Accessing Acute Care Hospitals in the San Francisco Bay after a Major Hayward Earthquake

Earthquakes can severely disrupt healthcare services for many communities, especially in dense cities. Here, we study the acute care hospital system in San Francisco Bay, California, to identify the most impacted communities after a magnitude 7.25 earthquake on the Hayward Fault. We integrate seismic hazard information with unique granular infrastructure vulnerability and connectivity data for 76 acute care hospitals with 426 buildings and 16,639 beds. We leverage the rich data to formulate a coupled risk-network model that anticipates infrastructure failures and cascading effects affecting healthcare access. We show that the bed capacity within hospital buildings can be reduced to 49%. In East Bay, Alameda County will concentrate most losses, preserving only 19% of capacity. We also found that communities will travel disparately longer to access functioning hospitals, reshaping healthcare access across the entire Bay. The regional travel time will increase by 27%, but at micro-urban scales, increases are way higher and can be above 400% in East Bay. This study demonstrates the urgent need to prepare emergency plans and strengthen the healthcare infrastructure.