Okay, I think we'll get started. Good afternoon, everybody, and welcome to this special Gilbert White lecture here at the National Academy of Sciences. I'm Carol Hardin, I chair the Geographical Sciences Committee at the Academies and we are the ones who sponsored this lecture and it's just my great pleasure to welcome you and it was even my great pleasure to carry some extra chairs in. What a delightful thing to have to do. This lecture series is named for and honors the memory of Gilbert White, who is a geographer, a leader in natural hazards research, and a member of the National Academy of Sciences. Gilbert White held a variety of positions in academia and in government, too. He was a celebrated leader in the academic world and a very influential leader in national and international efforts to improve the response of governments to hazardous natural events, and especially those involving flooding. He served in various capacities here in Washington, D.C. for eight years during the Roosevelt administration. He served on the Mississippi Valley Commission on the National Resources Commission and he worked for the Bureau of the Budget, too. He's been called the father of floodplain management in the United States. In the last five years of his life, which were 2001 to 2006, he served as a member of the FEMA Steering Committee for Evaluation of the National Flood Program. I was lucky to know him when I was a graduate student in geography at the University of Colorado and he was on the faculty there, so it's a very special privilege for me to be able to introduce to you this year's Gilbert White speaker, who is Dr. Don Wright. Dr. Wright is chief scientist at Environmental Systems Research Institute, better known to many of you as Esri, based in Redlands, California. Before joining Esri, she was on the faculty in the College of Earth, Ocean and Atmospheric Sciences at Oregon State University. She, and she retains a courtesy appointment there as a full professor. Her PhD from the University of California at Santa Barbara was an interdisciplinary degree in physical geography and marine geology, and her research has combined the power of geographic information systems and spatial analysis with exploration and mapping of the relatively unknown world of the ocean floor. She has literally deep experience with the world's oceans and ocean floors. Before she joined the faculty at Oregon State in 1995, she had worked as a marine technician for the International Ocean Drilling Program and participated in numerous expeditions of the research vessel, the Joides Resolution, which took her to, and I'll name some places, probably not all of them at all, the Indian Ocean, the South Pacific, the Japan Sea, the Philippines Sea, the Northwest Pacific, Waddell Sea, and Antarctica, and the Mid-Atlantic Ridge. And if that doesn't sound sufficiently adventurous, she participated in investigations of hydrothermal vent fields of the Wanda Fuku Ridge, that is off the coast of Oregon, in the Alvin submersible, a small capsule that lowers two scientists to study various aspects of the ocean floor. She has the distinction of having been the first African-American woman to dive to the ocean floor in the Alvin, and she did so not once, but three different times. Her research has garnered recognition from many quarters to mention just a few of these. She's a fellow of the American Association for the Advancement of Science, of the California Academy of Sciences, of the Explorers Club, of the Geological Society of America, and she's an Aldo Leopold Fellow. She received the Presidential Achievement Award of the American Association of Geographers. She's a Fulbright scholar, and she was the recipient of a career award for early career faculty from the National Science Foundation. Throughout her career, she's reached out to share her knowledge and experiences with others, especially the younger generation. She's active on Twitter. You'll find her at Don Wright at Deepsea Don. She received the Distinguished Teaching Honors Award of the American Association of Geographers, the Higher Education Distinguished Teacher Award of the National Council on Geographic Education, and she was named an Oregon Professor of the Year. Her service to the profession and to the country is exceptional. Among other commitments, she serves on the Science Advisory Board of the National Oceanic and Atmospheric Administration, the Science Advisory Council of Conservation International and the Ocean Studies Board of the National Academies of Science. There's far more to be said about Don Wright and her accomplishments, but we came to hear from her. So I encourage you to look at her website and to read her CV, which is inspirational as well as fun. The title of her talk today is A Turn to the Territories, Featuring a Cautionary Tale of the 2009 American Samoa Tsunami. And please help me welcome Don Wright. Okay. Thank you very much, Carol. It's such a pleasure to be here, especially in the presence of so many students. What happened? Are final exams over? Or what's gone to you guys supposed to be studying? Or maybe this is extra credit. So it's really a great pleasure and honor to be here. The prior Gilbert White lecturers have all been mentors of mine. Carol Hardin has been a mentor of mine and someone I've admired for so long. So, and I've never had the chance to meet Gilbert White. I've heard so many stories about him and as you students probably have heard the great stories about Gilbert White, hopefully we can carry on his legacy. I wanted to give this lecture to honor his legacy of field work and his legacy of place-based case studies in far-flung parts of the world as well as the United States. Gilbert White has done so much to teach us about water, the importance of water as a right to every human being, the dangers and hazards of water. And so that's what I had in mind when I put together this presentation. And now I'm greatly relieved because I saw the PowerPoint death sign a few minutes ago and I thought, well, let's see what I can think up without slides. But we've got the slides. So now in terms of advancing the slides, is there, okay, there's a nice little device here. So let's give this a go. So this is about the territories of the United States. Territories for me are very close to my heart because I came from a territory and most of you probably come from territories whether you realize it or not because most of the states of the United States were territories before they became states outside of the 13 colonies. I'm from the Hawaiian Islands and so as we know Hawaii and Alaska were territories before they became states in 1959. And in 1959, that was a big year because I believe Oklahoma, Arizona and New Mexico were entered into the union during that year as well. Two years later, I was born and so was Barack Obama. We share the same birth date. And so that was quite a year. I believe four years later Gilbert White returned to the University of Chicago to assume the chairmanship of the Department of Geography at the University of Chicago. We don't often think of our current U.S. territories. Now I know we've heard a lot about the travails of Puerto Rico in the wake of Hurricane Maria. And let me see if I can get this to work. So Puerto Rico is here. We have geographers here so I won't belabor the locations of these places. But Puerto Rico is one of five territories that are populated. There are 11 other territories. They're mainly island chains or islands that are not populated but they are a part of the United States. And they are a very important part of the United States. Each of these territories has their own story to tell in terms of why they were entered into the family of the United States and what they give to our nation. And one of the things I'm gonna argue in this talk and I hope that we can have a nice discussion about it is how can we become more aware of these territories and learn from them, particularly with regard to natural hazards and to issues of water. The US Virgin Islands is another one of our territories. There's the British Virgin Islands as we know but there's the US Virgin Islands as well. CNMI is the Commonwealth of the Northern Mariana Islands. This is a chain of islands in the far western Pacific. The very tip of this chain of islands is the island of Guam. And so that is a separate US territory. And CNMI and Guam were hit by a super typhoon in September, I believe. There was a super, no, there was a super typhoon in September that broke the record in terms of the strongest storm on the face of the planet this year. 180 mile per hour winds. And then a month later, CNMI and Guam were almost wiped out by those storms. How many of you heard about that in the news in October? Okay, only a few. So that's a case in point. This part of our US family was almost wiped off the map and we barely heard about it. And there's a lot that we can learn from that. I want to focus on American Samoa where I've had a chance to do some field work and I still have very good friends there. That's our southernmost US territory. The Samoan Islands, has anybody been to Samoa? Either Samoa or American Samoa? Okay, you two can keep me on the straight and narrow then. If you go almost due south from the Hawaiian islands, our state, and I'm from the island of Maui in Hawaii, you'll hit a Samoa. The interesting thing about Samoa is that it is very similar to the Hawaiian islands in terms of its tectonic state. And I'm wondering here if this pointer will work for me. Oh, here we go. So, the Samoan Islands are a chain of islands. These two islands, Savai and Opolu, those are an independent country of Samoa. They used to be under German possession. American Samoa are these islands, Tutuila, Ofu, Olasenga, Tau. And then there is a seamount by Lulu that will one day become the next Samoan island. Very similar to Hawaii, because Hawaii has a linear chain of islands. Hawaii is actually formed from a hotspot in the mantle and as the Pacific Plate moved over that hotspot, then you had a nice line of islands forming. Very, very similar in terms of Hawaii and Samoa. There is a Samoan hotspot as well. Now in the, again, the tradition of Gilbert White, I want to give you a case study of American Samoa in terms of the 2009 tsunami. And see if we can draw some lessons from that incident, from that case study, that we can use to inform how we respond to and recover from disasters in the United States. We often think that there's not much that we can learn from the developing world. I think that notion is changing. And again, I hope we can have some nice discussion about that. So I want to first give you some physical, geographical and geological facts and set the context for American Samoa. And then we'll talk about the actual event and then what happened on a community level after that tsunami. So now in terms of a tectonic setting, I've already told you about the lineation of the Samoan island chain, how it's similar to Hawaii in terms of a Pacific