The Brief

In light of the tsunami advisory issued Tuesday, July 29, following an 8.8 magnitude quake in Russia, we're resurfacing a 2017 story from our partner newsroom KQED in San Francisco.

In 2015, Steven Horowitz was watching one of the summer’s big blockbuster action flicks, San Andreas. In the movie, the San Andreas fault shifts, triggering a magnitude 9.6 earthquake in San Francisco. Disaster ensues — and for the rest of the movie we watch as all of the West Coast’s greatest landmarks are destroyed one by one in an epic, computer-generated spectacle.

“I was sitting there watching the giant tsunami course through the Golden Gate and into the bay,” he says. “I looked at that and thought: Wouldn’t there be some kind of dissipation coming through the Golden Gate?”

In 2017, he asked KQED's Bay Curious: If a tsunami were to hit the Golden Gate, what would be its real effect on communities facing the San Francisco Bay?

It’s all about our faults

Despite the terrifying image of a 250-foot wave about to wash over the Golden Gate Bridge, tsunamis do not actually pose a considerable threat to the Bay Area.

It all has to do with the kinds of geologic faults that we have (and don’t have).

Tsunamis are caused when one tectonic plate slides underneath another — a process called subduction. This slow movement is happening all the time, but sometimes a plate will get stuck and pressure starts to build. When it finally lets go, there’s an underwater earthquake that can move the seafloor up and down, sending a wave to the surface of the ocean.

But the San Andreas Fault is different. It’s called a slip-strike fault because the two plates slide past each other horizontally. Of course, whenever plates move, the ground shakes. But here, there is no subduction and little displaced ocean.

Meaning no killer tsunamis. Even San Francisco’s infamous 1906 earthquake generated only a 4-inch wave at the Presidio gauge station.

Small waves still pack a punch

Although they aren’t generated here, tsunamis do occasionally hit our shores. Since 1854, more than 71 tsunamis have been recorded in San Francisco Bay. Most were generated by earthquakes in subduction zones near Russia, Japan or Alaska.

Eric Geist, a geophysicist at the U.S. Geological Survey in Menlo Park, says that size is the most important factor in evaluating risk.

“We can look at anything, from huge waves to micro-tsunamis, that you’d never see with your eyes but our instruments can detect,” he says.

The worst tsunami to hit the Bay Area was triggered in 1964 by a magnitude 9.2 earthquake in Alaska, Geist says, that killed 11 people in Crescent City. That wave rolled in at just under 4 feet and damaged marinas and private boats in Marin County.

The infamous 2011 tsunami that devastated parts of Japan also arrived in the East Bay 10 ten hours later at just over a foot in height, and caused millions of dollars of damage in Crescent City.

The Cascadia subduction zone, which runs roughly from Mendocino County to Vancouver Island, could also produce a massive earthquake and tsunami. But Geist says it’s unclear how a tsunami from “The Really Big One” would affect the Bay Area.

The 2011 Japanese tsunami, photographed as it arrived in Emeryville. Click to see video of the tsunami.

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Steven Winter via Flickr

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“Oregon, Washington and California north of Eureka would really bear the brunt of that tsunami,” he explains.

But what if a Big One arrived?

Although it’s unlikely, Steven Ward, a professor of earth and planetary sciences at UC Santa Cruz, has created a series of animations to show how a big tsunami might spread through San Francisco Bay.

In Ward’s simulations, the incoming wave stands just over 16 feet tall. This is much larger than historical tsunamis, but Geist agrees that a wave this size is theoretically possible.

Approaching the Golden Gate at 55 mph, the wave would first hit the outlying areas of Point Reyes National Seashore and Montara. It would then start to flood low-lying areas like Half Moon Bay.

“It’s not like splash and dash,” explains Ward. “When the water comes in, it’s going to flood.”

It would feel like a 12-hour tidal cycle was packed into an hour.

“And it will do as much damage when it goes back out and drags along cars and debris,” he adds.

The original wave and splashbacks from shore would then start to pile up as they squeeze through the 1-mile-wide Golden Gate. In Ward’s simulations, the wave reaches a maximum height of about 30 feet.

“That’s barely to the top the pylon,” says Ward, who is confident that the bridge would have no trouble withstanding the wave energy. “It probably wouldn’t even touch the steel.”

