Grand Jury Report on Fire Department EMS in Orange County

The recently published document by the Orange County grand jury regarding the deployment and response of resources by Orange County fire departments to emergency medical calls for service is both stunning, and concerning in the inaccuracies, opinions, and falsehoods presented as fact. The determinations made appear to be based on these failures or research, and lead to what may be a pre-ordained belief, without factual support. Because this document rehashes a 2012 effort of a similar matter, I am disturbed by the need for another review that fails to build on the earlier discussion.

Fundamentally, the local fire department deploys resources designed to respond to and to mitigate the unwanted effects of the environment on life, property, and the environment itself. Albert Einstein is quoted as saying that the environment is “everything but me,” referring to himself at the time. Except for specifically law enforcement related matters, unrelated to unwanted fire, this defines the responsibility of fire department emergency response. The two most time sensitive, or emergency responses, include fire suppression and emergency medical/rescue code-three (with lights and siren) response. The fire service is truly a multi-mission operation that serves to address many of the emergency needs of the community. The capability of the local fire department is only limited to the funding and leadership provided by the governing agency decisionmakers.

To fully understand the importance of emergency response it is necessary to carefully consider the concept of time, and the influence of time on the growth of uncontrolled fire and patients in extreme medical conditions i.e., coronary, stroke, blood loss et al. In all these situations the outcome is directly related to timely intervention. The sooner that trained personnel, operating efficiently, arrive at the scene and begin fire suppression or medical treatment the more likely that a desired outcome is probable. There are three components to the total response time of a fire department: call processing time, turnout time, and travel time. The only component that cannot be manipulated to a great extent is travel time as rescue personnel can only travel so fast through the city streets to arrive at the scene of an emergency.

The distribution of fire stations across the land mass of a city like Newport Beach serves to place fire department rescue personnel near potential fires or medical emergencies under static conditions. During times of fire department system stress due to uncontrolled fire i.e., Emerald Bay and Coastal Fire recently, in Orange County and specifically Newport Beach, a rapid and integrated system is employed to shift similar resourced into areas of reduced coverage. This was recently demonstrated and reported to the City Council in a timely fashion by the fire chief regarding the Coastal Fire in Laguna Hills. Rapid intervention serves the people you, and your fire department serve.

Of the two identified time sensitive functions of the fire department, fire suppression and medical/rescue, resource deployment should be considered for the need based on a timely response to the incident, or potential incident. Because the building stock of a community changes slowly over time, the deployment of firefighting resources and staffing at the local firehouse responsible for initial fire suppression efforts should be based on factors related to risk, occupancy type, and travel time to all areas of initial responsibility, or first due for the resources staffed at that firehouse. Earlier intervention of fire should equate a smaller fire that is extinguished faster, requiring fewer total resources from neighboring firehouses. This concept should result in a more efficient operation that has fewer fire stations assigned to a fire and committed to a fire outside the first due area.

Because the community will need the firehouses staffed for fire suppression needs, the use of these same firefighting personnel for emergency medical/rescue response was seen as a wise use of taxpayer funds. The report fails to understand the wisdom of this important concept, and in fact fails to consider this altogether. Fire apparatus, fully equipped to perform all the multi-mission functions, and available 24/7 unless committed to a prior emergency is the gold standard of the business. The idea presented to staff a two-person medic unit in place of a “second” engine at the Laguna Woods firehouse fails to consider the multi-mission functions of a fire station that protects a large hospital, a very busy complex of freeways, and housing with mature residents who will need additional support under emergency circumstances. That Laguna Woods firehouse is staffed in that fashion because it is the busiest firehouse in a densely developed county of over 3 million residents. Drawing broad conclusions based on a limited, and often false understanding, has resulted in a bad recommendation.

I found it unusual that Newport Beach in particular, with a somewhat unique deployment of resources only matched by the City of Orange, was not mentioned in text of this report. This was especially noteworthy as the thesis of the report was focused on resource deployment, city operated ambulance services, and the Orange County Fire Authority (OCFA). The limited investment by the OC grand jury into the research on this important subject only serves to support the idea that the effort was biased from the start and will provide ample information for those intent on diminishing the value of a future OC grand jury report on a similar subject.