plate that's in motion over a hotspot. But when that Pacific plate reaches the far western extent of the Pacific, part of that Pacific plate runs into this Tonga trench. And so for those of you who are students of plate tectonics, you'll know about a convergence zone. This is a place where the seafloor literally disappears into the earth. And as a result of that, the earth says something about that in terms of the earthquakes. The tectonic setting here is, in terms of its convergent rate, is among the fastest on the planet. The convergence rate near the epicenter of the earthquake that we'll talk about in the ensuing tsunami, 86 millimeters per year, or about 3.4 inches per year. That's faster than Los Angeles traffic. So it's a very tectonically active place. There are earthquakes that are sensed shallow in the crust, but very deep into the crust because of this down going plate, the subducting plate. And it's an old, cold Pacific plate. It's basaltic, so it's very heavy. And it sinks and dips steeply as it goes down into the earth. So in terms of the earthquakes, it's very, very interesting because you can actually trace the subducting plate by the earthquake signatures as it's going down into the mantle. You can certainly see this vertically from this profile view of shallow, medium, and deep focus earthquakes. And you can even see it in the map view, the horizontal view in terms of the color coding of these earthquakes, the shallow, the medium, and the deep focus earthquakes. And that is the Pacific plate sliding down under the Indo-Australian plate. So this is a place where earthquakes are going to happen. And it's also interesting because we know quite a bit now about how these earthquakes are characterized if they're on the outer rise just before a plate goes down into the mantle. There's a little bit of a bulge there. That's why it's called the outer rise as that plate makes its initial ascent or descent into the mantle. So it was not really a big surprise when on September 29th in 2009, there was a great earthquake, magnitude 8.1. It happened at 6.48 in the morning, which in one sense is a hidden blessing. The Samoans, both in American Samoa and Samoa are early risers. So many of them had already gotten up and left for the day, where many of them were in their, quote unquote, island rush hour. If they had still been in their beds, if this quake had happened overnight, I think it would have been a different story in terms of the death toll. Nine people died in the Tongan Islands. So what you're looking at here is some regional bathymetry from my old lab at Oregon State University, which was called Davy Jones Locker, because we mapped the bottom of the ocean. And we gave all of our machines had pirate names, and some students went really wild on Halloween. But that's another lecture. So this is a three-dimensional visualization of this area. The box here, draped over the bathymetry, is the epicenter of that quake. And so you're looking at the bathymetry of the Tongan Islands and part of the Samoan Island chain here. So unfortunately, nine people lost their lives in Tonga, 149 in the independent nation of Samoa. So they really got hit hard from the tsunami that generated waves in both directions, to the northeast and to the southwest. And then 39 people in American Samoa. So this was the deadliest quake and tsunami in history, $150 million in damage, which for this part of the world is very, very catastrophic. This just gives you another look at the sea floor, which generated the earthquake and the ensuing tsunami. One of the things, can I go back? One of the things also about this particular part of the world is not only do we have subduction going on along the Tonga trench, but this is called the Samoan Corner, or a bend in the Tongan trench. It's very unique in the entire world in terms of a major plate tectonic boundary that changes its character from subduction to strike-slip motion. So instead of the plate being munched into the earth, it slides past another plate. So all of that is happening right here. So again, there's really no surprise that we have these great earthquakes. And if you take a look at this area, you may not be able to see it with the lighting here, because these slides are best when it's pretty dark. There's a lot of faulting that's going on in this Samoan Corner. Part of the plate is actually being crumpled instead of being subducted. In fact, there is a seamount here. Thank you very much. There is a seamount that is about to be subducted into the trench, which is also another very interesting geological and geophysical circumstance. But one thing that we have been able to identify in the bathymetry is a lot of hinge faulting in this area.  So there are three types. I'm giving you quite a bit of geology here, but I was raised as a geologist before I became a geographer. So thank you for humoring me here. They're normal reverse and strike-slip faults. We often think of normal faults as being very easy to understand because something just drops down. And then you have the ensuing earthquake from that.  And oftentimes on the seafloor, it's the thrust faults that we hear about as the ones that really generate the big tsunamis. And then the strike-slip faults where things are just sliding past each other. Hinge faulting is in the normal faulting category. And that's what's quite interesting here, because on one hand, you would expect a thrust fault to generate such a large tsunami. But the seismologists who studied this event identified this as a normal fault on or near the outer rise of that subducting plate. That solution, that earthquake solution that they came up with, was consistent with the bathymetry that we were able to map. Several of us have mapped the ocean floor in this area. And so again, it's very interesting from a geological standpoint, because the plate is bending here as well as faulting. Regardless, 14 meters of slip on the seafloor occurred in that event.  And at the time, it was the third largest normal quake, normal faulting quake on the outer rise after these events in Japan in 8.4, Sumba Indonesia in 8.3. And then in 1917, an event in Tonga, magnitude 8.3, that was the last big quake to produce as large a tsunami in this region. So this is the context. These folks, those of us who live in California, can really relate to the people living here, because they're living on the edge of danger. And oftentimes, a quake does generate a tsunami. So this is probably something that you've hopefully seen in all of your earth science classes. A tsunami actually forms on the ocean floor. It disrupts the water column above it and sets in motion usually a chain of waves, many waves, not just one wave. And these waves are really moving across the sea surface, often at the speed of a jet airplane. And so when you have something at that particular wavelength and velocity moving across a large part of the ocean and then suddenly feeling the bottom as it gets to a shallow area, usually if it's a large earthquake and tsunami, it's going to hit up against an island chain, in the case of Samoa, or it's going to hit up against the West Coast or a coast. And once that train of jet airplane speed waves feels the bottom, that horizontal energy is thrust in the vertical direction. And so you have these large waves. And so the tsunami can be something akin to this situation here, which is a graphic that was made after the big Sumatra Indonesian tsunami that happened on Christmas, near Christmas, many, many years ago. Here's an elephant and a human being, and here's the relative height of the wave. So these are very, very serious situations to deal with. And if we could go to the simulation of the 2009 event, this was done by my colleagues at the US Geological Survey in Menlo Park, California. And thank you, Remy, for playing the video. This is just showing you how the water above the sea floor is indeed disruptive, disrupted, and sending a whole series of waves, often in many directions. Again, it's not a single wave. It's many waves. We can play the video one more time. It's just, I think, it's just very interesting to see this in action in these kinds of simulations. And the USGS and NOAA do such a good job of making this come to life, particularly for those of us who live in tsunami zones around the United States, including the territories. So we can go back to the slides. These kinds of maps, I think, are very interesting as well, these tsunami propagation maps. So this is a tsunami, oftentimes it's called an energy map, a tsunami energy map showing you. It's really a mathematical surface that represents the disruption in the sea surface height as a result of the earthquake and the ensuing tsunami. So there's, of course, a lot of energy and disruption in the sea surface from the 2009 event. But that event propagated quite a bit to the east and less so to the west. These contours here, this is an old map that was produced right after the event so you can't really see the numbers in the map. But those contours are hours, literally hours after the initial event. This contour here is the 11th hour. So again, it gives you the sense of how fast these waves are moving. Another thing that's very interesting are these yellow triangles which show the locations of dart buoys. This is a line of defense around the Pacific. Dart stands for deep ocean assessment and reporting of tsunamis. And these are buoys that have sensitive instruments on them that can sense the tsunami wave as it passes. Many of them are coupled with sea floor sensors that can also sense the disruption or the quake on the sea floor as well. And so these dart buoys are really a great way to get out warnings to the opposite continents or places where there are populations. We've been working for many years, and my colleagues have been working for many years to get a similar network of these buoys in the Indian Ocean that was after resulting from the big Indonesian tsunami. So these kinds of maps are quite telling in terms of what damage can ensue not only locally but across an entire ocean basin. And the interesting thing now is that the NOAA Pacific Tsunami Warning Center uses the real-time forecasting of tsunami model, which is called the RIFT model. It uses this modeling to make these kinds of propagation and energy maps for current events that happen, but they can also use the same algorithms and they can recreate the energy map for past earthquakes. So this is earthquakes and tsunamis. So we had a major event in Anchorage, Alaska recently. The 7.0 didn't produce a tsunami, but this is from the 1964 event in Anchorage, a 9.0, 9.2 that did produce a tsunami. And the tsunami headed down the West Coast. In fact, there were nine people in California who were killed in that event in 1964. These are maps that you can get in ArcGIS online so that you can access the actual mathematical layer that was calculated. And you can also take a look at more information about how the RIFT model works. And at the end of this talk, I'm going to especially for the students for your extra credit, I'm going to give you the link to these slides so you can get all the notes. And you can actually get the link that takes you to these maps. So this is another tsunami propagation map that looks very familiar because this comes from the 2011 Tohoku-Oki tsunami in Japan that affected so many of us across the Pacific that was in 2011. One of the things about these waves, these tsunami waves, is that not only is energy transported across oceans, but in this case, this is a simulation of marine debris that was carried along for the ride from the Tohoku-Oki event in 2011. So this is a simulation that shows how 1.5 million tons of debris, trash, buildings, building parts were carried across the Pacific in 2011. And there is still material that is washing up along the West Coast to this day. On the bottom, you see a garbage patch. You've all heard of the Pacific garbage patch. This is a different kind because it comes from Japan. This is making its way across the Pacific in this fashion in 2012. This is an entire portion of a dock from a Japanese port that made its way to Oregon. And when it landed on the Oregon Beach, the Oregon Department of Fish and Wildlife immediately came out with blow torches.   