VICTORIA — Vancouver’s two largest emergency rooms are at high risk of collapse in an earthquake, along with many other aging hospitals and health care buildings across the Lower Mainland.

New seismic risk assessments show major buildings that house hundreds of patients — including the Vancouver General Hospital’s 12-storey Centennial pavilion (built in 1959), the north building of the Jim Pattison pavilion that houses the VGH emergency department (built in 1978), and the almost 100-year-old St. Paul’s Hospital in downtown Vancouver — are at high risk to collapse or suffer widespread damage in an earthquake.

Major buildings at the UBC Hospital, Richmond General Hospital, Lions Gate Hospital, Burnaby General Hospital, Langley Memorial Hospital, the B.C. Children’s Hospital and the B.C. Women’s Hospital have also been flagged at the highest earthquake risk in the reports.

Many of Metro Vancouver’s hospital and health care buildings were built before 1970, when the province adopted modern seismic building codes.

Consequently, the concrete or masonry structures lack the elasticity and strength to “bend but not fail” with an earthquake’s shocks, and they are more likely to experience failure in the walls and columns that support the floors and ceilings, said Clint Low, a senior partner at Bush, Bohlman & Partners LLP, the structural engineering firm contracted to do the assessments.

“If it’s rated very high, it may not collapse during the earthquake but it’d likely be unsafe to occupy post-earthquake, which is a big issue for a hospital,” said Low. “If you can’t occupy your hospitals, where do people go?”

If emergency rooms were unusable, patients would likely be triaged by medical teams outside, like during the Stanley Cup riots in 2011, said Jeanette Beattie, the Lower Mainland director for Health Emergency Management B.C. There’s a mobile medical unit available.

The B.C. government has spent $2.2 billion to seismically upgrade or replace 214 schools since 2001.

But it has no seismic upgrade program for hospitals, despite their importance as a rallying point for displaced residents and a trauma centre for those injured in an earthquake.

Instead, seismic upgrades are typically done during large hospital redevelopments, or when an old hospital is replaced by a new structure, which is built to the latest earthquake code.

Health Minister Terry Lake said the government is spending all it can afford to upgrade and replace hospitals, which has amounted to more than $10 billion since 2001, and another $2.75 billion over the next three years.

“I think most British Columbians are realistic on this, they understand there’s a risk, and people on the Lower Mainland and Vancouver Island know that better than anybody,” he said in an interview.

“But they also know there’s a reasonableness and a limitation to how many tax dollars you can put to pulling that risk downward.”

The $1.2 billion replacement for St. Paul’s Hospital will be built to modern seismic codes and include a new emergency room. But it isn’t scheduled to open until 2022.

The new seismic assessments have so far only studied one-third of the area’s 208 health buildings, but has concentrated first on some of the oldest sites.

The data so far shows 51 per cent of structural blocks assessed so far inside health care buildings are at high risk. But the figure rises to 63 per cent at hospital sites. (Structural block may refer to an entire buildings or a structurally independent section of a large building.)