Finally, the wave would fan out into San Francisco Bay. Parts of Crissy Field, Mission Bay and the Marina could see significant flooding, but by the time it reached Treasure Island or the East Bay, the wave would be less than 3 feet tall. It would probably not even make it to the South Bay.

Inundation maps for coastal counties are a great resource for understanding how high ocean waters could rise near you. Here’s San Francisco.

Red regions may be vulnerable to inundation by a tsunami.

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Courtesy Cal EMA

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Verdict: The Bay Area is relatively safe

Steven Horowitz, who asked Bay Curious the question, was glad to hear that the tsunami would be nothing like the movie.

“By the time it gets to Berkeley, which is where I’m sitting right now, I think I’m pretty safe,” he says. “Sounds like it’s not going to come rushing up University Avenue.”

Bay Area residents can also rest assured that there have been no recorded deaths from tsunami-related events in San Francisco. And even a worst-case-scenario Cascadia tsunami would take several hours to reach the city, providing ample time to mobilize a response.

And just in case, the City and County of San Francisco has a tsunami plan in place. It includes a strategy for evacuating people from vulnerable areas like Ocean Beach, coordinating basic services (like shelter, water, food, and medical attention) and performing search and rescue.

Still, “if you get a warning and are in a tsunami zone, follow the evacuation instructions,” says Ward. “What do you have to lose, a couple hours of your time?”

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The U.S. Department of Housing and Urban Development cannot impose dramatically different conditions for homelessness programs for now, according to an oral ruling Friday by U.S. District Judge Mary McElroy in Rhode Island.

McElroy granted a preliminary injunction to a group of states, cities and nonprofits who said a last minute overhaul of how to spend $4 billion on homelessness programs was unlawful. She also agreed with their argument that it likely would push many people back onto the streets in the middle of winter, causing irreparable harm.

"Continuity of housing and stability for vulnerable populations is clearly in the public interest," said McElroy, ordering HUD to maintain its previous funding formula.

The National Alliance to End Homelessness, one of the plaintiffs, said in a statement the order "means that more than 170,000 people – families, seniors, veterans, and people with disabilities — have respite from the government's assault."

HUD has sought to dramatically slash funding for permanent housing and encourage more transitional housing that mandates work and treatment for addiction or mental illness. The overhaul — announced last month — also would allow the agency to deny money to local groups that don't comply with the Trump administration's agenda on things like DEI, the restriction of transgender rights and immigration enforcement.

"HUD will continue working to provide homelessness assistance funding to grantees nationwide," said HUD spokeswoman Kasey Lovett in a statement to NPR. "The Department remains committed to program reforms intended to assist our nation's most vulnerable citizens and will continue to do so in accordance with the law."

'Chaos seems to be the point'

McElroy expressed frustration with a series of HUD actions in recent weeks. Just hours before a Dec. 8 hearing, the agency withdrew its new funding notice, saying it would make changes to address critics' concerns. But on Friday, HUD's attorney said the new version would not be ready until the end of the day.

"The timing seems to be strategic," McElroy said, asserting there was no reason the document could not have been ready before the hearing. "The constant churn and chaos seems to be the point."

In defending the agency, attorney John Bailey said HUD was simply trying to change its policies to reflect President Donald Trump's executive orders, which he called "legal directives." The judge interjected repeatedly to explain that he was conflating things, noting Congress — not the president — makes laws.

'It's kind of shocking'

HUD's changes were announced in November with little notice and only weeks before local homeless service providers must apply for new funding.

"Our agencies are just scrambling right now to try to respond," said Pam Johnson with Minnesota Community Action Partnership, whose members provide housing and other services for homeless people. "It also just reverses 40 years of bipartisan work on proven solutions to homelessness. So it's really, it's kind of shocking."

For decades, U.S. policy favored permanent housing with optional treatment for addiction or mental illness Years of research has found the strategy is effective at keeping people off the streets.

But many conservatives argue it's failed to stop record rates of homelessness.

"What is the root cause of homelessness? Mental illness, drug addiction, drug abuse," HUD Secretary Scottt Turner said recently on Fox Business Network. "During the Biden administration, it was just warehousing. It was a homeless industrial complex."

Turner and others who support the changes say the goal is to push people towards self-sufficiency.

But local advocates say mental health and substance abuse are not the main factors driving homelessness.