This picture is from as recent as 2016. And there's one story that I have to tell about this. There's one piece of debris that was really quite unusual. There is a startup company in near Seattle called Paris Scientific, and they make seafloor seismometers, seafloor sensing systems. One of their sensing systems was deployed in Japan to monitor and to track these earthquakes and tsunamis. And so it was part of the network of sensors that picked up all the information that we have about that 2011 event. But unfortunately, that particular sensor broke loose because of the force of the event. And it was in this debris field being carried across the Pacific from its origin point. But it landed in Willapa Bay very near where the company is, where the company's found it. So it made its way all the way home, and it was still working when they recovered it. So that was really nice for Paris Scientific. They make good instruments. So let me, enough of the background, let me now get to the actual, what happened in American Samoa as a result of this huge event. So one of the things that American Samoa had with its limited infrastructure, but very, very good infrastructure, was that they had a series of tide gauges that have been part of the water monitoring, storm monitoring for the region. So what I'm showing here is an index map of Tutu'ila, the most populated island in American Samoa, where most of the people live. And this is a wonderful natural harbor. In fact, most of the tuna that we consume in the United States by way of star-kissed and chicken of the sea comes through Pongo Pongo Harbor. They have a major tide gauge here, so you can get the similarity between what you're seeing in the photograph and what you're seeing in the coastline, the shape of the island here to get a sense for where that tide gauge was. Very good place for it, because when the tsunami waves came in to hit Tutu'ila, especially on this southern part of the island, a lot of the waves were really channeled into this natural harbor. What they saw there was in this tide gauge record from the event was an initial drawdown of the water level, which is often the case when a tsunami is coming. You see the water receding, which is counterintuitive. But when that water comes in, boy, does it come in. Many waves, again, including reflections of the waves onto the shoreline sloshing back and forth. There were three, you can see this in the tide record, there were three very large waves that caused most of the damage. And the second wave was actually the strongest one, not the first, but the second, with a wave period of about 12 minutes. And we know this from the tide gauge records, but also from eyewitness accounts. And these are pictures of the residents in American Samoa. Today we would call them citizen scientists who participated in terms of working with NOAA and working with the American Samoa government and with the other agencies on Tutu'ila, especially, to document, to lend their eyewitness accounts to the data. One of the things that people noticed is that it wasn't the earthquake that caused most of the damage, it was the tsunami. And again, this is something that we often hear from these types of events, that the earthquake, you may have a lot of discomfort from the earthquake, but the tsunami is gonna be much more of a problem. In the case of this tsunami, they had very little warning because they were so close to the Tonga Trench and to the epicenter of the earthquake, so they only had about 15 to 20 minutes. And again, they noticed, and as the data showed, the second wave was the largest. These eyewitness accounts were very, very instrumental in creating these very, now, for those of us who are in GIS, these are very simple maps, but they are very important maps. They really helped people to assess and recover. These maps are from the Upolu in Samoa, the independent nation to the West in terms of rapid environmental impacts after the event and assessing where to get first response and recovery. And there was a similar map that was created for American Samoa. Very proud of this particular map, even though it's quite simple, and these districts here are villages. They are not counties. There are no street addresses in American Samoa. Everybody goes to the local post office. So in terms of assessing things by street address, that is something that is not done here, and it's a way that we can, I think, learn from how they respond, even how they vote or how they work with civic processes because they do it without the street address. And we have places in the American, in the US where there are no street addresses as well, particularly on Indian reservations. So I just give that as a foreshadowing of some comments that I'll make at the end of the talk. Paul Anderson, the American Samoa government who came out of our program, our geography program at Oregon State, and was also, he was a big Gilbert White fan. He made the map for Tutuila. And he assisted with the international, there was an international tsunami survey team that surveyed the damage after the event, collected a lot of data of this type, the eyewitness accounts, water levels, where the water flowed, what the inundation distance was inland, looking at profiles, the topography, sediments, areas of substance, subsidence, areas of coastal change, and so forth. I put these data collection points on a more modern slide. This is a slide that shows what's available to so many of us now in terms of field data collection apps that are mobile that we have on our phones or that we have on our tablets. They come with smart forms. We have a digital map books that we can take into the field. We have all of these types of dashboards that can keep us up to date as conditions change. So this is the more modern infrastructure that American Samoa is seeking to move into. But going back to 2009, there were just a lot of people in the field doing good field work, making important observations, particularly trying to assess what the height of the wave was, or waves were at different points around the island. So they were doing wave height and run up in inundation distance measurements. Very simple. Right here, just looking at the interface between dead and living vegetation can give you a nice idea, a nice indication of how high these destructive waves went. Also looking at the where broken trees and debris, broken branches and debris were in the trees and the tree canopies and measuring that height. There's a person there for scale. And then they made some very simple maps in terms of what these run up heights were. Where run up is the elevation of that water reach at the time of the tsunami. So they had several key villages that they did these measurements. The run up, of course, was not as much on the northern side of the island because the tsunami came from the south. There was quite a bit on this side of the island. Anyway, these are the points, the very simple results of the international tsunami survey team about a month after the event. There was also an American Samoa hazard mitigation plan of 2008, which was proven true in terms of many parts of that plan which helped them in their recovery. And one of the points in the plan was that Ponga Ponga Harbor could sustain the worst damage due to amplification of the tsunami by the narrowing of the channel and that was certainly the case. This is some of the bathymetry that my lab collected along with the University of South Florida. It was around 2002 that we collected this bathymetry from offshore but going into the harbor and we did the first survey of the bathymetry in the harbor and you can certainly see at this neck here where everything could be amplified quite a bit. And we certainly saw this in terms of the damage. So these are pictures of the damage to Ponga Ponga Harbor with the first major wave that came in after the tsunami. There are many things to notice here. A couple of cars that are just completely flipped over to give you the idea of the ferocity of the wave. Another factor here is that this is right, of course, at the harbor but this vegetation is going up a very steep slope. These are very young volcanic islands and so there really is not a lot of horizontal area to escape from a wave. And looking at this area here, there's not a road network that takes you up into higher ground very easily. So that's something that they really had to contend with at that time. We're told to run to higher ground. Sure, you can try to run to higher ground here but you're gonna have to get through vegetation through very thick lush vegetation with no trails and what are you going to do? So a lot of people just may do where they could write at the harbor here. This is a picture of a minivan that was literally put through a door with the first major wave and then the second wave brought the intense flooding. So increasing the the misery throughout the area that's in Ponga Ponga Harbor. This is a simple map that just shows the distances in terms of the run up vertically and horizontally in terms of the inundation. So for instance, one end member here is Tula in the eastern part of the island. The run up distance was about 5.5 meters. The inundation distance inland, the waves went 235 meters inland. Other places, the run ups and the inundations are indicated here on this map. And just to give you an idea of what these places look like, this is a picture of Tula. In comparison to the rest of the island, this is a relatively low-lying coastal plain. So again, the run up was five to seven meters quite significant but it ran inland quite a few meters, 230 meters. There was a lot of damage there but different from Paloa on the opposite side of the island which is a place