California

The storm is not the emergency. The outage is.

What kills people afterwards is the generator. Portable generators cause roughly 100 unintentional carbon monoxide deaths a year in the United States, and they cluster in the days after a storm when the power is out. Carbon monoxide is odourless, and by the time you are confused enough to notice, you are too confused to act. Outside, far from the house, never in a garage with the door open.

The people who die are usually the ones who could not leave.

In the Camp Fire, 85 people died, most within the first twelve hours. Most of them were older residents whose homes burned before anyone could reach them — not people who chose to stay, people who could not get out on their own. The roads out of Paradise gridlocked and some abandoned their cars and ran. The decision that saves you is made before the smoke, not during it.

People drive into it.

More than half of all flood deaths are vehicle-related. It takes twelve inches of moving water to carry off a small car and eighteen to move a larger one. It is almost never a road you do not know — it is the one you have driven a thousand times, where you cannot see how deep it is or whether the road is still there underneath.

The days after are more dangerous than the landfall.

The wind stops, the power stays off, and the generators come out. After Hurricane Ida, Louisiana hospitalised dozens for carbon monoxide poisoning inside the first 48 hours. Cash matters here too — when the grid is down the card readers are down with it, and the store that is open cannot take your money.

Underestimated because of the name.

The rain and the outage do the damage, not the wind — which means the same generator and floodwater failures that follow a hurricane follow this too.

Two things kill, and neither is the cold on its own.

Carbon monoxide, when the heat fails and people bring a generator or a grill inside — generators are the single largest source of non-fire CO deaths. And hypothermia, which claims around 1,300 Americans a year. The house going cold is survivable. What people do about it is what is not.

No warning at all, so everything depends on what you did beforehand.

Where the shoes are. Whether the water heater is strapped. Whether anyone in the household knows the meeting point without being told. There is no decision to make during an earthquake, which is exactly why the ones made before it matter so much.

The illness is not the whole emergency.

In June 2020, 41% of US adults had avoided medical care because of COVID concerns — 12% skipped urgent or emergency care and 31% skipped routine care. The households that struggled were the ones with a prescription, a chronic condition or a caregiving duty and no plan for any of them.