"It's poverty. Poverty, low income and significant lack of affordable housing," says Julie Embree, who heads the Toledo Lucas County Homelessness Board in Ohio.

Many in permanent housing have disabilities that make it hard to work full time, she said. Embree agrees with Trump administration goals like efficiency and saving money, but says pushing people back into homelessness, where they're more likely to land in jail, the courts or a hospital, is not cost-effective.

"One emergency room visit is just as expensive as a month of sustaining this [permanent housing] program," she said.

In Los Angeles, Stephanie Klasky-Gamer with LA Family Housing said there is a need for more transitional housing, but not at the expense of long-term housing. And the idea that programs could simply switch from one to the other is not only unrealistic, it's illegal.

"You cannot take a building that has a 75-year deed restriction and just — ding! — call it interim housing," she said.

Those challenging HUD say providers who own such properties – or states who've invested millions of dollars in permanent housing projects — face "significant financial jeopardy" if their funding is not renewed.

In addition to the legal challenges, members of Congress from both parties have questioned HUD's sudden shift on homelessness. Advocates have lobbied lawmakers to step in and, at the least, push for more time to prepare for such a massive overhaul.

President Donald Trump said the administration has reached agreements with nine more drugmakers to bring their U.S. drug prices more in line with what other wealthy countries pay.

Fourteen companies in total have now reached what the administration calls most-favored-nation pricing deals. The companies that took part in Friday's announcement were: Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Genentech, Gilead Sciences, GSK, Merck, Novartis and Sanofi.

They agreed to charge the U.S. government no more for new drugs than the prices paid by other well-off countries. The agreements will allow state Medicaid programs to access lower prices from the nine companies. In a statement, the White House said the change will result "in billions of dollars in savings."

The drugmakers also agreed to invest at least $150 billion in manufacturing operations in the U.S. The president is seeking to increase domestic production of pharmaceuticals.

In addition, the companies agreed to make some of their most popular drugs available at lower prices to consumers who pay out of pocket through a government website called TrumpRx.com. The TrumpRx website is expected to launch in early 2026, and would take consumers to pharmaceutical companies' direct-to-consumer websites to fulfill orders.

For example, Merck will reduce the price of Januvia, a medication for Type 2 diabetes, from $330 to $100 for patients purchasing directly through TrumpRx, the White House said. Amgen will reduce the price of Repatha, a cholesterol-lowering drug, from $573 to $239 when purchased through TrumpRx.

In exchange for these concessions, the companies will be exempt from possible administration tariffs for three years.

The extent of savings for consumers under the agreements is unclear. Medicaid and its beneficiaries already pay some of the lowest prices for drugs. And people with health insurance could spend less on copays for their medicines than paying cash for them through the drugmakers.

Separately, Trump said during the press event that he would like to get health insurers to lower their prices, too.

"I'm going to call a meeting of the insurance companies," he said. "I'm going to see if they [will] get their price down, to put it very bluntly."

America's new top health diplomat is Bethany Kozma.

The job she took on this week — leading the Department of Health and Human Services Office of Global Affairs — does not have a high profile. And Kozma herself is not a familiar name in the world of public health.

But it is a position with power — and Kozma has a record of public statements and activism on health issues, equating abortion with "murder" and campaigning against gender-affirming care.

The office sometimes is referred to as the "diplomatic voice" of HHS. As director, Kozma will have considerable influence over how the U.S. shapes health policy in other countries in the wake of the Trump administration's foreign aid cuts and withdrawal from the World Health Organization.

Kozma declined to be interviewed for this story. She doesn't appear to have a background in global health based on publicly available information online. The HHS website offers few details about her professional profile. In response to questions about her qualifications and vision for the role, HHS responded with this statement.

"The Office of Global Affairs (OGA) advances the Trump administration's agenda and priorities by bringing common sense, transparency and gold-standard science to global partners. Under Secretary Kennedy's leadership, OGA is committed to strengthening the United States' position as the global gold-standard for public health and ensuring Americans are protected at home and abroad."

Who is Bethany Kozma?

Kozma began her career in public service during the George W. Bush administration, working at the White House Homeland Security Council. During the Obama years, she re-entered public life as an activist.

In a 2016 commentary for The Daily Signal, a conservative news website founded by the Heritage Foundation, she argued against the Obama administration's guidance that public schools should allow children to use the bathroom that comports with their identity.