where the coast is fairly steep. So that entire village was destroyed. Interestingly enough and thankfully enough no one died. I think again because of the time of the morning most people had left their homes and they were headed around what was a very slow but open route headed to perhaps to Pongo Pongo during that morning. But the run up was significantly more but the inundation distance was significantly less. These are just some pictures from the destruction in Samoa and also in American Samoa. This is particular, I mean Samoa got the brunt of the damage and the fatalities unfortunately. And back then high resolution satellite imagery was the state of the art was Iconos. And so these are a couple of Iconos images showing a pre-scenamy in one bay and right after the tsunami so you can see the obvious damage there. And here's the measured inundation limit from field surveys on the ground. So in making these maps and in taking an assessment of the damage but also how to prepare for the next event these were the factors that the international survey team and the American Samoa government and also the villages. One of the things about American Samoa is that there are protected areas and parks but those are in fact there is a national park. There's a US national park in American Samoa but that land is leased by the United States from the indigenous people in American Samoa. They still own that land. And anyway they were taking assessments of of course the shape of the coastline, the coastal topography and vegetation but also one of the things that we're still educating the public about tsunamis is that the bathymetry, the bathymetry is going to have quite an influence on the character of the waves once they reach us on the shore. So understanding the bottom roughness in the bays as well as the near shore bathymetry. And so this is again some early work from Davy Jones Locker where we participated in bathymetric surveys around the island. Then we partnered with NOAA which filled in the broader shelf bathymetry and I had a student who stitched together the land digital elevation model, the bathymetry that we have been able to capture in many of these bays and inlets. And then stitched in the shallow water gaps interpolated over the shallow water gaps to create a seamless bathytopal model for Tutuila. And this is in progress for some of the other islands in American Samoa because with a seamless topobathy model then it's very easy to do or easier to do tsunami run up simulations and to assess which parts of the coastline, which parts of the island. For some folks the island is the coast. There's not that much of inland to escape from. And then we did some deeper regional bathymetric compilations for different reasons because we're just trying to get the rest of the sea floor mapped at the same resolution as a map of a national park because about 95% of the sea floor is still not mapped at a very high resolution. So that was part of our contribution there. Now these are just some of the very simple steps that the local authorities and citizens took, lessons learned from this event. Constructing markers showing where the inundation area was in 2009 with a likely repeat of those areas being inundated again and making sure that people are not rebuilding in those areas if they can possibly manage that. Of course having the tsunami hazard zones that for those of us on the West Coast anyway these are very, very familiar. Also locating critical structures, hospitals and schools that are out of the inundation zone that can serve for first response and recovery places to bring people. And then in terms of the reconstruction just planning these to include routes and paths to easily lead people to safe areas. And then again especially in these steep vegetated areas to create some paths for people to use in terms of an escape where there were none before. The importance again of field data collection and maintenance continues to be very important here again for these parameters. But the American Samoa government and the American Samoa GIS user group are now working with real time dashboards and web maps to keep everything maintained and updated and seamless for the next event that will happen. And the interesting thing about this type of field data collection is that it can often be disconnected from the internet or disconnected from a server. And that's one of the success stories in Puerto Rico in terms of the use of these mobile mapping technologies to get the information out in terms of what places still have electricity, what stores are still open and available, where places where people can get medical supplies and so forth. So as always there's no easy solution to reducing risk. I'm not sharing anything that's ground breaking or it's not, much of this you can read in many of the National Academy reports, especially the tsunami hazard report that came out several years ago from the Ocean Studies Board. Simple messaging, the earthquake is the warning. Take as soon as you feel the shaking, take action, get to higher ground. Long term planning is essential, public education is key and individuals have to know what to do. But how do individuals know best what to do? How do we actually educate individuals? And this is another, I think very nice circumstance in American Samoa in terms of the communication and the seamlessness with which the government worked with the community college and some of the K through 12 programs. There's a NOAA Coastal Management program there. There's the American Samoa Power Authority and the American Samoa EPA in addition to the US EPA Historic Preservation Office working with all of the villages there. A lot of intercommunication particularly through a user group. So these types of user groups and these are just pictures from the user groups that I was involved in when my students and I were working in American Samoa. Just keeping that type of community engagement. Now Andrew, my colleague at ESRI, has developed a nice software platform that encourages and facilitates this type of community engagement through initiatives. So it certainly can be done with technology. In the case of these communities and territories, they're doing it first face to face and then they're turning to the technology afterwards. So it's a very, very nice community that's being developed around some of these difficult circumstances. And then there are thoughts toward the future in terms of how can building structures be better fortified in the face of such disasters. This is a nice example from Oregon in Canon Beach. It is a concept in terms of a structure house or a duplex for multiple dwellings where everything is further up in terms of this first level here where cars are parked not down at the street level but up on this platform and everybody lives up in this structure where they can take stairs or a small elevator but more importantly stairs in the case of a tsunami wave coming in. And Canon Beach is a part of the Oregon Coast where it's flatter so it's not as easy for them to get to higher ground very quickly. And then there are also templates for the next big event coming. I couldn't give a Gilbert White lecture without showing a flood map of some type. So these are pre-planning flood maps that are fashioned for the city of Austin, Texas. They're doing a lot of wonderful hydrologic and first response work in Texas of course. Operation flood maps that show what the water levels and the access issues are for individual addresses in communities. But again, how do you fashion this for communities that have no street addresses? What is the best way to create the equivalent and then strategic flood maps for planning in the future? Another point is that we often think about the government. We think about our local government, our state government, the federal government in terms of these types of actions and responses. And they're also wonderful nonprofit groups but there's a lot of really good will that's going on, a lot of really good work toward this that's happening in the private sector as well. And so Esri and Google and many startup firms in the private sector create a lot of wonderful resources to help with these types of events. And one of the things that's always impressed me since I started working at Esri was the fact that we have a disaster response program. It's not just a program that gives out software but we actually send people into the field. We had one member of the program embedded with the Red Cross during Hurricane Harvey throughout the length of that particular event, especially in terms of working with first responders on workflows, additional data sets and supporting the technology as it's being deployed in the field for all of these different areas, hurricanes, earthquakes, floods. Many of us have been so heartbroken about the recent fires in Southern California. I know we have one member in the audience who was actually evacuated from the Woolsey fire in Southern California. So technology can play its part, good technology in the hands of good and skillful people. So I just wanted to make that point very, very quickly. And technology can help us, particularly first responders, to have a really good synoptic view of what's happening. One of the things that the National Water Center has identified now is that four out of five counties throughout the entire United States have experienced or reported a water disaster over the last six years. Four out of five counties in the entire United States. And so this is why we have technologies and data sets. In this case, we were drawing upon the national water model to give a really fast indication mapping of the inundation and forecasting that inundation throughout the Houston area after Hurricane Harvey. So this type of coordination is going to be increasingly important. And it's coordination that we need for our US territories as well. You've probably seen these many swipe maps. See if I can go back. Especially if you focus on the tennis court in the middle of the image and you just get an assessment of just the horrible amount of flooding there after Harvey. This is one of the response catalogs or resource catalogs that our disaster response team at Esri puts together after just about every major disaster. And this is one of the most extensive ones created for US territory. Hurricane Maria, this particular response resource catalog has had a lot of resources for Puerto Rico. So it's very nice to see this attention given to Puerto Rico, even in terms of where Walmart's stores, which stores were open or closed. So this type of response or resource catalog has apps, data sets, plans, imagery. Just this list here is only a portion of what is available at that particular catalog. So you can always go to disasterresponse.maps.arcgis.com, or I've got another catalog of ocean related story maps where this can be accessed. So that's what I wanted to share with you. Again, it's been a real pleasure to do this in honor of Gilbert White and to be inspired by him. And again, I present this not with any broad sweeping. I've got all the answers to the questions of how we should relate to or learn from the territories. But I wanted to just give you some ideas to think about as fodder for some discussion. So you've heard about a use case, a field-based use case from American Samoa. And as the people in Samoa say, fa afatai tele lava, thank you very much for your attention. Thank you so much. We're just about out of time, but I think we probably have time for a burning question or two. And if you have a question, please step to a microphone. There's some microphones around. Any burning question? Or maybe burning isn't the right adjective here. Any soggy questions for Dr. Wright? Well, if there are no immediate questions, help me thank her again. Thank you so much.


