The next disaster

Our precariously situated city isn't ready for a Katrina-level catastrophe

By A.C. Thompson

Talk to city government insiders these days, and you'll hear some pretty scary stuff. Numerous knowledgeable sources we interviewed told us San Francisco really isn't prepared for a Katrina-level catastrophe, despite the hundreds of millions we spend annually on emergency services and the looming specter of another major earthquake. They have an abundance of worries, from the city's shortage of hospital beds and ambulances to its lack of comprehensive disaster blueprints to our decaying century-old firefighting system.

Glenn Ortiz-Schuldt is assistant deputy chief for emergency medical services at the San Francisco Fire Department. A primary concern of his is whether the fire department has the "surge capacity" to scoop up all the casualties of a high-magnitude earthquake, fire, tsunami, or terror attack.

"A major surge like, for example, the Glendale train accident" – which killed 11 and wounded more than 100 near Los Angeles earlier this year – "would present a problem," he says. "The first problem is, we don't really have the vehicles. We don't have a bunch of additional ambulances we can put on the street." The Fire Department, which employs some 350 paramedics and 1,200 EMTs, is the primary source of ambulance service in the city, running 26 ambulances on a day-to-day basis.

Ortiz-Schuldt is also worried by the city's paucity of emergency room beds. In the past decade, as the economics of the health care industry have changed, hospital chains have increasingly sought to slash costs by closing costly trauma centers, funneling ambulances to a handful of facilities around the Bay Area. Financially, it makes perfect short-term sense, but Ortiz-Schuldt sees huge problems in the offing.

"The hospitals are completely unprepared for a surge," he says, noting UCSF's Mt. Zion and Children's hospitals have both shuttered their emergency rooms in recent years. "Even if we commandeered a school bus or a Muni bus, we wouldn't have anywhere to take people."

A third concern is the lack of detailed disaster planning coming out of the San Francisco Office of Emergency Services and Homeland Security, which, in the post-9/11 environment, is supposed to spearhead the city's response to terrorism and natural disasters. According to Ortiz-Schuldt, the agency hasn't devised "clear or specific" plans for dealing with attacks by biological, chemical, nuclear, or conventional explosive weapons.

The relatively new agency is headed by Annemarie Conroy, who was moved into the spot last year by Mayor Gavin Newsom as part of a political power play that landed Sean Elsbernd on the Board of Supervisors; Conroy had previously overseen the goings-on at Treasure Island and served as a supe. In the view of Ortiz-Schuldt, the agency "is still trying to figure out what they're supposed to do. That's the nicest way I can put it."

In response to multiple requests for internal documents made under the Sunshine Ordinance, the office released paperwork revealing it hasn't updated or completed seven key strategy papers, including its plans for handling earthquakes and evacuating the populace. To be fair, Conroy's crew has drawn up 22 plans that cover oil spills, tsunamis, floods, and a lot of other nastiness.

Conroy was out of town, and her spokesperson, Laura Adelman, had no comment for this story.

While Ortiz-Schuldt is critical of the city's disaster czar, some Fire Department grunts have their own critique. In addition to its 26 regular ambulances, the Fire Department has 12 backup vehicles on standby, to be used if an ambulance craps out, or in the event of a major calamity.

But multiple sources at the Fire Department told us the backup ambulances aren't fully stocked with medical supplies and life-saving equipment, and they worry we'll be screwed when the Big One hits.

"The city should have these rigs stocked and ready to go," says one insider, who asked to remain anonymous. "We don't even have enough gurneys right now." These sources say it could take "two to four hours" to get the unstocked ambulances on the road.

Both Ortiz-Schuldt and Fire Department spokesperson Pete Howes downplayed the concerns. "I think it could happen faster than that," Howes says, adding that the department has a "whole warehouse full of supplies" and could quickly load that stuff onto the vehicles.

The San Francisco Department of Public Health oversees ambulance service in the city; its agreement with the Fire Department doesn't require the department to maintain a specific number of vehicles or keep its backups fully stocked.

Martha Hawthorne, a public health nurse at the Castro-Mission Health Center and a designated "first responder" in the event of a disaster, has her own set of worries. "I'm a first responder, and I don't know what the plan is," Hawthorne gripes. "As far as I know, the plan is for me to turn on my radio and listen for instructions."

Hawthorne says the last time nurses like herself actually engaged in disaster drills was prior to New Year's Eve 2000, when city officials drew up contingency plans to deal with the feared Y2K computer meltdown. In an era when wackos are flying commercial airliners into skyscrapers, that would seem to be just a tad slack – and it should be noted that other key personnel, like firefighters and paramedics, have done drills.

She also says many folks on the "A list," the team of people who'll descend immediately on any disaster scene, live outside the city or have young children. "I don't think it's realistic to have them on the A list," she says, noting that people with toddlers or infants may be unable to leave them, and those dwelling beyond the city limits may have trouble simply getting onto the peninsula.

One positive note in all this comes from the San Francisco Public Utilities Commission, the people responsible for the water and power infrastructures. In 2003 the Civil Grand Jury dogged the agency, saying it had no plan for distributing drinking water if the city's water lines were snapped in a disaster. Earlier this year the PUC unveiled a common-sense scheme for handling such a crisis and started purchasing water trucks and stockpiling thousands of gallons of bottled water.

"We wouldn't be in a situation like you've seen in New Orleans," PUC communications director Tony Winnicker says. "We still have more to do, but we do have a plan."

There is, however, one serious and lingering issue when it comes to water: the city's archaic and decaying auxiliary water system, a web of pipes put in place after the earthquake-induced fires of 1906. The system is designed to provide water should the city's regular water infrastructure collapse, as happened both in '06 and during the 1989 Loma Prieta quake. There's widespread agreement among city officials that the system is in need of a major overhaul. Yet so far there hasn't been the political will to do it.

"A lot of those pipes have never been changed," notes Ortiz-Schuldt, who's pushing for top-to-bottom renovation. "There are parts of the system that have never been touched."

E-mail A.C. Thompson at acthompson@hushmail.com.