Those blazes — the Atlas Peak and Tubbs fires — were two of dozens that would break out Oct. 8, ultimately killing 44 people and damaging or destroying 21,000 homes.

A five-month KQED investigation of what happened that first night of the fires found a series of failures and missteps by both local and state officials that go well beyond previously documented evacuation delays: Our review of thousands of 911 and dispatch calls, along with dozens of interviews, has revealed large systemic problems with the state’s emergency response procedures.

The review shows that even with homes burning and lives on the line, first responders and decision-makers remained hamstrung by those problematic procedures and policies. They struggled to adapt as quickly as the fires were moving.

Among our findings:

Electrical problems sucked resources and delayed emergency response: The fires started early; many were caused by downed power lines, which overwhelmed the electrical grid and lit new blazes. These electrical problems sucked firefighting resources to smaller blazes, leaving first responders short-staffed when the larger fires broke out later. The power issues also delayed fire crews, who had to wait for utility workers to power down live lines.

Communication among first responders broke down: Inconsistencies, in the technology and terminology used by different jurisdictions to tell people to evacuate, caused confusion and delayed alerts to the public.

911 centers were overwhelmed: 911 operators were juggling dozens of calls at once and were often unable to answer calls from people in danger. When fire victims did get through, dispatchers didn't know what to tell them about the safest way to flee the flames.

California has one of the most well-funded and advanced emergency response systems in the nation.

But some of the problems we uncovered — the potential for electrical fires, the shortcomings of alerts — were well-known before the fires began, and changes were already underway, or being considered, at the state and federal level to fix them. Authorities certainly knew that conditions were perfect for fire, and that these ferocious blazes are the new normal in California: About half of the state’s worst recorded wildfires occurred in just the last decade.

Even so, many officials defend the decisions made that first night, including Mark Ghilarducci, who directs the governor’s Office of Emergency Services.

“The events as (they) unfolded on that evening presented extreme challenges,” he said in a recent interview. “I wouldn't call it failures — I would call it, you know, cascading challenges that occur.”

Yet he acknowledged that state and local officials are working to make changes.

Residents who lost family members, pets, homes — or remain traumatized from fleeing the fires — aren’t interested in excuses.

Jason Meek and his elderly parents got no warning to evacuate — from neighbors or authorities. Their home in the hills above Santa Rosa is gone, and they almost died trying to drive out of flames that were at their front door by the time they woke up a little before 2 a.m. — nearly four hours after Biermann heard that the fire was heading toward Santa Rosa.

Meek finds it remarkable that no one bothered to warn his family about this fire.

“Like we get all these text messages from CNN and Washington Post, or, you know, all the media that's telling us what's going on, on a minute-by-minute basis, in the world. But here — my world was burning and I heard nothing,” he said.

“We deserved to know that there was a fire.”

Electrical Problems Exacerbated Fires

Cal Fire is still investigating the official cause of the wildfires that sparked that night. But in a series of lawsuits, thousands of fire survivors, along with the counties of Napa, Mendocino and Sonoma, already are blaming PG&E, California’s largest utility, for causing the fires.

Even if Cal Fire finds that PG&E equipment did not cause the biggest fires, KQED’s review showed the utility’s equipment played a big role in slowing fire response.

KQED’s review of dispatch tape and 911 calls found that people started reporting electrical problems by 4 p.m. Callers reported high winds knocking down power lines, sparking fires. In other instances, they reported explosions.

Between 7 and 10 p.m. dispatchers in Napa and Sonoma counties discussed electrical fires, transformers blowing and power lines arcing more than 40 times. Sonoma County dispatchers also received dozens of calls about electrical incidents.

These calls drained fire resources: Cal Fire Unit Chief Anale Burlew said officials were so busy taking calls and responding to dozens of fires — many of them electrical — that it slowed their ability to ask for desperately needed resources from neighboring counties.

Burlew said that every time an electrical incident is reported, it is rated top priority because it’s such a threat to the lives of first responders and the public.