Hello, my people, my name is Meacham. Welcome to the Score Channel. I'm your Dean of Awesomeness, here to present you with the first ever Dean's List. Today, we're ranking the top 10 party schools in the United States. Life is about more than just studying and learning things. It's about having fun. It's about meeting new people. It's about partying. And if you think I don't know what I'm talking about when it comes to partying, let me show you what I really know. There's some partying right now. That's what I'm talking about. Watch and learn, kids. Remember, this is not beer, okay? So, it's perfectly fine. Yeah! All right. Tell you shotgun to not beer. Woo! I decided to make my own official party score for this list and I'm gonna show you how it works before we get into it. What are the ingredients for an awesome party school? Everybody knows that the best parties happen at frat houses and sororities. You've seen them in the movies and in real life, they are just as amazing. And so, I counted up the number of frats and sororities at all these universities by using greekrank.com's latest data. That's our base. From there, I multiply that by the acceptance rate. Why the acceptance rate? Think about it. If you're a selected school that only admits like 10% of people, those are people that have been trying hard and like working on 20,000 different extracurricular activities and staying up late to study. Those aren't the people that are gonna party hard at the ranger. They ain't doing keg stands. Your location also matters and so I've created a score for both the city and the state that you're in, which we will multiply to get our final numbers. The city score is pretty simple. If your university is located in a town that only exists because of the university, like Purdue, you get a one, all right? No penalties.  And this makes sense because it's not just about partying on campus. It's also about the city that you're in. Are there bars to go to? Are there concert venues? Are there pro sports venues? Not everything happens on campus. The state score is comprised of two distinct variables. All right, because there's two things that are essential to a party that states have control over. Number one, I'm talking about that sweet nectar, the liquid courage, the stuff that makes questionable decisions happen, the fermented fruit juice, alcohol. In the United States, the average person drinks 2.35 gallons of pure alcohol every year. That's 10.7 liters for all of you people in not America. To illustrate that, I got 10.7 liters of water right here. That would be this much plus this much, plus this little guy right here. If your state consumes more than the national average, that's a good sign for party scores. If you're like Utah and you only consume about half of the national average, that's gonna drop your score. Number of people admitted also matters. So I took the total number of undergraduate students because let's face it, postgraduate people don't party and divided that by 1,000 to add to the score. We put all these variables together to get our party score. If you guys disagree with my methodology and you think you can do it better or you have a problem with how I put these numbers together, then complain in the comments below because I wanna hear what you have to say. So let's get to it. FIU is a university that appeals specifically to international students. What do you get when you take thousands of international students from over 140 countries and pack them into the sweltering heat of Miami? You get a lot of sweaty party in. This university literally has its own EDM festival called Summerfest, which they host every year. And on top of that, they've got a Greek barbecue with their 35 different frats and sororities. That puts them in 10th place with a score of 95. Our number nine school was formerly number eight according to Playboy magazine, which is obviously a really good source of information for partying. Even though they have the fewest frats and sororities on our top 10 with just 34, they make up for it in other ways. With a really strong state score and an extremely high acceptance rate, Colorado State ranks number nine on this dean's list. Even though it's a relatively small school compared to the others in this top 10, their bonus points from all the other categories put them at 98 points. But enough for number nine on the list. Number eight on this list is a university that I was just talking about with somebody who commented on our pit video. I was asking if Syracuse is a better party school than Pittsburgh and let me tell you something people, Syracuse is a top 10 party school. The numbers don't lie. They got 46 frats and sororities. Syracuse is a cool city. It gives people plenty of things to do in a state that gives them plenty of substances to enjoy if you know what I'm saying. And they host two major festivals. There's Mayfest, which for some reason they always do in April. They got the annual Juice Jam which kicks off the school year too. So you end the year and start the year with an awesome rager hosted by the university. The other big thing you gotta talk about with Syracuse is their love for sports. These guys take it really seriously and are known to get extremely rowdy when there's a football game. Princeton Review also used to rank party schools and this school used to be number one for three years in a row. On our list it reaches number seven. This university breaks the record for fraternities and sororities. They have 81 Greek associations. Greece doesn't even have that many. They've got an alcoholic beverage in their names. University of Illinois at Urbana, Champagne. Pop the bubbly. These guys have a history of going hard and nothing will slow them down. Not even a global pandemic. Back in 2021, Delta was popping off and Delta showed up to all the frat houses and was like, what's up bro? I'm Delta. Oh, what's up Delta? We're Delta too. Delta, what's up bro? Delta rolled up into the campus and people didn't even care. UIUC had a perfect plan for containment to keep cases down. But they forgot to calculate one thing, how much they loved to party and within a couple of weeks, the plan failed completely. They had to shut down classes for like three weeks because cases just blew up because everybody was going to the frats and getting their party on. It's a testament to the party spirit at UIUC respect. All right, number six is kind of a controversial choice on this list. Here's a big university with lots of frats. High acceptance rate but it's in a state that does not favor a lot of fun activities. In Pennsylvania, you've got to go to the state store to buy beer.  But with over 66,000 nitney lions, there is a ton of party scene available at Penn State. Why don't they appear on everybody else's top 10 lists? Unfortunately, Penn State has partied a little too hard. Back in 2016, a student died during a fraternity hazing ritual. That's intense. On top of that, you've got some other scandals from the sports department in Penn State and all those things together have pretty much made them the kind of university that nobody wants to touch with a 10 foot pole. But that's why my rankings are pure, baby. We're using numbers, not feeling. Numbers don't lie. Penn State is a party school. Number six on the list. Know your limits, kids. Number five is another public school that is known for tearing it up on campus and off. Despite being in the God awful state of Ohio or perhaps because it's in the goddamn state of Ohio, these people know how to party. They need to take their mind off of the bleak existence that is living in Ohio. I'm talking about Ohio State located in Columbus.  That means you got a ton of house parties. You got a ton of bar hops. You got drinking everywhere around Ohio State. The party scene on campus is so bad that the university will actually help professors and staff to pay for local houses. We'll literally help pay for your house just so that it doesn't become another student party house. One student that was interviewed in the area said that you have to wear earplugs if you wanna sleep. That's hardcore. They got a score of 128. That's a party school. All right, we're starting to get into the big dogs now. The top four party schools. It's gonna get intense. Even though this one is the most selective school out of all of our lists with an acceptance rate of about 51%, they make up for it with location, location, location. I'm talking about UMD, not the proprietary Sony PSP disc. I mean the University of Maryland. You can't get a better location. UMD is right between Washington, DC and Baltimore, Maryland, which means you've got sports events, concerts, bars, everything you want, and you got two cities to choose from. That gives them a big city score of four. They got over 60 frats and lady frats, which means there's plenty of party opportunities. They even created their own on-campus Uber called Night Ride. Night Ride will just pick you up in the middle of the night wherever you are and take you back to your bed. I like that party support coming from UMD. It got so out of hand that in 2019, the city council of College Park, Maryland passed an ordinance that tried to curtail the party scene. This ordinance changed the definition of nuisance and created a new category of nuisance called an unruly social gathering. I wanna read you a little bit of this law because I find it hilarious. It is unlawful for a property owner or any responsible person to conduct, cause, aid, allow, permit, or condone an unruly social gathering at a residence or other private property. Now look, I'm not a lawyer, but if you cause, aid, allow, permit, or condone an unruly social gathering, then you're not a responsible person and so the law does not apply to you. Boom, party on UMD. People, it's getting hot, it's getting spicy. Top three, these schools make the other universities look like a seven-year-old's Chuck E. Cheese birthday party. Our number three university is MSU, Michigan State University. Michigan State has 68 fraternities and sororities. It also has a Wikipedia page dedicated to times that riots broke out at Michigan State with an enrollment of 35,000 and a very high acceptance rate of about 75%. You've got all the ingredients for an amazing party school. I grew up in the Michigan area. I know that the reputation that Michigan State students get is that they were not smart enough to get into University of Michigan. And I don't know if that's entirely true, but I will say that their party reputation is well earned. There's this site called Unigo where they survey students and ask them different questions. And one of the questions was like, what's the typical perception of students at your school? I just want to read a couple of the amazing responses from that site to you. Over my three years at Michigan State, I became increasingly intolerant of the overwhelming frat bro crush your beer can on your head atmosphere at Michigan State. Crush your beer can on your head, you don't say. Ah! I was able to find a great girlfriend and we're still going strong years later. Her parents also met at State. Parties have their positives. See, at MSU, you might just meet your soulmate at a party.  