CrisisReady researchers probe health risks from California wildfire season

With $1 million Google.org grant, Direct Relief and Harvard University coordinate researchers, public sector and safety net professionals to improve response in communities hit by natural disasters

As California begins wildfire season with some of the driest conditions on record, researchers across the U.S. are extending a collaboration that began last year to fight the spread of Covid-19, using population mobility and social vulnerability data tools to help public health and safety net organizations prepare for and respond to wildfires. CrisisReady is funded in part by a $1 million grant from Google.org.

CrisisReady participants have been analyzing and sharing data to identify communities most vulnerable to health risks from the massive wildfires that have burned large parts of California in each of the last several years. In addition to the direct risk to life and property, these risks include lost power to life-sustaining medical equipment; lost access to medicine and medical services; smoke inhalation hazards; heightened disease transmission risk in temporary shelters; and psychological impacts of displaced and disrupted lives.

CrisisReady is a collaborative project between Direct Relief and researchers at Harvard School of Public Health, Harvard Medical School, Stanford University, and a network of researchers in epidemiology, public health and disasters. The collaboration evolved from the Covid-19 Mobility Data Network, a volunteer research network of 100+ scientists from around the world that formed in early 2020 to collect and analyze population movement data, helping local and national governments reduce Covid-19 transmission through social distancing policies.

Nearly 95% of California is currently in severe drought, according to the National Integrated Drought Information System. “The fuel is there for serious events that can have enormous adverse consequences,” said Andrew Schroeder, Vice President of Research and Analysis at Direct Relief.

While wildfire is a natural part of the California landscape, the massive wildfires of recent years have brought new threats to public safety, including more frequent and more severe fire-related electrical power outages, and the increasingly frequent encroachment of wildfires into heavily populated urban and suburban areas. Within a few weeks in October 2019, the Saddleridge Fire came within five miles of more than 200,000 households, while the Getty Fire came within five miles of 190,000 homes, said Mathew Kiang, an instructor in the Department of Epidemiology and Population Health at Stanford University School of Medicine.

Power outages, including intentional Public Safety Power Shutoffs (PSPS) to reduce the risk of wildfires caused by downed power lines, have become far more common in California. In 2019 there were nearly 1,100 power outages of at least eight hours, covering over 111 million household-days across 56 of the state’s 58 counties, and 149 24-hour power outages across 45 counties accounting for 8 million household days, Kiang said. Potentially deadly risks from power outages include carbon monoxide poisoning, gastrointestinal illness, heart attack, injury, mental health impacts, renal disease and temperature-related illness. The neighboring Riverside, Orange and San Bernardino Counties in Southern California all have large numbers of households relying on durable medical equipment and have experienced frequent, long power outages, Kiang said.

Researchers with CrisisReady are also looking at how smoke and particulate matter generated by these massive wildfires has affected the health of the people nearby and downwind of the fires. Other research directions include incorporating hospitalization and mobility data to better understand where people go during fires or immediately after fires, their medical needs, and a better accounting of resources including shelters, hospitals and long-term care facilities.

CrisisReady is building open source, web-based tools to help communities meet surges in demand for health resources. Named the “Health System Resilience Mapper,” the tools will help communities, response agencies, healthcare systems, and aid agencies optimize their health care service capabilities in preparation for increased demand during and after natural disasters.

Disasters often simultaneously cause an immediate spike in demand for urgent health services and a reduction in existing capacity to provide those services. For example, a fire that causes injuries and also damages the area hospital requires alternatives to be identified for both fire victims and persons who were relying on care at that facility. Similarly, when a disaster or potential disaster prompts mass evacuations from one area, the areas to which evacuees flee can experience immediate surges in demand for health services that evacuees bring with them.

To date, no U.S. health care system can predict the demand for these services after a disaster. Data on health care utilization, environmental threats and population mobility exists in silos across many institutions, but CrisisReady’s Health System Resilience Mapper will combine, for the first time, these data streams to provide real-time actionable information for decision-makers working to protect populations affected by disasters.

“The escalating number and scale of wildfires is putting disproportionate pressure on the most vulnerable communities in California,” Schroeder said. “In order to build health systems that adapt equitably and respond effectively to those pressures, it is vital to have much better data before events happen.”

The Health System Resilience Mapper will let public health agencies run simulations to anticipate demand surges for healthcare when a fire breaks, as well as provide real-time decision support tools that help predict the level of the humanitarian aid needed in a specific region after a crisis has hit.

“Interdisciplinary, cross-sector teams can greatly improve disaster response by bringing together different kinds of data and building the tools we need to support health systems in advance of a crisis,” said Harvard’s co-leads for CrisisReady, Caroline Buckee, Associate Professor of Epidemiology at the Harvard T.H. Chan School of Public Health, and Satchit Balsari, Assistant Professor of Emergency Medicine at Harvard Medical School. “The data we need to more effectively help disaster-affected communities exist already, but they need to be in the right place at the right time—and they need to be analyzed appropriately—to support decision makers during a crisis.”

“As a long-time California resident, I’ve seen the increasingly devastating effects of wildfires, first-hand: countless homes and neighborhoods destroyed, small businesses forced to close their doors and irreversible damage to our environment,” said Jacquelline Fuller, President of Google.org. “But what we often don’t see are the secondary effects these natural disasters have on the lives of thousands of people with complex medical care needs who face the risk of infrastructure disruption, interrupted care, and forced displacement. As wildfires continue to grow in intensity and severity throughout the U.S., particularly in California, Google.org’s grant will help enable the critical work Direct Relief and Harvard University are doing to help communities better prepare, protect, and serve those in need the next time our home state is faced with a disaster.”