E nvision medical facilities with no more room for the injured, the social fabric unraveling while bewildered federal, state and local officials line up in front of the camera for their turn to point the finger.

Think this is a rehash of the Gulf Coast disaster? In fact, this could be the scene following a serious earthquake or outbreak of pandemic influenza in Washington state.

How could history repeat itself so quickly? Unless we make more headway in Olympia, the answer is a familiar one: failure to prepare.

Numerous preparedness scorecards have been published in the wake of Katrina, but none of them do justice to the crisis that results when disaster strikes a particular region.

Washington’s own Working for Health Coalition (WFHC) prepared a report that focuses on our state and adds an important missing piece to the preparedness dialogue: What does being prepared look like? And what does it take to get there?

According to the report, a pandemic influenza (e.g., possible bird flu outbreak) would leave 4,000 Washingtonians dead and another 17,000 hospitalized.

And a looming flu pandemic is only one possible threat. As we look back five years to the Nisqually earthquake, we may recall the likelihood that our region will experience a 9-magnitude earthquake every 100 years. At that rate, we are 200 years overdue.

As detailed in the WFHC report, a 6.7-magnitude earthquake along the Seattle fault could lead to 1,600 deaths, 24,000 injuries, tens of thousands of displaced citizens and a complete breakdown in the transportation of goods and people.

Many communities in Eastern Washington would lose access to needed food and medical products because of disrupted utility and transportation lines. In addition, it is likely that a large portion of the displaced population from Western Washington would move, at least temporarily, east of the mountains.

Registered nurses – from public health to hospitals – bear witness to the tragedy that results when the health system lacks a solid foundation. Every day we see increasing cases of children not immunized, tuberculosis, sexually transmitted diseases, measles, whooping cough and, in some populations, infant mortality. It’s getting difficult to impossible for the public health system to keep up with the rapid demand in need.

Two years ago there were two separate field teams consisting of nine nurses to serve all of North and South Spokane County. In 2005, there were only five full- and part-time field nurses and a total of only 22 public health nurses serving a community of over 450,000 residents.

If we can’t keep up with day-to-day situations, what’s going to happen in the event of a disaster?

These are the signs of a deeply troubled public health system whose shortcomings cannot be rectified by polite legislative maneuvers. Given the state of our state’s public health system in its day-to-day operations, it is difficult to imagine the effects of a major event, be it bioterror, influenza or natural disaster.

Yet even now our Legislature is seeking to pare Senate Bill 6366 – a no-nonsense bill that seeks $20 million to prepare us for a flu outbreak. This is hardly an extravagant request in light of the circumstances.

Washington’s public health system is in jeopardy due to decades of neglect and erosion in public health funding. The ability of our local public health department to perform its core functions has been hamstrung. As the health care budget lies under siege, Washington loses ground on emergency preparedness targets in addition to all that we’re currently facing in poor early childhood health and emergency rooms overflowing as a result of our skyrocketing uninsured population.

State and federal investments in public health capacity are urgently needed to help protect Washingtonians. We need to make investments to our public health capacity to guarantee a sustainable system that will be there for us now and protect us when disaster strikes.

Today, SB 6366 is a step in the right direction. We must take that step with utmost haste. And then we must take the steps after that.

Washington can’t afford to gamble with its health system.