The profusion of early fires also overwhelmed dispatch centers, not only preventing the public from reaching 911 but also hurting authorities’ ability to talk to one another.

By 10 p.m. a dispatcher in Napa County trying to connect to Cal Fire reported getting a busy signal. At the same time, a dispatcher in Sonoma County trying to connect to Napa County also got a busy signal.

“We're totally inundated,” a Sonoma County Fire employee said to a Sonoma County dispatcher over the phone, “I can't even count. I wanna say there's like 30 calls pending right now.”

Aaron Abbott, executive director of Redcom, the fire and medical dispatch center for Sonoma County, said his crews were working as hard as they could.

But, he said, “everybody in the entire region was absolutely overwhelmed.”

Things got worse before they got better: The Redcom dispatch center itself, located on the northern side of Santa Rosa, lost power as the wildfires chewed through the electrical grid. Redcom transitioned to a backup generator, but lost its air-conditioning system. The room filled with hot smoke, making it difficult for dispatchers to work. And, as the fire marched down the hills toward Santa Rosa, Abbott had to weigh more than once if he needed to evacuate the 911 call center.

“It was very difficult on the dispatchers because they were not only handling a high-call-volume emergency, but they were also having to endure some not-so-good conditions inside the dispatch center,” Abbott said.

Downed Power Lines Stall Rescuers

Out where the fires were burning, electrical problems were also hampering first responders’ ability to keep people safe.

At 10:30 p.m. firefighters responded to reports of an explosion and power lines down across Highway 101 in Windsor, 9 miles north of Santa Rosa, and fire on both sides.

“We're going to fight the one on the southbound side because there's no power lines,” the firefighter said on the phone. “The northbound one's going to burn a while till PG&E gets out there.”

Yet many of these challenges could likely have been avoided by doing something that’s common practice in many other parts of the U.S. and even other regions of California: Shutting off the power during a natural disaster.

It’s normal procedure in Southern and Eastern states where hurricanes occur. And Cal Fire asked one Southern California utility — San Diego Gas & Electric — to shut off power more than a dozen times in 2017 to prevent fires from starting during windy conditions.

But officials in Northern California said they did not consider asking PG&E to shut down power before or during these fires, even as reports of electrical problems continued to flood in.

“That is not something that we have historically done,” Burlew said.

In the wake of these deadly wildfires, that procedure may change.

Ghilarducci, the state’s Office of Emergency Services director, said his office is working with all of the state’s utilities to mitigate fire risk. And as PG&E faces the prospect of losing billions of dollars to lawsuits, the utility appears to be on board.

“Given the changing conditions related to climate change and the new normal we are all witnessing,” said PG&E spokeswoman Erin Garvey, “we have reached a determination as a company that there may be times in the future when we will need to consider proactive de-energization of certain electric lines in advance of weather events.”

Garvey added that the utility has historically relied on Cal Fire asking it to shut down lines. But she said PG&E is in the process of talking to state regulators and elected officials about how to deal with the issue moving forward.

However, Garvey said de-energizing lines is not a panacea and there are risks to shutting down power. For example, she noted that a shutdown could affect the ability of first responders to communicate, disrupt operations of critical facilities such as hospitals, hinder efforts to convey evacuation orders and cut power to people using medical life support equipment.

Communication Failures Among Authorities

But electrical problems weren’t the only avoidable challenges facing first responders: KQED discovered numerous communication problems between public officials that night.

At 10:30 p.m., as the Tubbs Fire was beginning to explode, a Cal Fire employee called a Napa County operator.

“I need you guys to send out a reverse 911 so we can tell them [residents in the area] to evacuate,” a Cal Fire employee asked a Napa County operator.

“OK, I'm just not, I'm sorry I'm not familiar with what a reverse 911 is,” the operator responded. “I'm sorry.”

The Napa County operator didn’t know what Cal Fire was talking about because each of California’s 58 counties uses different technologies to alert people. Some call landlines in small designated areas that emergency officials want to target for evacuations; others send text and email messages to anyone who signed up ahead of time. The text and email alerts also can go out to targeted areas, like ZIP codes.