It's like Maryland. It's a relatively selective school, not the biggest, but it's got an awesome location that makes it a party central for anyone who wants to find a good time. University of Washington in Seattle is in a prime location for the party scene. Everything's legal in Seattle. They love to get their drink on. They got over 60 breweries in the city alone. You've got all your sports venues and it's the birthplace of Grunge Music. So basically every concert comes to Seattle. They got festivals all year round and perhaps because of the rainy, depressing weather, these people get their drink on any day of the week. UW does it a little different. Most places are like, okay, Thursday, maybe start off. Friday, definitely. Saturday for sure. Sunday, recover. But no, no, no, no, no. Here at Washington, they start the party on Tuesday. Drinking on a Tuesday. I don't even do that most of the time. Washington's party score is way above everybody else, but it's nothing compared to our number one university on the dean's list. Our number one party school in America is perhaps the most ripped on university of all time. They have been the butt of jokes for over 40 years. Whether it's Alec Baldwin. Parent is the one person who is supposed to make their kid think they can do anything. Thinks they're smart even when they go to Arizona State. Stephen Colbert. My own network of completely free diploma generators, offering degrees from such prestigious institutions as Prattstown, Notre Dame, Mount Holy Smokes, Stanford and Sun, Skidmark, John's Hot Pants, Dartface, and Arizona State. Or Seth MacFarlane, a million different times. Hey Sam, why do you have a duffel bag that says Arizona State? Because that's where I went to school. You went to Arizona State? Where's your mascot, a broken condom? Arizona State University has been the laughing stock of the United States for its perceived reputation as the biggest party school in America. But it's a well-deserved reputation. And again, my numbers add up. You go to greekrank.com and just read the reviews of their frats and sororities. You'll see that they're all being brigaded by all of the other ones all the time. And these fraternities have some serious track records of causing trouble, everything from stabbings to vomiting over a bridge and causing a car accident, to starting a race riot that had over 500 people. Yeah, it's pretty fascinating. But ASU's party antics have started to catch up with them in recent years. Since 2002, President Michael Crowe has been on a war with the party. He's been trying to change the campus reputation. He even turned it into a dry campus, which means no alcohol is allowed on campus anywhere. You can't even have a beer bong. But that doesn't stop the Sun Devils from partying. Because if there's one thing that I know about the party, it's that you say no to authority. They just love the party too much. It's you can't put rules and laws on the Sun Devils. They're devils. And due to their massive enrollment and their extremely high acceptance rate of 89%, they're gonna be a party school whether Michael Crowe likes it or not. You can't change what you are, ASU. You're the number one party school in the United States. Now for the honorable mentions, shout outs to a few party schools who didn't make the top 10 but deserve a nod anyhow. West Virginia University, you guys know how to party. I've been to West Virginia before. There's really nothing else to do. So I get it, y'all get plastered, good for you. Same goes for Bama, Roll Tide. You're in Alabama, there's nothing else to do.  Big shout out to FSU where Burt Crusher, a living legend of the college party scene, went to university. And if you guys like this kind of thing, hit the like button and let me know. Maybe I'll make this a regular segment. Maybe I'll even give it its own day of the week. We'll see. That depends on you people. But if you've made it this far, thank you for watching. I appreciate it. I just made a mess in my room for you and I will see you next week.


In the middle of March of this year, several hospitals were overwhelmed with COVID-19 patients. Most of the ERs in these top hospitals were inundated by critically ill COVID-19 suspects. They needed help and all pointed to the director of the largest medical center in the Philippines to help out. The Philippine General Hospital is a teaching hospital under the University of the Philippines. It took up the big challenge to help out the nation and become a COVID-19 referral hospital. Today, we will listen to the stories behind the making of UP-PGH as a leading COVID-19 referral hospital in the National Capital Region and the Philippines. Welcome to TV UP, Health Issues and this is your host, Dr. Teddy Herbosa. Our guest today is the best Filipino surgeon clinically and academically. He is a graduate of the UP College of Medicine and took his residency of neurosurgery at the UP-PGH. He had been president of the Academy of Philippine Neurosurgeons and the Asian Association of Neurosurgeons. He was also a former medallist of the UAAP UP track and field team in running in the event 400 meter low hurdle. He is a skilled saxophonist, but most importantly, he is the current director of the largest teaching hospital of the Philippines, the UP Philippine General Hospital. Welcome, Dr. Gap Legaspi to this particular episode of Health Issues. Hi, Gap. Hi, Gap. Good afternoon. I'm happy to be here. It's my honor to be sharing our experience here in the Philippine General Hospital. So let's talk about it directly and give me the story behind how UP-PGH became a COVID-19 referral hospital. Well, I think it started and we started reading the signs. Our ERs being swamped by people with upper respiratory tract symptoms. But we call regularly in the ERs severe acute respiratory illness or SARI. And that was the time, middle of March, when the COVID pandemic was getting out of hand. And it was reflected mainly in the private hospitals as an overwhelming overcapacity of their emergency rooms, their ICUs. So if you read that, it was a matter of time before it got to the government hospitals, mainly because the first wave was from people who traveled abroad and probably well off people who went to private hospitals. So we were assessing the situation and we thought that this is a matter of time before us government hospitals got overwhelmed themselves. So I got to talk to some of the directors of the government hospitals, the DOH hospitals. And I got to talk to the directors of the private hospitals that we were all in agreement that maybe the Wuhan formula where they built a mega hospital of 1000 plus beds might be what we needed at that point. Because we needed to save a health system, hospital system. We cannot let all of these hospitals fall down at the same time because of overcapacity. So we had a meeting and I brought it up with the special assistant of the secretary of health who mentally set up a meeting with the secretary and we explained the concept itself. And I ended up talking to the technical advisory group the next day who already was also thinking about it. And in fact, when I got to the table with them that was March 19, they already had the idea of assigning PGH, Jose and Rodriguez Memorial Hospital in Lang Center as the exclusive COVID referral centers. So that's around I met the secretary March 18. I met the technical advisory group March 19 and I met the field implementation team of the DOH and CR hospitals also on March 19. And that's when finally we were assigned different quadrants of Metro Manila. We had the biggest coverage because we committed 130 beds, scale up to 200. And so we got the southwestern part. So that's Las Pintas, Paranyake, Pasay, Mandaluyong, Makati, Manila, and parts of the gig, Ensan Juan. So that's quite a big area. So that's how it ended up. But coming out of that meeting, I thought we could probably do our work better if four conditions were agreed on. One, there should be full support of financial funding from the DOH. Number two, there should be manpower augmentation. Number three, there should be a good referral system to take the non-COVID patients from those hospitals. And number four, a command center. Luckily for us, three of the four were instantly given and the fourth was we worked on the fourth one in the coming weeks. So those are the next questions I'd like to find out. What were the engineering requests to convert the Philippine General Hospital into a COVID hospital and the creation of a command center as you described? Yes. So again, going back to the Wuhan manual, they believe that a negative pressure environment made their infection rate really low for their health workers. They have a surprisingly low infection rate compared to the initial phase. Of course, the first part, they had quite a number. But that's impossible in the wards of PH because of the turn of the century design, high ceiling, big windows. So we employed three groups of engineers and architects, a hospital architect, engineering expert, and UP experts as well. And they all agreed that natural ventilation will also work as long as the air exchange is ensured. So what we did was we blew air into the ward. It's a long 200, 100 meter long ward. We blew air into the ward. We sucked in air from one side with reverse exhaust fans. And then we blew out air onto the other side with the regular exhaust fans. And then we turned on the elect fans from the ceiling so you can now imagine a net effect of going in one direction. So institution of some kind of a positive pressure so that the air doesn't stay within that particular ward. So it's the air exchange that was correct of the key to that. In fact, there is a WHO manual that supports that. Actually, the WHO article that supports that saying that good ventilation is even better than the PPE. That's what they were saying. And the enclosed space, right? The enclosed spaces that reported high incidence of health care working. So