"This radical agenda of subjective 'gender fluidity' and unrestricted shower and bathroom access actually endangers all," she stated, noting that "predators" could abuse the policy.

In 2017, she joined the Trump administration as senior adviser for Gender Equality and Women's Empowerment in the United States Agency for International Development, eventually being promoted to deputy chief of staff. In videos obtained and released by ProPublica, Kozma recalls calling the U.S. a "pro-life" country in a closed-door U.N. meeting about women's rights in 2018, when access to abortion still was protected nationally by Roe v. Wade.

In August 2020, Sen. Chris Coons, D-Del., and four other Democratic senators issued a letter labeling Kozma and several other political appointees at USAID as "prejudiced" and called for them to be removed from their posts. Kozma has "spoken extensively and derisively of trans people and trans issues," the senators wrote.

During the Biden administration, she also was involved in Project 2025, the Heritage Foundation's "blueprint" for a new Republican administration. She played a prominent role in Project 2025 training videos, obtained and published by ProPublica.

In one nearly 50-minute training video focused on left-wing language, she called for a Republican administration to "eradicate 'climate change' references from absolutely everywhere," and said that concerns over climate change are efforts at "population control." She also called gender-affirming care "absolutely infuriating" and said "the idea that gender is fluid is evil." Overall, she argued that changing language around these policies should be a priority for political appointees.

Kozma joined the second Trump administration as a chief adviser at the HHS Office of Global Affairs. In September, she spoke at a U.N. event commemorating the 30th anniversary of the declaration that denying women's rights is a human rights violation.

"While many may celebrate so-called successes gained for women over the last 30 years, one must ask what defines true success for women?" she began, adding that "biological reality is rooted in scientific truth and is confirmed by the universal truths that we are endowed by our creator who made us 'male and female.'"

Those views can be divisive but have garnered some support for Kozma's promotion.

"Bethany is an excellent pick for global affairs at HHS," says Roger Servino, vice president of domestic policy at The Heritage Foundation. "She was an early champion of protecting children from gender ideology back when the medical establishment was able to silence voices of reason and dissent and she is perfectly placed to help push back on global health bodies trying to impose left wing pseudoscience on the American people and the world."

What will her goals be at the Office of Global Affairs?

Kozma is taking over as director of the HHS Office of Global Affairs at a time of drastic change for global health.

In previous administrations, a main focus of the office was dealing with the World Health Organization. Typically, the director, who usually has a background in public health, is involved in negotiations on sharing data for pathogen surveillance or developing vaccine policy, for example.

After President Trump withdrew the U.S. from WHO, the administration has started a new strategy: striking deals with individual countries to give health aid in exchange for their meeting certain policy prescriptions. Kozma has been involved in some of those negotiations, but the details aren't quite finalized.

Some reproductive rights advocates believe Kozma will use her new position to insert anti-abortion and anti-LGBTQ policies into these agreements.

"[Kozma] is vehemently anti-trans, anti-LGBTQI+, anti-abortion," says Keifer Buckingham, managing director at the Council on Global Equality, a coalition of advocacy organizations that focuses on LGBTQ issues. "For those of us who want to ensure that the provision of U.S. foreign assistance and health doesn't discriminate against people based on who they are, [Kozma's appointment] raises a lot of red flags."

One particular worry is about the Helms Amendment, a U.S. policy that prohibits foreign aid being used to fund abortion services.

"There's been speculation that there's an intention by the U.S. government to expand the Helms Amendment beyond abortion to include LGBTQ's as well," says Musoba Kitui, director of Ipas Africa Alliance, a non-profit that works to provide access to abortion and contraception. He's concerned that health groups that serve those populations could lose funding. That speculation is backed up by reporting from The Daily Signal that the administration is planning to prohibit U.S. aid funding for "gender ideology and diversity, equity and inclusion initiatives."

Given LGBTQ people are often at higher risk for diseases like HIV, such policies could make these communities even more vulnerable, says Kitui.

"We could see more marginalization, inequality, spikes of infection," he says. While many African governments signing these deals understand those dynamics, Kitui says they may still agree to more restrictive conditions as aid cuts have "starved health systems to a point of desperation."

Have information you want to share about ongoing changes at federal health and development agencies? Reach out to Jonathan Lambert via encrypted communications on Signal: @jonlambert.12