My COVID-19 Antibody Testing Experience

The Novel Coronavirus disease has impacted the country at all levels of society, influencing and perhaps exacerbating beliefs about the value of science, importance of government, and the public’s appetite for risk. Because so much of everyday people’s understanding of the science of disease progression, and COVID-19 in particular, is not well understood by the population at large, each day new information is learned that shapes and/or fortifies earlier held feelings. And because of the availability of information that has not been vetted is written and published on an hourly basis, it may be difficult for the everyday American to carefully consider all of the important nuances in each article or news segment.

Like many others I was interested in learning if I had been exposed to COVID-19 earlier this year. I had been sick with a significant respiratory illness about the time of when the virus is reported to have first arrived in California. Because I regularly provide assistance to elderly relatives, I felt motivated to understand what my potential was for contracting and transmitting the disease. Early information indicated that the availability of testing was limited and that available COVID-19 tests would be reserved for those workers whose employment regularly interfaced with infected individuals.

With the passage of time I learned of a number of locations around Orange County, California that had COVID-19 testing capabilities. It was important that I establish baseline to learn if I had been exposed to COVID-19 to an extent that I had developed antibodies. During one of my limited trips to the supermarket I saw a sign that advertised “Instant COVID-19 antibody testing now available.” I made an appointment for the next day at 0800 when the emergency care facility opened for business that day.

When scheduling an appointment, I was pre-screened online by answering questions about why I wanted the COVID-19 test and if I believed I had been exposed. I was able to obtain the first appointment for the following morning, and upon arrival was surprised to find that I was the only customer at the facility. Because of the prominent sign advertising the availability of such a test, and the limited availability of testing, I had expected greater interest. I walked into the local emergency care facility, followed the written instructions pertaining to disease spread, and made contact with the medical receptionist. The process was efficient and involved a very limited amount of contact. I had worn an N95 face mask that I’ve had for months and the only other potential for transmission was the paper I handed to the receptionist. All of the billing questions and associated HIPPA questions were managed previously via online.

After about ten minutes, I was invited into a treatment room where I was met by a lab technician. The room looked exceptionally clean and the technician was professional. He looked for a site to draw blood and choose to use my left antecubital vein. Using and alcohol swab, proper site preparation and a small needle the technician drew a small sample of blood rapidly. When I asked about the anecdotal figures for those COVID-19 tests he noted that many of the tests were negative, specifically for Orange County. Without elaboration he seemed to indicate that the outcomes were different in other areas.


The testing that was performed was an immunoassay for suspected disease caused by the 2019 novel coronavirus, rapid SARS CoV 2 IgG + IgM Ab, QL IA serum or plasma. To the best of my understanding, this testing process attempts to determine if I have the antibodies following exposure to COVID-19. The test is designed to find antibodies for both near term, such as the last two weeks from the time of the blood draw (IgM), to long term (IgG). The sensitivity and specificity of the assay were not presented.

After about 15 minutes, I was given my result: my test was negative for COVID-19 antibodies, meaning that I was not exposed to the virus if this test proves accurate. The cost was $70.00.

This benefit of this exercise is that it forms a baseline for my exposure moving forward. Assuming I use the same cellular phone I would be able to track my movements and find when/where I am exposed in the future, if that happens. Other technological values that I do not fully understand may be used to follow my movements that could be used in the future to determine a when/where/who of a possible/suspected exposure. My experience illustrates the value of public testing and how this can be used to manage the risk regarding COVID-19 and the reopening timeline specific to state and local government.

Seal Beach Pier Fire

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Seal Beach, CA May 20, 2016

The structure fire in an abandoned restaurant at the far end of the Seal Beach municipal pier illustrated the challenges and capabilities of fighting fire using vessel based pumping systems in Orange County. A review of the defensive firefighting operations from this uncontrolled fire in strong onshore winds demonstrates the value of adequate fire pumping capabilities from a fireboat platform necessary to limit property damage and public injury.

