Tornadoes are natural disasters that can have devastating effects, such as loss of life and the ability to render many homeless as well as resulting in significant economic losses. Tornadoes present a low probability of occurrence but potentially high impact on structures. They are heavily influenced by location (i.e., "tornado alley"). Hospitals and other critical facilities must be kept in service or have loss of service minimized in order to provide shelter for immobile patients and care for survivors. This paper discusses the current, somewhat limited, building code requirements for the design of buildings in areas with a high risk of tornados and will focus on critical healthcare facilities that must remain functional during natural disasters. Some of the lessons learned from reviewing two healthcare facilities, one damaged by an EF-5 tornado and one damaged by an EF-1 tornado, will be presented. As with any type of multi-hazard engineering, reducing the risk and exposure to natural disasters are fundamental; however, it also comes with an economic cost that must be carefully weighed.
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