Report - PEER - University of California, Berkeley

Report - PEER - University of California, Berkeley Report - PEER - University of California, Berkeley

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2. RESILIENCE CONCEPTSResilience for both physical and social systems can be further defined as consisting ofthe following properties:• Robustness: strength, or the ability of elements, systems, and other units ofanalysis to withstand a given level of stress or demand without sufferingdegradation or loss of function;• Redundancy: the extent to which elements, systems, or other units ofanalysis exist that are substitutable, i.e., capable of satisfying functionalrequirements in the event of disruption, degradation, or loss of functionality;• Resourcefulness: the capacity to identify problems, establish priorities, andmobilize resources when conditions exist that threaten to disrupt someelement, system, or other unit of analysis.• Rapidity: the capacity to meet priorities and achieve goals in a timelymanner.As such the vertical and horizontal axes in Figure 1 (left) address the ends ofresilience, namely robustness and rapidity. However, Figure 1 can be expanded in 3-D and 4-D to capture the means of resilience as is illustrated in Figures 1 (right) by athird axis, that added resources can be used to reduce time to recovery. In theory, ifinfinite resources were available, time to recovery would asymptotically approachzero. Practically, even in the presence of enormous financial and labor capabilities,human limitations will dictate a practical minimum time to recovery.3. RESILIENCE OF ACUTE CARE FACILITIESResidents in seismic areas have expressed their strong expectation that acute carefacilities should be available and operational following an earthquake (Nigg 1998).As such, fulfillment of this expectation would significantly contribute to enhancingthe seismic resilience of communities. California has already taken steps in thatdirection by enacting ordinance SB1953 which requires that acute care facilities beretrofitted by 2030 to a levelthat would allow them to beOption 1: Quality of LifeHealthyfully operational followingPopulationBaseline correctedto eliminate effectsof naturalan earthquake.100%population growthDeathsTo quantify the seismicIf no deaths resultingresilience, the quantity to beDLHCCfrom hospital lossesmeasured by the vertical axisof the resilience chart mustfirst be defined.A first option is to quantifyDeaths due to loss inHealth Care CapacityNot dead butunhealthy w/r baselinequality of life as thet ot long term picturepercentage of healthypopulation (Figure 2). UsingFigure 2. Quality of life — measure of performance.163

the total healthy population in absence of an earthquake as a reference basis, andnormalizing it to eliminate the effect of population growth over time, the horizontalline drawn at 100% on the vertical axis represents the healthy population that residesin an area that could be affected by a scenario earthquake. A first drop in populationhealth would occur when individuals are killed by seismically deficient structures.Injuries suffered during the earthquake would account for the remaining reduction inthe healthy population at time t 0 . In the best of scenario, in absence of hospital losses,all these injuries would heal, and no more deaths would be added to the toll.Conversely, deaths due to loss in health care capacity (DLHCC) would occur, i.e.,deaths that could have been prevented if the health care system capability had notbeen reduced by the earthquake. This approach has the advantage that it seeks toquantify the impact of an earthquake on the health of a population, a significantmeasure for the purpose of policy making.A second, alternative, option focuses on relating the seismic resilience offacilities to the number of patients/day that can be provided as a measure of thetreatment capacity of the health care facilities (Figure 3). For example, prior to anearthquake, the impact of SB1953 is shown (Figure 3) as resulting in the loss of somepatients/day capacity, asOption 2: Treatment Capacitysome hospitals areof Total Hospital Infrastructureexpected to close. Patients-daysCollapsed / closedhospitalsFollowing the major loss ofpatients/day capacitydirectly attributed to theearthquake, is the shortburst of recovered patients/day capacity as a consequenceof the “parkinglot”medicine providedoutside of hospitalfacilities. In Figure 3, forconvenience, two distinctand concurrent recovery100%Proportionate to avoideddeaths in collapsed hospitals*Repair of facilitiesEffects of SB-1953(hospital closures)t o * Parking lot palliative interimmeasures until weather inclementor until National Guard leavesRebuildingof capacity(decoupledfor illustrationpurposes only)Could beentirelyabsorbed byoverflow todistanthospitalst long termImportant to not let this temporary measuredistort the long term health measure- Focus on physical facilitiesFigure 3. Hospital capacity — measure ofperformance.activities are illustrated as sequential, namely: repair of capacity and rebuilding ofcapacity.The advantage of this second approach is that it focuses on the physicalinfrastructures and their ability to provide their intended function, which facilitatesengineering quantification. This framework makes it possible for a coordinatedearthquake engineering research effort to contribute in a focused and effective mannerto the broader problem. While the engineering effort and resources needed tocompletely address all issues likely still requires the concerted efforts of multiplegovernment agencies and considerable funding, it is possible for smaller scaleengineering efforts to develop some of the tools and methodologies that could beintegrated into decision support systems. In this respect, these engineering164

2. RESILIENCE CONCEPTSResilience for both physical and social systems can be further defined as consisting <strong>of</strong>the following properties:• Robustness: strength, or the ability <strong>of</strong> elements, systems, and other units <strong>of</strong>analysis to withstand a given level <strong>of</strong> stress or demand without sufferingdegradation or loss <strong>of</strong> function;• Redundancy: the extent to which elements, systems, or other units <strong>of</strong>analysis exist that are substitutable, i.e., capable <strong>of</strong> satisfying functionalrequirements in the event <strong>of</strong> disruption, degradation, or loss <strong>of</strong> functionality;• Resourcefulness: the capacity to identify problems, establish priorities, andmobilize resources when conditions exist that threaten to disrupt someelement, system, or other unit <strong>of</strong> analysis.• Rapidity: the capacity to meet priorities and achieve goals in a timelymanner.As such the vertical and horizontal axes in Figure 1 (left) address the ends <strong>of</strong>resilience, namely robustness and rapidity. However, Figure 1 can be expanded in 3-D and 4-D to capture the means <strong>of</strong> resilience as is illustrated in Figures 1 (right) by athird axis, that added resources can be used to reduce time to recovery. In theory, ifinfinite resources were available, time to recovery would asymptotically approachzero. Practically, even in the presence <strong>of</strong> enormous financial and labor capabilities,human limitations will dictate a practical minimum time to recovery.3. RESILIENCE OF ACUTE CARE FACILITIESResidents in seismic areas have expressed their strong expectation that acute carefacilities should be available and operational following an earthquake (Nigg 1998).As such, fulfillment <strong>of</strong> this expectation would significantly contribute to enhancingthe seismic resilience <strong>of</strong> communities. <strong>California</strong> has already taken steps in thatdirection by enacting ordinance SB1953 which requires that acute care facilities beretr<strong>of</strong>itted by 2030 to a levelthat would allow them to beOption 1: Quality <strong>of</strong> LifeHealthyfully operational followingPopulationBaseline correctedto eliminate effects<strong>of</strong> naturalan earthquake.100%population growthDeathsTo quantify the seismicIf no deaths resultingresilience, the quantity to beDLHCCfrom hospital lossesmeasured by the vertical axis<strong>of</strong> the resilience chart mustfirst be defined.A first option is to quantifyDeaths due to loss inHealth Care CapacityNot dead butunhealthy w/r baselinequality <strong>of</strong> life as thet ot long term picturepercentage <strong>of</strong> healthypopulation (Figure 2). UsingFigure 2. Quality <strong>of</strong> life — measure <strong>of</strong> performance.163

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