what were the other things aside from creating those designs? The command center. The command center. So that's where the system comes in. I think we were just lucky that the president had the foresight to create a command center. Because around that time also we were asking for a lot of help both from the government and private. And it was quite overwhelming at some time. The president asked Chancellor Menchit Padilla, the UP Manila Chancellor, to create some sort of a call center that will function as one. A donations coordination center and two as a patient communication center. Like a call center. Like a call center with multiple purposes. So we had that, we used that to communicate with patients and communicate with other centers as well. And I think that communication center helped not plug up the ER of the PGH. The idea was that the doctors could talk to them and tell them if they should go to the hospital or they should stay at home and just wait it out, right? Yes, remember at that time the DWH mandate on us was to send the mild PUIs home. Yeah, that was the old protocol. They were advised not to come here anymore. That really helped a lot because we were not swamped with PUIs. Correct, correct. How about in terms of equipment, PPE and supplies? Ventilators, PPE and equipment. What equipment was needed to be stockpiled to be COVID-19 hospital? So based on our estimates, if we had 130 beds, 30% of that will become critical. So we were thinking maybe 100 beds of regular warmth and 30 beds of ICU. We actually had around 22 high-end Puritan Bennett respirators but we were able to acquire 10 more of the same nature. And then on standby, actually 12 more. And then on standby we kept our private partners in the outsourced respirator supply. On standby with 30 respirators and correspond to respiratory therapies. So I think one of the things that really made the difference also was the high-flow auto-nasal cannula. Correct. Because it's a new device. A certain point, the belief of early intubation turned around to late intubation. And the high-flow auto-nasal cannula helped in preventing a lot of patients from being intubated. Of course we bought monitors, oximeters. We bought equipment to move patients around, transport ventilators. And of course, millions and millions of pesos worth of PPEs also. So what was your utilization of PPEs at the height of COVID patient? How many PPEs did you need in a day? For the 130 beds, it was initially estimated that we probably would have needed 3,400, 1,800 a day. For the 130 patients if they were in single rooms. But because we put them in cohorts, in the wards, 22 per ward at 6 feet apart, we were able to bring down our PPE consumption to 600 to 700 a day. So we were able to save at least three times of what we would have needed. And before declaring us open, we said that we will not open unless we have at least one month supply of PPE. So we had one month only stock open. Yes, we had at least 20,000 PPEs and 95 goggles. So only then when we declared the wards open on March 30, we started preparing March 22. I know that in the beginning there was a lot of uproar in social media. Several of our own doctors and healthcare workers weren't in agreement with your idea of becoming a COVID-19 hospital. So they were ranting on social media about why PGH should be the COVID hospital. How did you handle this descent from our own specialists and our own healthcare workers in PGH? So I think the concerns were quite valid because we were serving 1,500 patients a day in the hospital. And they were thinking that we became COVID hospital. All of these services we got. Yes, actually they were affected. But my reading of the situation that time is even if we did not become a COVID hospital, we would have lost those patients because it was ECQ. The OPD was true. We were banned from doing elective surgeries. And then the ER patients weren't going to the ER because of the EUIs. The numbers were actually decreasing already. In fact at one point private hospitals had 20% of their admissions already. So even if we did not become a COVID hospital, we would have lost our patients. And we would have been swamped with COVID patients because we were the big government hospital that people would probably go through. So the other one of course is the fear, the fear of COVID. And because of all the doctors who passed away, our friends, our colleagues and friends. So it was managing the fear really that probably was the first step. And I think the fear was managed by telling them that we had the systems in place. Our ECQ gave information campaign. Our PPE supply as I said was one month and our PPE level was 0.5 to 1 on top of WHO recommendation. And I saw of course your official letter to the PGH community and joining them and rallying the troops. That this is part of national and they were nationalistic to help out our country. So that was a struggle. That was an obstacle, right? It was an obstacle. Making sure that there was a buy-in. Yeah, so I think the most important thing is there were people who eventually he did the call. Well, when we were organizing it, of course, you cannot help but doubt if you made the right decision. But one of the crisis team members said, The advantage of our PGH, he said, The advantage of our PGH, That's not what we call it. After the initial fear and it was the fear was tempered by the PPEs. The hotels that they were staying on in, the buses that were provided to them, the food that they were getting. Eventually they were making suggestions already on how to make it work. But of course those who stayed home probably will not feel the same involvement. That's why even as it was going on, it was really difficult to temper the expectations of our other members. But two months down the line, I think the problem is not the COVID ward anymore. The problem is how to get back to how we were before working on that.  You had convinced the people to open up. What was next? The next was to make the necessary guidelines, protocols, and training. Tell me more about how you did that. How did you train people? How to don and adopt the PPE? How to enter and avoid places that are COVID part of the hospital, etc. How was that done, the training and the protocols? Like in true UP fashion, when you do something, you try to do the best. So you wanted to be the best, had the best system in all of this. So one was we had a very good hospital infection control unit headed by Dr. Nina Berba.  She makes decisions based on evidence. And I think people respect her when she talks about these protocols. So the way we did spread out the protocols is by having an information education committee, with very attractive infographics. And I think regular communication was done through here because no one was in the hospital. We just got through them through Facebook or Viber. So there was a regular progressive instruction campaign on how to don and adopt. There were actual donning and docking courses given by nurses and residents. And to make it even safer, I think the positioning of a safety officer in the donning area, that makes sure that all the steps are taken just like flying an airplane. You cannot fly until all the steps are checked. So that was one of the safety measures. Number two, we allowed them to change because we know we're only humans. We allowed them four hours of break. Because also they found this really useful in maintaining well-being of the nurses, of the staff, and also maintaining performance level. But lo and behold, most of them decided to stay for eight hours in the same PPE. Maybe to help us in. And some of them even wore diapers because they didn't want to take out the PPE. Oh, I see. Yes, yes, yes. For eight hours, that's right. So the way to make it safe is they entered only in one area and exited in another. So they never went back the same door to DOF to remove the PPE. So after they get infected, they only move in one direction towards the other end of the pavilion where the doffing station is. But before they get out of the door to be assisted by another safety officer, they go through a nano mist tent that for 30 seconds is sprayed with isopropyl alcohol. It's still in full gear and hoping to decrease the viral load on the surface of the PPEs. And then they doff. And then they go straight to a shower that was built at the entrance of Ward 3. So they shower right after doffing. So the life of the healthcare worker totally changed. The behavior, the practice on how to care for patients totally changed. Yeah, so there were people who painted, there were people who, you know, panicked as soon as they put on the N95 mask because it's hard to breathe.  I think that a lot of these officers are dermatologists. They got into consultation and intervention there. So I guess the other ways that you made it safe as we, I think we're one of the few hospitals to do fit testing of face masks. Of the N95. So what is the fit test? Can you describe to us what the fit test is all about?  N95, 8210 model, you put it on your face, mold it. They put a hood on top of it on your head. It's like very much like with our kids, we put a plastic bag on our head. But this one had a clear shield. And it had a hole near the mouth. And the bitter solution was aerosol was sprayed inside the hood. And you start breathing deeply. You start turning your head, chewing, moving your lips. If you feel any bitter taste inside, that means there's a leak. That's a leak. So that test is not a good fit. That mask is not a good fit. That's a good fit. So only when you don't taste the bitter taste any more, then that's your mask. So you keep that with a weak supply of that. So I think that also lessens the infection rate. By the way, how many of the healthcare workers have been infected? How many have been infected so far? The total number? Caring at the PGA. So for those who work in the COVID-19 ward, and there are 1,050 of them, around 24 healthcare workers have been infected already. So that's around 2%, 2.1%. And for the whole hospital, around 4%, 4.5%. So meaning more healthcare workers were getting infected outside of the COVID ward in the community rather than the COVID ward itself. So when we investigate that, they will eat. Yeah, you did also something different in terms of duty of the healthcare worker. I think you changed the usual duty mode to beat the incubation period and exposure. Can you describe that for our viewers? So when we didn't know exactly how the infection will get into the hospital because we were still open at the time, very porous. And MEQ was declared, ECQ was declared. We adopted a one week on two weeks of duty schedule for two reasons. One, you decrease the personnel that are in the hospital. So just in case you get someone to spread something, you have one third of the workforce only in the hospital and two thirds can substitute the one third that will get sick. So that's the first one reason for doing that. The second one is if they go on duty and they somehow