Shortly after a massive twister struck his city in May 2011, Joplin, Missouri, resident Brandon McCoy described what he saw during what turned out to be one of the worst tornadoes in U.S. history.
“Standing on the sixth floor, I was trying to help a woman out of some debris, and you look outside and, just, everything’s gone,” he told NPR at the time. “Everything. And nobody knew what happened.”
The tornado left a wide swath of destruction in its wake. One hundred fifty-eight people died. Property damage was catastrophic.
One of the structures that took a direct hit was St. John’s Regional Medical Center in Joplin.
“It was just unbelievable. I mean, just the devastation and the damage to the hospital,” says John Farnen, executive director of planning, design and construction at Mercy, the hospital’s parent company based in St. Louis. “What you saw on television just couldn’t do justice to when you saw it for real.”
Farnen says that, in the weeks after the disaster, architects and engineers studied the ruins of the hospital, with its blown-out windows, torn-up roof and crushed generator, and took what they learned to the drawing board.
Withstanding natural disaster
Nearly four years later, Norman Morgan, of HKS Inc., an architecture firm headquartered in Dallas, shows off the distinctive features of Joplin’s new hospital. It’s covered in concrete and brick paneling, and many of the windows are built to hold up in 250-mile-per-hour winds.
Visible outside is the roof of an underground bunker, where generators and boilers are housed out of danger’s reach.
If another natural disaster strikes Joplin, the reinforcements should help the hospital stay open – and not just for emergency medical care. During disasters, hospitals frequently serve “… to also provide essential community services as the most resistant or significant buildings in communities,” says Robin Guenther, a principal with Perkins+Will, an architecture firm headquartered in Atlanta.
Guenther co-authored a recent report for the Department of Health and Human Services on how hospitals can better withstand natural disasters. Many hospitals, she says, may need to be rebuilt from scratch, particularly on the coasts, where flooding poses a risk.
“Those hospitals actually need to be built upside down, meaning all of their key equipment needs to actually be on the roof,” she says.
The full-on storm hardening done at Joplin added about 2.5 percent to the total construction costs, or about $12 million. But Guenther says the job can be done for 1 percent of construction costs or even less in areas less prone to storms.
Even so, prevention is a tough sell.
“We increase the level of strength of a building wall or roof based on a disaster that causes damage, not before it happens,” she says.
Against the odds
And judged strictly by the odds, there’s reason to be skeptical about the actual danger posed by a tornado, even for hospitals in the heart of tornado country.
“If we look at the probability of any particular structure getting hit, the most likely for, say, an F2 and greater tornado – the kind of thing that’ll take the roof off of a house – is about once every 4,000 years, and that’s somewhere in southern Oklahoma,” says Harold Brooks, a meteorologist with the National Severe Storm Laboratory in Norman, Oklahoma.
Brooks says there’s no evidence to indicate severe tornadoes are on the rise due to climate change. In fact, some studies show they may be decreasing. But climate change could be contributing to another trend he’s observed: rather than occurring one at a time, tornadoes are now happening more often in different places at the same time.
“Overall, if we look at an average of, say, 10 years, the number of tornadoes and the locations appear to be just about the same as they would be any of the 10-year periods we look at, but the days would look different,” he says. “You’d get to that same number of tornadoes by having a small number of very big days and not very many small days.”
But after seeing tornados destroy hospitals in Joplin, Greensburg, Kansas, and Moore, Oklahoma, hospitals in Kansas don’t need convincing about the dangers, even if the odds they’ll be affected are slim.
“Having grown up in Kansas, I think we’ve all learned to respect the power of tornadoes, and I don’t think there’s any skepticism that it couldn’t happen to any of us,” says Ron Marshall, who coordinates hospital preparedness for the Kansas Hospital Association.
At St. Francis Health in Topeka, for example, the focus is on improving preparation strategies: creating safe command rooms, and improving coordination and evacuation plans.
Instead of new buildings, storm-hardening will more likely happen as old hospitals are replaced. Moore Medical Center, which is currently under construction in Moore, draws from reinforcements and designs inspired by the new Joplin building.
“We’d all love to go out and build a new tornado-safe hospital, but in today’s reality of economics and health care, that’s unfortunately not really an option,” Marshall says.
Alex Smith is a reporter for KCUR, a partner in the Heartland Health Monitor team.