The past four months in Portland have felt like nature doling out warning slaps, demonstrating the fragility of all of our systems.
In the midst of years of far right groups mobilizing and marching in the city,ย months of militant and bold demonstrations against police violence, and after COVID had arrived earlier, our local and national economy teetered, threatening a slide into a broader economic crisis.
Whatโs been made clear locally is that even in a region managed by the progressive and liberal political class structures of power, they are too shortsighted.ย In reality, they are bloated with bureaucrats, or just too inept to actually engage and respond in ways which can confidently be seen to mitigate the multiple crises.
I work in emergency medicine. ย In late March and April we had moments where we could sense our approach to the threshold, where things went from busy and stressful to being overwhelmed by spiraling dysfunction, almost approaching collapse. ย Then the lockdown came, and the numbers receded, enough to be manageable. ย Despite the pandemic, management utilized the economic losses from diminished health care utilization to cut staff, and though patient volumes have returned to typical rates for this time of year, staffing levels have failed to recover.
Driving home from our local trauma center this last Monday during the windstorm, the power was out along the entire three-mile drive.ย The only places that had power or lights were the chain corner stores that pepper the route (apparently they have generators).ย Iย twice watched the sky light up, followed by loud booms as transformers blew out. ย I thought about the sabotage in California some years back, when someone intentionally took down a high-powered transmission line and it almost resulted in a cascading chain of failures across our gridded power system. ย Experts then talked about how a failure in one strategic node could have left swaths of the country without power for months.
Back to Portland, yup, it is bad here. ย Though the initial estimates of 500,000 people evacuated statewide have been significantly revised, now somewhere between tens of thousands and 100,000 have been evacuated or displaced by the fires that this storm ignited.ย In a state of three million, it is a significant number either way.
Two of our dozen or so hospitals in the city had to evacuate two nights ago, which closed down two emergency departments and meant that emergency medical services were overwhelmed with moving patients, as well as attending to emergency calls. ย Meanwhile emergency departments have been overwhelmed with critically ill patients (COVID is a small stream in the background, but not the primary issue).ย When there is smoke, people with both respiratory and non-respiratory chronic conditions tend to get sicker.
We got a call in the emergency department the other night from someone who runs a small home-based care facility. They were being evacuated, and had an emergency evacuation plan, but their emergency plan involved going to a hotel with their patients. That hotel also happened to be in the evacuation zone. They managed to find another hotel (after a lot of frantic phone calls), but one of their patients required a stretcher to be transported. ย Because ambulance services were so overwhelmed with emergencies, they couldnโt get 911 to send a stretcher ambulance to move the patient.ย The last I heard, they were left sitting in a smoky building waiting for their condition to become urgent enough to bump them up the list of priorities.
This is the second period working emergency medicine in the past four months where I’ve feltย we were nearing one of those qualitative tipping points whereby if stresses and demands increased even by small margins, the functions of our medical ‘system’ could begin to decompensateย and unravel.
It will only be known in a month or so what impact this significant population movement and forced concentration of large groups into refugee centers will have on the COVID spread in the state (we were doing relatively well until this week).
And in other news, State and County police and 911 systems, as well as the FBI, have had to send out public messages asserting that Antifa is not roaming the state starting fires, and for people to please stop calling them to report such events.ย The reports and calls are occurring on a scale that is disrupting the provision of emergency services.
Local reporters have been menaced or chased out of areas by armed militia groups who have mobilized to defend against Antifa, even to the point of them setting up armed checkpoints on roads around rural communities. ย Last I heard, local police had convinced those running the checkpoints that they couldn’t legally stop random people and demand IDs.ย They had reached a compromise whereby the vigilantes would videotape and document anyone coming and going through their roadblocks.
We can only hope that the rain will begin to dissipate the fires on the land. ย Its hard to imagine that the outcomes of these compounding crises will calm the fires in the hearts and minds of people on all sides of the political spectrum.