get infected and they feel the symptoms, at least they have the two weeks to rest to be relieved of the symptom. And hopefully days after that, they'll be able to go back to work again. One step is negative. So that's the reason why we introduced the one week on two weeks of, of course, the other ones for them to rest. And this is really very new to them. They can barely move during their duty. They were suffering from heat and exhaustion. So they were given a longer time to recover. So how about the Bayanian Center? That was the command center, right? It's better called the UTI Manila. Can you describe to me where it is? Who manned it? Who were the people there? What type of transactions happened in the Bayanian Center? So it's quite interesting also because the chancellor set it up like a professional call center. So you have 20 computers there with 20 interns who volunteered. So there's some medical know-how. So people will call for two reasons, as I said. There were scripts that she wrote to answer almost all types of queries. So that it's all consistent and very professional. So they will ask on how to proceed with the donation. So they were given instructions on that. So they went on 24-hour duties for that. So we got a lot of donations from there going through there. And also they were given scripts on how to answer medical questions. From patients or patients' families. Those that they cannot answer at their level are referred to consultants or to the services and duty. So it could be like a call center. It was operating like a call center for medical. It was also the place to give donations, right? Because people wanted to help. Yes, it was in the university's home. That is the 1938 Kamasma Poova building in the northern part of the hospital. Where the huge social house donations were gathered by this group. So now it's evolving to our portal for the telemedicine of PGH. That was my next question to you. How does telemedicine help the safety and treatment of COVID-19 patients? How does telemedicine work? I was going to say telemedicine in terms of continuing outpatient care for our patients who cannot come to PGH anymore. So the Bayanian Center is one portal of getting your doctor or an appointment to the clinic. But as far as telemedicine is concerned, I think you saw in some of our infographics or our announcements that our in-house masters in computer science, Dr. Dr. Homer, developed one, a telekomustahan modulver. The laptop is wheeled to the patient and he starts talking to his relative via Zoom. That was really very effective and the social workers cried with the patient. They were crying. The other one is he created an EMR for the COVID patient. Doctors don't have to go into the ward and write the order. So he developed an EMR outside the ward. And number three, our C-ball group, Dr. Ewang and the orthopedics group, they developed an iPad-based telehealth module where they wheel in an iPad on a tripod into the patient in the ICU with the pulmonologist or the intensive care specialist outside the ICU. Now remember, our ICU doesn't have a window or we can peek through and see our patients. So the iPad camera afforded the internist or the pulmonologist outside the ICU to see the monitors, the patient themselves. If the mask, they were using the venti mask, the snorkeling mask. It was fitted well. If needed, the adjustment. So those are the things that how telemedicine was used also. When we take an X-ray, we don't have to pay for the film anymore. So we can view it together here. I think that's what the patients who recover say. They never recognize the face of the people, the nurses and the doctors that took care of them because they're all wearing PPE and face masks and goggles. So they don't recognize who took care of them. Plus, they're all isolated from their relatives. And this telemedicine portal allowed them to communicate with the relatives. Yes, the telecom was really very ingenious for Dr. Humberkot to come up with it also. So innovations being put out by our doctors at the Philippine General Hospital for better care. Better quality of care for the patients. So what are your learning points in this endeavor? I think you're the only PGH director that faced the pandemic. This will go down in history. So why don't you tell us what are your introspection? What are the things you learned about this very unique experience of running a Covid-referral hospital for the Philippines? Okay, I guess the first pitfall was lack of communication. I think communication is really key. I think that was why a lot of the alumni and our faculty were also ranting about it because we didn't have time to communicate. We had one week to set it up. So how can I meet all of them? And I refused to explain anything on Facebook. So I was banking on the chairs and my fellow alumni to explain to them. So communication is still key. And we found out that no matter how distinct the departments are, given the challenge they rise up to it. I think being mindful of statistics, of reading the sign, that helps you make the right decisions is very important also. So having very well-researched ideas helps to make the right decision for a decision-maker like a director. The other one is we realize that no one is indispensable. For those of us, we just look for another one who can do the same job. So nurses didn't come, doctors didn't come. So there's someone who's going to replace them. And I think in that case, the DOH volunteers, given by the Department of Health, really helped a lot. There are 130 of them. You know, our organization, the Crisis Committee, was created outside of the Director's Advisory Board. It's all surgeons. Oh, no, our surgeons are designed for crisis intervention. That's what my mentor said. You've been trained all your life to solve problems. Solve these problems. So they were your problem solvers, right? This is the situation. There was no organizational chart. There were just four people that I talked to. I told them do what you need to do. And it just proved that it is the people who really work and not the committee. So you just choose the right people and they did a fantastic job. Denis Serrano on the... Donations, the donations. Logistics. On manpower. And so easy. Anything that moves, Rodney will take care of that. Anything that does not move. Equipment and manpower, human resources. If they need to travel. That's safe. That's a man on a bicycle. That's Rodney. And both of them put all the flows together. Flow the system. That's wonderful. Those are interesting golden nuggets. I do hope you will write that in a big book one time. And become the playbook of how to convert a big teaching hospital into a COVID deferral hospital. Question. When are you returning to the new normal? When will you start doing elective surgery? When will you start admitting the other critically ill patients that PGH caters? Okay. Again, as I said, you have to read the signs. So when they say they're going to leave the modified ECQ on the 31st, you cannot admit everyone on the first. We all know that a second surge is really possible. Yes. So my initial gut feeling is going to be bad. But I think right now, because of the testing, we're able to handle the PUIs better. So, confidently, this afternoon, just before coming to this interview, we just finished the director's advisory board. And we agreed that in one, we'll start piloting our system. We changed everything. There are no more departments in PGH. Only service ones. So there's a surgical service and a medical service. So they agree who comes in for surgery first. Malignant tumors over benign or non-deferable or deferrable, non-blood requiring versus blood requiring. Or those that you require. You've been able to do what no other PGH director has done to break the silos. Break the silos of the different specialties in the hospital. Yes. And they now talk and work together as one. Wonderful. Yes. So it's really, as a director, when I saw all the problems of PGH, maybe in the middle of my directorship, I said, the only way that we can solve PGH is probably if we reboot PGH. I think this is the rebooting of PGH. This is the rebooting. It's like turning off the computer. Yeah. Well, the final word. Tell me about how PGH will be in the new normal. I mean, you've discussed some of it already with the removing of the departments, et cetera. Yes. What will happen to training? What will happen to research? What will happen to patients? What will be the new normal life for the Philippines general? The new normal life is there will be less patients, I think, because of the physical distancing until the vaccine comes in. So we reduce everything at least by 50%. Hoping if we get the 60% resumption, I'll be happy with that. So the key is to remove the COVID patients from the wards. So we're building a 40-bed ideal isolation unit so that we put all the COVID wards there. The operating room is going to be in the outpatient department, so they're all outside the main building. So we plan to resume COVID-free Philippine general hospital. So that's a big thing. So what we foresee is that we become what we've always dreamed of to be a truly tertiary center. We only take in those who will get robotic surgery, interventional cardiology, interventional radiology, stemting, coiling, and leave the ecolysis and appendectomies and the pneumonias and the diaries to other hospitals that will be able to handle them. So the new normal will be a higher level number of cases. Our residents will have to go out to train the basic and come back here to finish off with the advanced training. As of now, I'm looking at this as to our, finally, our primary health care program to take off because we will be forced to send our internal medicine and family med doctors to the community, to the areas, to the people who cannot come to PGH anymore because they are not tertiary care requiring. That's right. Thank you very much, Dr. Gap. I think I envy your position. You are in a position like the captain of a big battle, the general of a big battle in a historical. Congratulations on your victories. And I do hope that you've learned a lot and that you can share that wisdom to the rest of the medical community and other hospital administrators. Thank you very much, Dr. Ligasti. Thank you very much. Thank you very much. Thank you. Thank you, gentlemen. Thank you. We'd like to thank Director Gap Ligasti for his surge in terms of his volunteerism to lead the Philippine General Hospital from a university teaching hospital to the leading COVID referral hospital in the Philippines. There were many lessons learned. He described all of them, some golden nuggets of advice and wisdom. And with all of that, we bid you all thank you for listening to us. We do hope that you will support the Philippine General Hospital and all the doctors and healthcare workers that sacrifice there and show their heroes. Maraming salamat. This is Dr. Teder Bosa for TV, UP Health Issues. Goodbye and thank you very much.