At 0735 on Friday May 20th, 2016, the Orange County Fire Authority (OCFA) responded to a fire in a restaurant at the end of a pier that is 1835 feet long. While the fire was declared under control at 0905, strong onshore winds fed hidden fire that led to a conflagration that consumed all adjacent structures. Pumping operations from numerous fireboats from the Long Beach Fire Department and the Orange County Sheriff’s Department-Harbor Patrol limited damage to the pier itself. Additional fireboats from the Los Angeles Fire Department and Los Angeles County Fire Department were requested during the expansion phase of the fire.

Several important lessons were learned from this event. First, the coordination and cooperation from the many agencies involved including federal, state and local government stems from proper preincident plans development. This is critical during an event that can potentially impact the coastal water environment in California. Further, the assistance provided by fire boats based in Los Angeles County reinforced a gap in capability by all fire agencies in Orange County and proved critical to the suppression effort. No Orange County fire service agency has a fireboat capable of pumping water on a fire. And, while some believe that there are too few boat fires and pier fires to expend the resources for a fireboat, the data suggest otherwise. Initially, consider the time, effort and expenditures expended to prepare for a wild land fire. Realistically, what is the wild land fire threat potential near the coast with higher humidity and near constant marine influence? Does it exist? Certainly. But so does the threat from a fire on the water as demonstrated in Seal Beach.

There are three harbors in the County of Orange: Dana Point Harbor, Huntington Harbor and Newport Harbor. Each of these is unique, but fundamentally they share a common challenge regarding fire protection. Fire suppression in the water environment is delivered by the Orange County Sheriff’s Department-Harbor Patrol (OCSD-HP) from fireboats deployed in the harbors, and not the local fire departments. Because this is not a required service, as determined by the county counsel in a report on the Harbor Patrol in 2010, the sustainability of this important protective service is subject to the support from the OCSD and not by legislative mandate. However, the initial and on-going fire suppression training given to the Orange County Sheriff’s deputies is not equal to the established standard of the fire service in California. OCSD-HP deputies are trained in a curriculum not vetted by State Fire Training. This is probably most problematic during offensive interior operations aboard a vessel when operating in a marginal situation. Proper training is essential and until this gap in training is addressed, the risk to the public is elevated.

Of the three Orange County harbors, the most significant fire suppression challenges are seen in Huntington Beach and Newport Beach, but for different reasons. In Huntington Harbor, all boats are dockside and reachable by land-based firefighters unless underway. There are no offshore moorings in Huntington Harbor, however a unique challenge is the offshore oil platform Eureka. This platform lies in the near shore environment and within Huntington Beach city limits if you observe a three-mile mark from mean high tide. When the platform is operational this represents a potentially significant fire suppression challenge beyond the capability of the OCSD-HP and the local fire department. Another significant challenge is in Newport Beach. Newport Harbor has over 1200 public moorings beyond the reach of land-based fire fighters, as well as several areas of anchorage for larger vessels. Each of these moorings and anchorage sites potentially represent a floating residential condominium beyond the reach of land-based firefighters. Each of the vessels should be recognized as a complex structure that holds combustible and/or flammable liquid as operational fuel, as well as hazardous mechanical and electrical systems in a confined space environment. Together, these hazards pose a significant challenge for fire suppression actions for the local fire department in the form of resource deployment, training, and apparatus acquisition and deployment.

The challenge for Dana Point and Newport Harbor is that the fireboats that were available for the Seal Beach pier fire would have a much greater reflex time to reach the site of any similar fire suppression incident either Dana Point or Newport Harbor. The extended reflex, or travel time, would exacerbate the fire problem and increase the time before suppression actions were employed, leading to a larger fire and greater damage to property and the public. The fire in this scenario could develop beyond the capability of standard fire suppression tactics and potentially consume all available fuel in its path.

The likelihood that fireboats specifically designated to protect such a vital commercial port operation and national interest would be released from that primary duty and made available for something far from their primary duty in the port of Los Angeles/Long Beach is an open question that would be determined at the time of the event