VGH and St. Paul’s ERs among many aging Metro hospital buildings found to be at high-risk of collapse or being rendered useless by a strong tremor.
Vancouver’s two largest emergency rooms are at high risk of collapse in an earthquake, along with many other aging hospitals and health care buildings across the Lower Mainland.
New seismic risk assessments show major buildings that house hundreds of patients — including the Vancouver General Hospital’s 12-storey Centennial pavilion (built in 1959), the north building of the Jim Pattison pavilion that houses the VGH emergency department (built in 1978), and the almost 100-year-old St. Paul’s Hospital in downtown Vancouver — are at high risk to collapse or suffer widespread damage in an earthquake.
Major buildings at the UBC Hospital, Richmond General Hospital, Lions Gate Hospital, Burnaby General Hospital, Langley Memorial Hospital, the B.C. Children’s Hospital and the B.C. Women’s Hospital have also been flagged at the highest earthquake risk in the reports.
Many of Metro Vancouver’s hospital and health care buildings were built before 1970, when the province adopted modern seismic building codes.
Consequently, the concrete or masonry structures lack the elasticity and strength to “bend but not fail” with an earthquake’s shocks, and they are more likely to experience failure in the walls and columns that support the floors and ceilings, said Clint Low, a senior partner at Bush, Bohlman & Partners LLP, the structural engineering firm contracted to do the assessments.
“If it’s rated very high, it may not collapse during the earthquake but it’d likely be unsafe to occupy post-earthquake, which is a big issue for a hospital,” said Low. “If you can’t occupy your hospitals, where do people go?”
If emergency rooms were unusable, patients would likely be triaged by medical teams outside, like during the Stanley Cup riots in 2011, said Jeanette Beattie, the Lower Mainland director for Health Emergency Management B.C. There’s a mobile medical unit available.
The B.C. government has spent $2.2 billion to seismically upgrade or replace 214 schools since 2001.
But it has no seismic upgrade program for hospitals, despite their importance as a rallying point for displaced residents and a trauma centre for those injured in an earthquake.
Instead, seismic upgrades are typically done during large hospital redevelopments, or when an old hospital is replaced by a new structure, which is built to the latest earthquake code.
Health Minister Terry Lake said the government is spending all it can afford to upgrade and replace hospitals, which has amounted to more than $10 billion since 2001, and another $2.75 billion over the next three years.
“I think most British Columbians are realistic on this, they understand there’s a risk, and people on the Lower Mainland and Vancouver Island know that better than anybody,” he said in an interview.
“But they also know there’s a reasonableness and a limitation to how many tax dollars you can put to pulling that risk downward.”
The $1.2 billion replacement for St. Paul’s Hospital will be built to modern seismic codes and include a new emergency room. But it isn’t scheduled to open until 2022.
The new seismic assessments have so far only studied one-third of the area’s 208 health buildings, but has concentrated first on some of the oldest sites.
The data so far shows 51 per cent of structural blocks assessed so far inside health care buildings are at high risk. But the figure rises to 63 per cent at hospital sites. (Structural block may refer to an entire buildings or a structurally independent section of a large building.)
The Lower Mainland’s health authorities hired the structural engineering firm to update 15-year-old seismic reports.
“We haven’t (assessed) all of the blocks,” said Paul Becker, the chief facilities operating officer for the authorities’ shared Lower Mainland Facilities Management team. “That’s a funding issue.”
The structural data is being entered into a new earthquake database, which for the first time could give the region’s decision-makers a real-time look at the earthquake readiness of hospitals, as well as the cost to bring old buildings up to modern seismic codes.
The health authorities are this month expected to debate a 10-year earthquake master plan, which would have them spend up to $15 million to finish the seismic assessments, as well as provide more detailed engineering and cost estimates to strengthen specific buildings.
The final plan includes assessing non-structural hazards, like falling medical equipment or fragile utility lines for gas, electricity and water. If those items break, it could leave a hospital unable to operate even if its structure survives the initial tremors.
“There is no discreet line item at the health authority level for seismic (repairs) but that’s what the 10-year plan would do,” said Becker. “We’d say here’s the plan, here’s the funding, and let’s create line items we’d be accountable for.”
Opposition NDP leader John Horgan said the government needs a program and plan in place to ensure hospital safety in an earthquake.
“This strikes me as an area where (government) has been negligent at best, and potentially putting people at risk,” he said. “When a shaker comes, where are we going to take those injured and in distress? You want to take them to your acute care facilities and they too could be in rubble. That should be a major concern.”
Lake said government has spent five times more money on hospitals than schools since 2001, even without a dedicated seismic program for health care buildings.
The government has increasingly wrestled with whether it’s worth spending millions on seismic upgrades to aging hospitals, only to be left with old buildings that don’t meet modern medical needs, aren’t designed to infection-control standards, lack private rooms and are still beset by expensive problems in ventilation, electrical, plumbing and elevator services.
Increasingly, the government has opted to build new hospitals.
“The detailed analysis of risk would have to be put into the equation with the cost of mitigation, versus using those capital dollars towards a new investment,” said Lake.
Lake said numerous new hospital projects are in the works, including replacing the 1940s-era Shaughnessy building at B.C. Women’s hospital, $260-million for redevelopment at Royal Columbian Hospital and two new hospitals on North Vancouver Island. That’s in addition to the $512-million patient tower and emergency department at Surrey Memorial Hospital, which opened in 2013, as well as redevelopment at Abbotsford Regional Hospital.
Horgan called on the government to follow California’s lead. State law requires California hospitals to be structurally upgraded to withstand a strong earthquake by 2020.
“The intention was ultimately that hospitals should withstand an earthquake and remain operational after an earthquake,” said Eric Reslock, an assistant director in California’s Office of Statewide Health Planning and Development.
In addition, California health facilities have until 2030 to ensure their medical equipment and non-structural hazards are safety-proofed to be operational after an earthquake.
California’s laws were created in response to a damaging earthquake in 1971, and then updated after the 1994 Northridge earthquake, which killed 72 people and injured more than 11,000 during magnitude 6.7 tremors.
But the California state government didn’t put any money into paying for the seismic work. Instead, local counties, primarily responsible for buildings, had to fundraise or turn to taxpayers for billions in repairs. The state also has private hospitals that had to find the money themselves.
Currently, 90 per cent of California’s 3,000 acute-care buildings are considered earthquake safe, and the public has access to a seismic inspection database for all acute care facilities.
Lake rejected the California method.
“Our capital plan is very aggressive, so to go beyond what we’re doing, fiscally would be very difficult to sustain,” he said. “You could put in all the laws you want, but where’s the money going to come from?”
B.C.’s answer doesn’t necessarily involve massive funding to earthquake proof all the existing buildings, said Becker, who is leading the charge for the revitalized seismic program in Lower Mainland health authorities.
“We need to be much more clever than that, and not just throw money at the problem but be clever and intelligent and creative on how we mitigate those risks,” he said.
“So you could do a combination of structural and non-structural.”
Auditor General Carol Bellringer said in a report this week the government should do a better job informing the public about the condition of its physical assets, like hospitals, bridges and highways, and the long-term cost to keep them safe and operational.