Wildfire and Smoke: Sharp HealthCare’s Fire Plans

This member-only article appears in the February issue of Patient Safety Monitor Journal.

Last November, the innocently named Camp Fire killed over 80 people in California, making it the deadliest wildfire in the state’s history. The fire destroyed 10,500 homes, filled the air with smoke for miles around, and burned an area the size of Chicago. The fire was just one of 6,228 that took place in California last year.

Nationwide, wildfires burned 8.5 million acres of land in 2018. For scale, that’s as if all of Maryland, Delaware, and Rhode Island burned down with an extra 300,000 acres left over to burn down a few cities of your choice.

While the destruction last year was high, it wasn’t abnormal. As climate change raises temperatures and brings more droughts and dry weather, experts say wildfires will become even more frequent and dangerous. This growing danger will require even more vigilance on the part of providers and hospitals, particularly in high-risk states like California, Colorado, Idaho, Montana, Oregon, Washington, and Wyoming.

San Diego County has been spared from this year’s fires, says Sharon Carlson, RN, director of emergency preparedness at Sharp HealthCare. But that’s not to say the health system has had no experience dealing with them. PSMJ spoke with Carlson about lessons learned from their previous brushes with wildfires, and how Sharp is preparing for the next one.

In 2007, San Diego County had a huge wildfire that forced several hospitals, nursing homes, and behavioral health hospitals to evacuate. Sharp HealthCare was one of the hospital systems to take in some of those patients. And the area suffered from a devastating wildfire in 2003, known as the Cedar Fire. During those times, Carlson says the largest problem wasn’t the fire or evacuation. It was smoke.

“Smoke gets into your hospital, and you have to work with your engineering department and air handlers to make sure the filters are changed and the environment is safe for people to breathe,” she says. “I think that is some of the stuff that Northern California is dealing with right now [in 2018]. The communities that are devastated by the wildfires are now surrounded by smoke. So they’re dealing with increased asthma and [other respiratory problems].”

Her facilities are better protected from flame damage because they all sit in a very metropolitan area, she says. The buildings that surround them act as a buffer, and many are made from fireproof materials. However, it’s different for wooded, rural counties.

“In Paradise, California [location of the Camp Fire] … it was surrounding them and burning right through to their hospital because it’s not a big city,” she says. “Our risk for that happening is less than theirs—not that it can’t happen.”

Wildfire prep no different
What facilities need to remember, says Carlson, is that basic preparedness doesn’t differ between urban and rural systems—not even for wildfires. You do a Hazard Vulnerability Analysis (HVA) to identify your risk factors, then rank those risks based on geography and location.

“We know in San Diego, wildfire and earthquake are always at the top [of risk factors].” she says. “We live in a state where there’s earthquakes and where, it feels like, wildfires are becoming an everyday occurrence.”

That said, she points out that their risk of actually being overrun with fire is lower than an area like Paradise or Northern California that’s home to smaller, rural communities with a lot more brush, shrubs, and trees.

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