Despite hazardous conditions in the days before the Camp Fire became a conflagration, Pacific Gas and Electric company elected not to take advantage of one of the most aggressive and effective tools in its wildfire prevention arsenal: De-energization, also known as a public safety power shutoff (PSPS).

According to California’s Public Utilities Commission, in 2015, the last year for which data are available, utility lines accounted for just 8 percent of fires, but they burned 150,000 acres, more than all other causes combined. Many of the state’s lethal fires have been attributed to power equipment. Utilities may opt to de-energize their lines when a lethal combination of weather factors converge: It’s hot, dry, and extremely windy.

While utilities determine when to make the call in different ways, the National Weather Service red flag warning of increased fire risk is often a factor. More than 50 percent of Northern California alone is at “elevated” or “extreme” fire risk, putting hundreds of thousands of residents in the danger zone. California’s Public Utilities Commission is deep in the heart of rulemaking around the relatively new approach to wildfire prevention as the state also explores options like burying utility lines and more aggressive vegetation management for preventing utility-associated wildfires.

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But de-energization comes at a cost. When it occurs, customers can be without power for hours or days. Utilities are supposed to provide advance notice, but some customers say that’s not happening. Instead, they complain recent Pacific Gas and Electric and Southern California Edison shutoffs have occurred with insufficient notice and been accompanied with outdated, confusing information on estimated time of power restoration, including lags in translating outage information.

This is a particular concern for customers who are electricity-dependent. In any given outage block, there may be hundreds or thousands of customers who registered with the utility to indicate they rely on medical equipment to stay healthy, and, in some cases, to stay alive.

Known as “medical baseline customers,” they may require ventilators and similar life support equipment, while others have conditions that can become uncomfortable or dangerous without medical equipment and cooling systems, or have medications that must be refrigerated. In recognition of their increased energy needs, utilities provide them with an extra allotment of energy at the base pricing tier. Other customers may have similar electricity needs despite not being enrolled in the medical baseline program, for a variety of reasons.

Utilities are supposed to be proactive about providing early and frequent notice to medical baseline customers to ensure they’re aware of the possibility of an outage. Kari Gardner, Southern California Edison’s Senior Manager of Consumer Affairs, explained that Edison, like PG&E and other utilities, has a multi-step warning process including a two-day warning that an area is being monitored, a one-day notice, and, ideally, one to four hours of notice before an area is de-energized, though rapidly-changing weather conditions can make this challenging. The utility, she said, is always working on better ways to reach customers, with a particular focus on medical baseline customers; the utility sends out door knockers for notification if they can’t get through on the phone, for example.

Jill Jones, who lives in Sonoma County near the site of 2017’s infamous Tubbs Fire, an area primarily served by Pacific Gas and Electric, is not a medical baseline customer but does have a condition called hereditary angioedema type III, which causes sudden intense swelling, including of her airways. She needs air conditioning and a low-stress life to reduce the risk of swelling episodes, and she also relies on a very expensive medication that must be refrigerated. “As soon as the air conditioner stops, the clock… when I will have an attack starts ticking fast,” she said.

Her condition was foremost on her mind when warnings of a possible shutdown started swirling in late September. Jones tried to track information about de-energization events through the PG&E website as well as social media. “They did not respond to my pleadings for them to consistently post updates. Their website and its map were either not updated and had info only from the day or two previous,” she said, noting the utility’s social media was slightly more current, but that not everyone could access it. She turned into an information conduit for those with limited computer literacy struggling for access to current information.

Lack of clarity led her to pack up and leave to stay with family outside the threatened zone, fearing that her power might be cut. “I have had to set up an emergency ‘go bag’ with a plan and network of family ready to house and come get me should we experience a Public Safety Power Shutoff. We have had to set up my parents’ RV to be ready to both run AC and safely house my medications should we lose power,” she said.

This issue isn’t just access to accurate and current information in multiple common languages about the possibility and status of a de-energization, though. The state’s information site, with language borrowed by the utilities, includes planning that is not necessarily practical or accessible for all medical baseline customers or others who rely on electricity for survival. Planning ahead for customers with medical needs is expensive, and disabled people are at a much higher risk of poverty — 26.8 percent compared to 10.3 percent for nondisabled people. In rural areas like those prone to shutoffs due to worries about vegetation on utility lines, that risk is even more extreme.

Recommendations include suggestions to buy generators or backup batteries, which are costly, and not always safe or practical in apartments and some rental single-family homes. Customers are also advised to “stay with a friend,” for those who can travel and have friends with accessible homes outside the range of the de-energization. The utilities operate respite centers with power and cooling, but they’re only open during the day.

This is something Gardner says utilities recognize when making the call for a PSPS and developing resources for medical baseline customers who may be caught up in fire prevention efforts. Utilities and the state are both working on programs to increase the affordability and practicality of emergency planning. One of the new bills Newsom signed encourages utilities to provide more support; tools such as microgrids and backup batteries can help electricity-dependent customers and their larger communities.

“What needs to happen is a genuine consideration of the risks of keeping the system on versus the risks of shutting it off,” said Melissa Kasnitz, a disability rights attorney with the Center for Accessible Technology. “Right now, utilities are only focused on one side of that equation.”

Kasnitz noted that while ventilator users and others with devices that require electricity may come to mind, there are other implications for medical baseline customers. For example, like Jones, diabetics need to keep medication in the fridge. In a country where one in four diabetics reports rationing insulin due to cost, losing a supply could be devastating.

