Estimating mass care resources: the example of the Kumamoto earthquake

I've been trying for over 20 years to estimate the amount of mass care resources that would be required in a disaster. In 2004 when Florida was hit by 4 hurricanes in a 6 week period I had multiple opportunities to try and figure this thing out. One thing I learned pretty quick in the 6 weeks was that when someone wanted me to provide a mass care resource they wanted it RIGHT NOW. Or, preferably, yesterday.

I also learned that in the State Emergency Operations Center during a hurricane response we weren't able to do "right now." For certain things that were already in the State Logistics Staging Area (like bottled water) we might even be able to do "tomorrow." More likely it was going to be day after tomorrow. And if they wanted something that we hadn't already ordered it would be, well, days until they would get it. That is if the requester was lucky and everyone, including me, did everything right.

There was a lot of things that I remembered and a lot of things that I forgot after Charlie, Francis, Ivan and Jeanne paid us all a visit. My big takeaway was that we needed to be able to estimate mass care resource requirements before the damage assessments were completed and in some cases, before the event actually happened.

How in the world are you going to do that? you may ask. Think about it. If a Category 5 Hurricane is lined up on Miami and forecast to hit there tomorrow we don't need to say, "Well, as soon as the damage reports are compiled, probably a few days after the storm hits, we'll know what we need to order. We'll just have to wait until then to figure out what we need."

We have to do better than that.

The things we need to order are always the same: cots, field kitchens, shelter managers, bottled water. What we don't know are what numbers we need to put in the quantity blocks of the requisitions. What frequently happens are conversations like this:

MASS CARE GUY: I need cots.
LOGISTICS GUY: How many?
MASS CARE GUY: I have no idea.
LOGISTICS GUY: "I have no idea" doesn't fit in the quantity block of the requisition.
MASS CARE GUY (MAKES UP A NUMBER): What about 10,000?
LOGISTICS GUY (WHO DOESN'T CARE WHAT THE NUMBER IS BECAUSE YOU'RE JUST ONE MORE PROBLEM BETWEEN HIM AND THE END OF THE DAY): OK.

I've had those conversations during a disaster. More than once, I'm afraid to say. But what could I do? There wasn't a manual or instruction book explaining how to do all this stuff I was doing. I decided that there had to be a better way of doing things than making up the numbers.

After 10 years of talking, explaining and arguing with some knowledgeable mass care people we've come up with a process to estimate mass care resources. The process is crude and needs a lot of refining, but guess what? Doing it this way is better than making it up.

The demand for mass care resources after an event is based on three factors: population, intensity and vulnerability. The population numbers we can get from the Census. To estimate intensity levels we developed this chart:

Table to estimate event intensity.

What we do next is estimate the number of people who were affected by each intensity level. For hurricanes we have the Saffir-Simpson Scale.  The U.S. Geological Service puts out PAGER Alerts after significant earthquakes. The basis for measuring earthquake intensity in these Alerts is the Modified Mercali Intensity Level:

The PAGER system provides fatality and economic loss impact estimates following significant earthquakes worldwide. This information is usually available within hours of the quake and provides an immediate estimate of the number of persons affected.  The USGS put out a PAGER ALERT for the Kumamoto, Japan earthquake that happened several weeks ago. The PAGER looked something like this:

The PAGER showed estimates of the number of persons affected by MMI level. Using the Event Intensity Table I came up with the number of persons affected by High (194k), Medium (1,410k) and Low (2,865k) intensities. I entered these population numbers into the Mass Care Planning Tool spreadsheet that we've developed to estimate mass care resource requirements

Remember: the demand for mass care resources is a function of population, intensity and vulnerability. Using the Intensity Table and the PAGER we were able to estimate the population affected by intensity. From these numbers we need to estimate the % of people who need to be fed and sheltered, for each intensity level. The percentages would vary according to the vulnerability of the people.