Even though the reverse 911 request came in from Cal Fire at 10:30 p.m, Napa County didn’t send its first alert to residents until more than an hour later, through an opt-in system that sends out texts and emails. It didn’t call home phones about evacuations until 1:38 p.m. the following day.

OES Director Ghilarducci said this patchwork quilt of technologies is a problem.

“That's why the WEA, the wireless emergency alert system, was put in place,” Ghilarducci said.

The Wireless Emergency Alert system takes over your cellphone with a loud shrill noise — like an Amber Alert. But Napa County didn’t even have access to the technology — it is still waiting for approval from the federal government. And Sonoma County officials opted not to use it.

In an interview with KQED, Chris Helgren, the former emergency manager for Sonoma County Fire and Emergency Services, said the county avoided WEA because they worried too many people would evacuate, clogging roads and leaving people stranded in traffic as the fire approached.

Helgren also said the alert system doesn’t allow officials to target a small enough geographic area and limits messages to 90 characters -- and there’s no way for the county to know who received them. Federal officials are working to change some of those shortcomings.

But Helgren was reassigned in February after a report by Ghilarducci’s agency found significant problems with Sonoma County’s response to the blazes — echoing many of the issues identified by KQED. Helgren’s employment status and level of employment have not changed.

In general, Ghilarducci said, local officials tend to be overly cautious about warning people.

“There's always obstacles that they throw out in front of them,” he said. “ 'Oh, it's going to cause panic. Oh, it's going to be traffic. Oh, it may not get to the exact streets we're talking about. It may actually be broader than we want to do.’ I think that, you know, you can't let perfect get in the way of good enough.”

This is a lesson already being put into practice. When wildfires struck Southern California in December, Ghilarducci’s agency decided to notify residents using the WEA system. No residents died in that fire.

Officials Repeatedly Alerted the Public Too Late

For many survivors, the most glaring problem that night was the lack of communication about when to evacuate and where to go.

While many officials defended their decisions, saying the fire was moving too fast to get everyone out of harm’s way, KQED found significant delays between the time that first responders recognized the need to warn residents and when officials actually sent out those alerts.

In addition to the Napa County delays, there were also large gaps between when firefighters asked Sonoma County to start evacuating people and when those calls went out.

It took a full hour for Sonoma County to send alerts to about 2,000 residents on their home phones. Thirty minutes earlier, Sonoma County officials did send out wireless text and email alerts to any county residents who had previously opted into that system — but those can be more broadly targeted, so they may not have reached the right people. County officials don’t actually know how many people in the paths of the fires received those alerts.

And by that time, many people’s cellphones weren’t working anyway because so many cell towers had been taken down by the fires.

Some of these delays appear to be connected to California’s procedure for ordering evacuations: Firefighters can’t tell people to leave their homes; they can only recommend that law enforcement order an evacuation.

So that night, when firefighters on the ground saw a fire barreling toward homes, they had to call the Cal Fire command center. Someone there then called a county dispatcher, who let the sheriff’s office know. Finally, the sheriff would decide whether to evacuate.

Sheriff’s deputies were out going door to door, but they would not make it to every house. And in Sonoma County, the Emergency Operations Center, which can also send out alerts, wasn’t set up until hours after the blazes broke out.

The Sonoma County sheriff declined to be interviewed by KQED.

That meant people like Jason Meek and his parents never got a warning -- even though first responders knew for hours that the fire was headed toward his neighborhood and others nearby.

In other cases, authorities seemed to be so focused on urban fires they failed to recognize or communicate that rural areas also needed evacuation orders.

At 12 a.m. a Redcom dispatcher asked Cal Fire if the Kenwood area of Sonoma County needed to be evacuated.

“We didn't get any reports for evacuations there,” Cal Fire Capt. Jeff Hoag said.

“ ‘Cause I have two people, I have two people stuck on Chateau St. Jean's [a winery in Kenwood],” the dispatcher replied.