Similarly, people relying on the Supplemental Nutrition Assistance Program could lose all their food in an outage, with no budget for buying more — and the utility isn’t liable for that loss. And, said Kasnitz, people who work low-wage jobs who miss work because their employers can’t open might have to reshuffle their finances, putting prescription medication behind food or other needs.

Those customers might not necessarily be registered as medical baseline customers, highlighting the ripple effect of these outages, though she is swift to note that wildfires are also tremendously disruptive and sometimes fatal.

The debate over de-energization pits competing public health interests against each other, and it also has stakes far beyond California’s borders. Utilities in other states may begin to consider de-energization as an option in dangerous wildfire conditions with climate change increasing hot, dry weather. Disability advocates hope that consideration includes better planning for electricity-dependent customers with limited means as California learns how to navigate its new landscape. That’s something Gardener says is on Edison’s mind: “I want our most vulnerable customers to know that we do recognize that there’s additional risks when outages occur.”

That storm was one of a record 1,263 tornadoes in the U.S. tracked by the National Weather Service in the first half of 2019. Many of those storms have been concentrated in the Southeastern part of the country, in a region dubbed “Dixie Alley.”

Tornadoes in the South can be particularly deadly because there’s a relatively high percentage of the population there living in mobile homes — and most of those homes are spread out in rural areas, meaning lots of people with few options to escape the path of powerful tornadoes.

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Alabama and the Carolinas are consistently among the top five states with the most residents living in mobile homes — as well as in modular or manufactured housing, which is intended to be in a fixed location, but is similarly dangerous in severe storms. According to the Manufactured Housing Institute, residents of manufactured housing have a median household income of just under $30,000 per year.

Protecting these low-income, far-flung populations with limited resources from major storms isn’t easy. That made them a subject of particular interest to researchers involved in a recent University of Maryland study examining mobile homes.

The first challenge people face is receiving critical information in time to allow them to take action. The researchers found standard tornado warnings are falling short in protecting residents. In particular, mobile home residents were less accessible on social media and more dependent on their local TV meteorologist.

Researchers also found the majority of mobile home residents had incorrect assumptions about what they should do during a storm, with many believing myths and misconceptions that could be dangerous like “if you’re driving, you should take shelter under a bridge during a tornado.”

The researchers recommended that National Weather Service Weather Forecast Offices should work more closely with local newscasters to address this information gap. Similarly, forecasters could prioritize actions that mobile home residents can take to deal with limited physical supplies and inadequate shelter.

But educational campaigns can’t solve the problem completely, because residents (and the communities where they live) face significant planning challenges due to lack of resources and available services.

“Mobile home residents in our study reported statistically significantly lower perceived access to shelter and self-efficacy to take shelter compared to fixed home residents,” the researchers noted. Developing emergency evacuation plans is challenging in areas where many residents may lack reliable vehicles or other resources, or may be reluctant to leave their homes and belongings unattended for what may turn out to be a false alarm. It’s also hard to assemble an emergency kit when you can’t afford things like weather radios, hand tools, back-up batteries and chargers, or extra quantities of medications — let alone bigger items like generators.

Kelley said that in rural areas like his, residents often lack the time — and sometimes the transportation or ability — to get to a community shelter, even if they know where one is. “I wish every rural home had to have a storm shelter of some sort. We had four and a half minutes warning with this storm,” he said.

“It’s great to have community shelters available, but if people don’t have transportation to get there, or wait till they have confirmation of an approaching tornado before they move, the shelters are not effective,” said David Roueche, an assistant professor of structural engineering at Auburn University — located in Lee County. He specializes in researching wind damage and ways to make structures better protected from high winds.

He led a team that analyzed the impact of the March 3 storm, and specifically looked at the 19 out of 23 victims who lived in manufactured homes. Their investigation revealed that all of the manufactured homes involved either had degraded anchors, had anchorage systems that apparently didn’t meet state code, or lacked ground anchors entirely. Anchors are devices – generally made of metal, sometimes coupled with concrete – that are used in conjunction with straps or tie-downs to secure the structure to the ground.

“We know it’s a problem. What can these people do? We can enforce stricter building standards to give people a much better chance of survival in their home. We can install micro-community storm shelters — as in, smaller shelters that serve a street, or a cluster of relatives — but this all takes money that the residents don’t have. So how do we prioritize the limited pre-event mitigation funding from FEMA or other groups? What other funding mechanisms can we use? These are the questions we’re asking right now,” he said.

While progress has admittedly been slow, Roueche said he is encouraged by results seen in communities such as Moore, Oklahoma, which adopted enhanced building codes to strengthen their homes, with minimal impact on home prices. He is also a proponent of storm-vulnerable inland areas adopting the same Department of Housing and Urban Development building standards recommended in Florida and coastal regions, since climate change and unusual weather patterns have increased the incidence of extreme storms in a wider range of locations.

With nowhere else to go, Kelley said his family has no choice but to stay in their home while it is being repaired. “It is coming along slow but steady,” he said. He created a memorial area on a section of his property, where he will plant 23 fruit trees — one for each of the lives lost in the storm. The memorial also has a pond and chairs where people can come and remember the victims or just enjoy some peaceful solitude.

Kelley said he hopes it will provide some comfort to local residents.