third of all hospital beds useless the day after the quake; and cause about $70 billion in damages. "My previous director used to say he would immediately file two forms in the event of a major earthquake," says Kurt Pickering, spokesman with the Tennessee Emergency Management Agency. "The first would be the request to FEMA for a disaster declaration, the second his retirement papers."

One of the few good things to come out of Katrina, says former deputy security of homeland security James Loy, was that it forced officials in other hurricane-prone places to re-examine their emergency plans. "There are many other places in the nation that are now much better prepared," Loy says. Last month, Loy and former FEMA director James Lee Witt founded Protecting America, a coalition of emergency officials, first responders and insurers. The coalition suggested that Gulf officials learn from Florida's example when rebuilding their hurricane response capability. It is one of only five states that reports feeling confident in its evacuation plan, and Loy and Witt say it has exemplary building codes, public campaigns, equipment, interagency relationships, and a catastrophe fund that helps bolster insurance coverage.

Hurricanes regularly strike our coasts, but so do tsunamis, albeit with far less frequency. Major tsunamis have killed Americans and caused enormous damage three times in the past 60 years — in 1946, 1960 and 1964 — and a new one could strike at any time, according to the USGS. Despite the risk, only 27 coastal communities have the warning systems and evacuation plans they would need to be certified Tsunami Ready by the National Weather Service. "There should be more, and we're working aggressively to increase that number dramatically," says Troy Nicolini, the service's warning coordination meteorologist. "The scary thing is, the farther we get away from that event in the Indian Ocean, the [more the] momentum dies down and the funding dries up."

The 2004 tsunami in the Indian Ocean — which killed nearly a quarter million people — led to plans to beef up the number of monitoring buoys in the Pacific. The buoys can provide up to six hours' warning, says Nicolini, if the waves are coming from far across the ocean. But an earthquake in the Cascadia Subduction zone just off the Pacific Northwest could create tsunami-size waves within five minutes. "You'd feel that kind of an earthquake on land," Nicolini says. "If you do, start running to higher ground" — at least 40 feet above sea level. For residents of low-lying places, says Nicolini, "vertical evacuation" — climbing a tree or going to the top floor of a sturdy-looking building — may be the best they can do with just five minutes' warning.

Pandemic Flu
Seattle's King County could be struck at any time by an earthquake, tsunami or the eruption of nearby Mount Rainier. But the thing that has Eric Holdeman, director of the county's office of emergency management, really worried is the threat of a pandemic flu. "We expect to need 57,000 hospital beds," says Holdeman of a worst-case scenario. "We have 3,500. There's not enough ventilators, there's no vaccine, there's not enough Tamiflu."

The problem with a pandemic, by definition, is that it strikes everywhere at once. And according to a 2005 report by Trust for America's Health, a non-profit that focuses on disease prevention, few states are prepared to cope with major disease outbreaks on their own. The report found problems at every level: nearly half the states did not adequately track disease outbreaks; hospitals in almost one third of states weren't prepared to cope with a surge in patients; and 21 states did not have sufficient backup supplies to ventilate even 10 additional patients, never mind the thousands that would be needed in a full-fledged flu pandemic.

Of course, all the equipment in the world won't help if there's no one to operate it. A 2005 survey of New York health care workers found that less than half would be willing to report to work during a SARS outbreak. According to the Trust for America's Health report, hospitals in only two states, Rhode Island and South Dakota, have credible plans to get people to work during a major outbreak. According to a RAND Corporation study published last fall, there are also concerns about how seriously local public health agencies take the risk of disease outbreak. In one trial run, a health worker hearing the classic symptoms of bubonic plague advised the caller to go back to sleep because no similar cases had been reported.

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