In some places, for example, the percentages for sheltering would be 10% for High, 5% for Medium and 1% for low. There are different percentages to estimate the feeding numbers. I had no idea what %'s to use to make a shelter estimate for a Japanese earthquake so I used the 10/5/1 that I had. The estimate using those percentages for the Kumamoto earthquake was 118,550 persons needing shelter (see Table below). Then I waited for the off chance that I might actually be able to get an estimate of the number of persons requiring shelter.

A few days later I read in the Wall Street Journal": “A total of 41 people were confirmed dead in Kumamoto prefecture, the epicenter of a magnitude 6.5 quake on Thursday night and a magnitude 7.3 quake 28 hours later early on Saturday. About 110,000 people were taking refuge at temporary shelters there as of Sunday afternoon, a Kumamoto prefecture spokesman said.”

Weather.com also reported that: “Local media reported that nearly 200,000 homes were without power and an estimated 400,000 households were without running water…[and] 180,000 are without shelter.”

Now that I had some actual numbers of people needing shelter I could see that the estimate of 118k needing shelter was low.  The 10/5/1 shelter percentages that I used weren't high enough, and probably should have been higher.  In other words, their vulnerability to the hazard was greater than I estimated.

As we socialize this estimation process in the mass care community and people start using it in disasters our ability to estimate these vulnerability percentages will improve. The conceptual framework for this estimation process has been included in the new FEMA L418 Course: Mass Care/Emergency Assistance Planning & Operations Course. This concept is also included in the new (soon to be released) Red Cross Feeding Standards & Procedures.

 Like I said, the process is crude and needs a lot of refining. But take my word for it: estimating mass care resource requirements this way is one HECK of a lot better than making up the numbers.

The National Mass Care Strategy Website

One of the (many) cool things about my job at Red Cross National Headquarters is that they gave me my own website to play around in. Technically, the National Mass Care Strategy website is not mine but I’m going to take ownership of it anyway.

When I was the State Mass Care Coordinator in Florida I considered the State ESF #6, Mass Care website to be mine. I wrote or helped to write most of the documents posted there. I got to decide what documents were posted, how they were grouped and I even got to decide the names of the groups under which they were posted. Whenever anyone asked me a technical question I would tell them to go to my website and pull down a particular document in which they would find the answer.

When my friend Beth Boyd was managing the NMCS site at National Headquarters we had a friendly rivalry as to which web site was the BEST mass care web site in the country. Of course, I thought the Florida site was the best and Beth thought the NMCS website was the best. I still think that the Florida site has better content.

But now that I have the National Mass Care Strategy power I’m going to fix that.

When I left the State of Florida I copied all of my working files (6 GB) to the iCloud and this is now a reference library for me and I can share some of that data with the rest of the country. For example, I have all the shelter and meal count data that the state (me) collected from the voluntary agencies during the 2004-05 hurricanes. I did a lot of subsequent analysis of this data and I should be able to make this information available in documents on the NMCS website.

This may take some time because the Red Cross has me working on other projects than the website, but I’ll poke along at it. My first step will be to move all the good content on the Florida site over to the NMCS web. If a lot of this content is Florida specific, well, hey, I’ll work on fixing that, too. I’ll solicit good documents from my friends in the mass care community nationwide.

What kind of documents am I looking for? I believe that people want to see jurisdiction (not agency) feeding plans and shelter plans. The Feeding Template and the Shelter Template are good documents but if you have the task to write a feeding plan for your state (like Colorado just did) you want to look at examples of how other states did it. The same would hold with a shelter plan. And instead of having to dig through state websites looking to see if they even have a shelter plan, it would be better to know that everything available is collected at one central location.

Another thing I will be looking for are good examples of mass care plans at the local or municipal level. A big problem in particular is information geared to local emergency managers focused on the process of transitioning survivors from shelters to appropriate housing. Does anyone have anything written on that? Procedures, plans, after-action, reports? Let me know and we’ll put them up.