Copyright 2006 The Chronicle Publishing Co.
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By CHARLIE GOODYEAR AND CECILIA M. VEGA
The San Francisco Chronicle
As soon as 30 minutes after a large earthquake, terrorist strike or other disaster, San Francisco’s emergency medical operations would “fail catastrophically” and be unable to treat hundreds of severely injured patients.
Hospitals would be forced to turn away the wounded and helicopters carrying casualties would be prevented from landing at any of the city’s hospitals because none has a functioning landing pad.
Those conclusions are contained in a report to be released today by the county civil grand jury, which has been investigating disaster preparedness at the Department of Public Health and the Office of Emergency Services. The report comes a week after a blistering city audit found San Francisco’s Office of Emergency Services lacking in preparing the city for a worst-case scenario.
Supervisor Ross Mirkarimi, who was among several city officials to receive a copy of the grand jury report Thursday, declined to comment on its specifics, citing a legal prohibition on disclosure of grand jury information. But its conclusions, he said, are troubling.
“I think that the grand jury implicates (the Office of Emergency Services) and now other departments as far as disaster preparedness,” Mirkarimi said. “It shows a real need to turn around OES.”
Ahead of the release of the grand jury report, Mayor Gavin Newsom this week issued an executive order aimed at improving emergency medical disaster preparedness in San Francisco.
Among the grand jury’s findings was that San Francisco hospitals repeatedly have diverted patients needing emergency medical care because of a lack of staffing and capacity. The city’s only major trauma center is located at San Francisco General Hospital, but it is not large enough to handle demand during a major emergency.
The report notes a 2003 study that found that out of the 25 largest U.S cities, only San Francisco is served by hospitals with no helicopter landing site. A plan to add a helipad at San Francisco General is still in the initial phases. And while the city has identified 29 contingency landing sites in the event of an emergency, most of them have not been tested.
Many of the city’s hospitals still need seismic retrofitting. A 2001 study, according to the report, found that 62 percent of hospital structures in San Francisco are at risk of collapse in a major earthquake, compared with a statewide rate of 37 percent.
The grand jury recommends that the city’s Office of Emergency Services do a better job including hospitals in planning for a disaster. It also suggests that the Public Health Department hire its own disaster-response official and recommends more realistic emergency drills to test the level of preparedness for the city’s hospitals.
Anne Kronenberg, deputy director for policy and planning at the Public Health Department, said her agency agrees with a majority of the report’s recommendations.
“We thank the civil grand jury for spending all that time, and we will work to incorporate (the recommendations) in our planning effort,” she said Thursday.
But, Kronenberg added, some of the issues pointed out in the report are problems the department has been trying to solve for years.
For more than two decades hospital officials have attempted to get a helipad at San Francisco General, but neighbors have long objected, citing concerns over noise and potential crashes.
“We would love to have a helipad,” she said. “It’s just difficult to do things like that in San Francisco because of neighborhood concerns and worries.”
Kronenberg said that state law requires hospitals to have emergency plans in place. She conceded, however, that it would be difficult to treat a large number of patients in the event of a major catastrophe.
“Would (hospitals) be able to take 5,000 new people? No,” she said. “But that’s the reality of a major event. I’m not saying we couldn’t care for them.”
The city is working closely with hospitals around the region to develop a plan on how people could be treated outside San Francisco in the event of a disaster.
Kronenberg disagreed with the report’s recommendation that the department hire its own disaster-response official.
“That is contrary to state law,” she said, adding that the director of public health, Dr. Mitch Katz, is that person.
Newsom’s executive order issued Tuesday lists 12 items for the Public Health Department, Office of Emergency Services and other city departments to follow “in order to ensure that the health and medical needs in a disaster continue to receive the highest priority in this administration.”
He called for the creation of a multicasualty working group that would identify gaps in current disaster medical response. That group would also address issues of hospital evacuation and develop plans to address evacuation scenarios.
It also requires the Public Health Department to designate a person who would manage the city’s overall emergency medical response in the event of a disaster.
And it requires that the Office of Emergency Services include hospitals and health care providers in the creation of emergency plans and during disaster drills and training.