HOW MANY WARNINGS DO CALIFORNIA HOSPITALS NEED?

CALIFORNIA FOCUS
FOR RELEASE: TUESDAY, FEBRUARY 9, 2010, OR THEREAFTER

BY THOMAS D. ELIAS
“HOW MANY WARNINGS DO CALIFORNIA HOSPITALS NEED?”

First came the massive 7.8 earthquake that hit China’s Sichuan province in the spring of 2008. That one flattened buildings in cities as much as 250 miles from its epicenter, including damage in major cities like Chengdu and Chongching (the former Chunking).

Schools took some of the heaviest damage there, and so a disproportionate number of the 100,000-plus dead were children.

There was no big response to all this here in always earthquake prone California. Maybe that’s partly because schools are not the most vulnerable buildings in this state, chiefly because of the Field Act, passed in 1933 after a disastrous quake hit Long Beach. Most schools have been retrofitted to withstand temblors measuring 7.0 or more on the Richter scale and new school construction has had to meet high seismic standards. Schools did not suffer much in either the 1989 Loma Prieta earthquake or the 1994 Northridge shock.

But hospitals are another matter. Anyone who saw the now-defunct Granada Hills Community Hospital the morning after the Northridge quake and watched both ends of the building sag while patients were wheeled out as quickly as possible on beds and gurneys knows how deficient it was. Fully 16 years later, Granada Hills still has a lot of company among California hospitals.

That should not be the case, and now the utterly disastrous 7.0 Haiti earthquake with its estimated 200,000-plus dead (the majority crushed in pancaked buildings) demonstrates yet again why retrofitting California hospitals ought to become a far higher priority than anyone has made it. How can this state ignore the pictures of makeshift trauma centers set up in tents and groves of trees outside the ruins of Haiti’s few major hospitals? How can we downplay the scenes of American doctors performing amputations with ordinary hacksaws in the first post-quake days because sophisticated equipment those hospitals once possessed lies beneath tons of rubble?

But that’s what we’re doing, as California once again appears heedless of what looks like an explicit warning.

Two years after the 1971 Sylmar earthquake caused the collapse of the Olive View Hospital in the San Fernando Valley suburbs of Los Angeles, legislators got around to passing the Alfred E. Alquist Hospital Facilities Seismic Safety Act, which mandates strong standards for new hospital buildings.

The Northridge quake demonstrated graphically that law provided insufficient protection for the thousands of patients who lie in hospitals at any given time. After that temblor showed the inadequacy of California’s codes, lawmakers passed a follow-up to the Alquist act known as SB 1953. It demanded that any hospital not retrofitted by 2008 – two years ago – and posing any risk of collapse or significant loss of life during an earthquake could only be used for non-acute care. The idea was that non-acute patients may be more mobile than those getting urgent treatment and presumably can more readily escape a collapsing building.

But most affected hospitals now operate under five-year extensions of the deadline and complain they don’t have enough money to retrofit. A 2007 report from the Oakland-based California HealthCare Foundation and the Rand Corp. think tank in Santa Monica found almost half the state’s hospitals not in compliance. There has been only small improvement since.

Meanwhile, the U.S. Geological Survey estimates an 80 percent to 90 percent likelihood of a 7.0 earthquake in Southern California and a 62 percent chance of a similar-size one in Northern California before 2030. A 7.0 temblor like the one that hit Haiti would pack about double the power of the Northridge quake and roughly three times the energy of Loma Prieta, which knocked down buildings, freeways and bridges as far as 40 miles from its epicenter near Aptos.

Many hospitals lack both the money and the will to comply with the law, which says there can be no more extensions for them after 2030. But odds are good even 2030 will be too late to save lives. It’s gross negligence for this situation to continue.

Yet voters and politicians have not acted. They passed a high speed rail bond in 2008, essentially okaying $9.95 billion for what amounts to a luxury item, while hospital safety is as basic as anything can be and far more urgently needed.

If legislators don’t place something on the ballot soon enabling hospitals to finance somehow their needed retrofits, and if voters don’t pass it, lives will be surely lost. Chances are it won’t be as many as in Haiti or China, but still plenty.

The lessons of Sichuan and Port-au-Prince ought to be crystal clear: Wake up soon, California, or a lot of people will be killed or injured. It’s as simple as that.

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Email Thomas Elias at tdelias@aol.com. His book, "The Burzynski Breakthrough," is now available in a soft cover fourth edition. For more Elias columns, visit www.californiafocus.net