SANTA ROSA, Calif. — As fire blazed just eight miles away from Sutter Santa Rosa Regional Hospital, its chief executive Mike Purvis received a phone call from the Sonoma County Sheriff’s Office and Cal Fire, the state’s fire agency. The hospital was officially being ordered to evacuate.

Within minutes of the Saturday evening call, his staff was in motion. They went into an incident command center in an empty conference room and started calling other hospitals to find a place for each patient. Eighty-six were moved, many within a few hours, with ambulances rapidly shuttling the majority of patients and a few helicopters transporting the most critical cases.

Twelve hours later, Sutter was empty. On Sunday evening, the only noise came from medical equipment in empty rooms and a TV that droned in a deserted lobby.

As the nation’s most populous state adjusts to what could be years of record wildfires, cities, businesses and residents are acclimating to a new punishing regimen that will reshape life in California. Cities are using emergency powers to send mobile alerts to all residents. Authorities are giving far more time to families and businesses to leave danger zones, which have expanded in size. And residents are quicker to trust the calls to evacuate. The new evacuation strategies are a sign of how California, strung between the dueling risks of fires and rolling power outages, is adapting to a new reality many officials attribute to climate change.

Residents of the Los Angeles area find shelter and supplies at the Westwood Recreation Center while the Getty and Tick wildfires continue to spread on Oct. 28. (Peter Alton, John Farrell/The Washington Post)

“Certainly we feel well prepared now. We’ve done it twice, which is twice more than anyone would like to do it,” said Purvis. “But let’s hope that doesn’t become a regular thing.”

Memories of the fires in Sonoma County a mere two years ago — which claimed 22 lives — are still fresh here in this area which saw an exodus of 200,000 residents over the weekend. In interviews, businesses, families and others expressed a remarkably similar sentiment: this time, the evacuation went much smoother.

Maria De La O, who lives in Windsor, Calif., the city nine miles from Santa Rosa that was one of the first to burn in the Kincade Fire that started Wednesday, was evacuated three times over the weekend: from her house, then her sister’s in Santa Rosa, and then her mother’s, also in Santa Rosa. She said officials seemed much more prepared than two years ago. “I think the evacuations allow them to do their job and put out fires,” said the 55 year-old, who saw on TV firefighters dousing her house and saving it. “I know some people are probably not happy that they have to evacuate, but I would rather evacuate in case something happens.”

It is too early to tell whether the current blazes will be as deadly as two years ago. But some authorities attribute the lack of deaths to the way Californians are adapting.

As if to punctuate this new normal, authorities said Monday that the fires in Northern California, which are burning more than 66,000 acres, may not be contained until Nov. 7, according to officials. And PG&E has said its rolling power outages to prevent fires may continue happening for a decade.

Fires also burned in Southern California on Monday, forcing the evacuation of 10,000 people and destroying several homes.

About 1,100 firefighters, including hundreds from other departments around the state, were deployed to the Getty blaze, named for the famous hilltop museum close to where it began in the dry canyons and ridgelines in west Los Angeles. Some arrived after fighting the Saddleridge Fire north of town two weeks ago, then the Tick fire to the southeast late last week.

“This is what it’s going to take to get through these fires around the state,” Los Angeles City Fire Chief Ralph Terrazas said of the “reciprocal” cooperation agreements many departments have.

Los Angeles used a morning cellphone alert to begin warnings residents of the impending fire danger. But Officer Ryan Defer and his colleagues went door to door along Chautauqua Boulevard, reinforcing the evacuation order in a low-tech way.

The Sepulveda Pass where the fire broke out has burned before and recently. In December 2017, the Skirball Fire also blazed along the sides of I-405 and into Bel Air, burning a half dozen homes.

As the Getty Fire slowed at midday, Terrazas said the window to control it was small, given the heavy Santa Ana winds predicted to begin Wednesday and, along with dropping humidity levels, bringing a fresh threat to on-edge area.

Fire officials will begin flying drones equipped with infrared camera overt the Getty Fire footprint in the next day or so. The drones will be looking for “hot spots,” patches of small flames or smoldering ember that a strong wind can whip back up into a blaze.

“I want them to get this fire as cold as possible as fast as possible,” Terrazas said.

But the biggest fires are burning right now in Northern California. The Sonoma County Sheriff’s Office started by evacuating 1,000 people from the town of Geyserville when the Kincade Fire broke out Wednesday evening. On Saturday night, they made the call to designate the northern part of Santa Rosa a mandatory evacuation zone. To avoid panic, traffic and fatalities, the Sheriff’s department had given evacuation warnings for some areas first, so residents had more time to prepare. When the mandatory evacuations were announced for the Santa Rosa area, through texts and blaring mobile alerts, there was more time built in for people to get out than in 2017.

With lives and homes on the lines, the fires have forced everyone to adapt.

Florencio Rodrigues has had to evacuate so many times in recent years, from floods and fires, that he moved into an RV to make it easier to move in an emergency. The 51-year old was waiting out the latest fire at the evacuation center at the Petaluma Fair Grounds. He said he thought officials were doing a better job this year than before.

Not everyone had advanced notice. At 3 a.m. Sunday morning, 95-year-old Jacque Klein was awoken by the sound of sirens and police officers telling her she had to evacuate her Orchard Park home in Santa Rosa. She says she only had 10 minutes to get out. Her son, age 80, and her daughter, age 60, were also evacuated from Sebastopol. The three of them, three cats, and a dog, drove the next day to find a shelter with available beds.

“A few years ago, Santa Rosa was practically wiped out,” said Klein. “So now here we go again! California is being incinerated.”

The city of Healdsburg announced it was evacuating all 11,500 residents on Saturday morning at 10 am at a joint press conference with the Sonoma County Sheriff’s office and Cal Fire. By 4 pm, the town was almost entirely empty.

“Our community and our area understand the danger and the risk and take those notifications seriously,” said Healdsburg mayor David Hagele. “When we gave that notice at ten-o’clock, they were calm. I didn’t see anybody cutting each other off, there was no honking.”

Two years ago, during the disastrous Tubbs fire, Santa Rosa’s Sutter hospital and the nearby Kaiser Permanente were both evacuated. Sutter was closed for eight days.

“The first evacuation, the alerts and the warnings of the fire and the danger of the fire were not handled real effectively,” said Sutter’s Purvis, who also runs the Novato Community Hospital. “The hospital literally had fire very very close to it, winds blowing strong, and needing to evacuate it in an absolutely complete and total disaster situation. That was incredibly intense.“

While the situation over the weekend bore similarities to the 2017 fire, including the full evacuation of the same two hospitals, there were some key differences — most notably, the effectiveness of early alerts and the amount of warning time given by authorities. Kaiser moved 110 patients out of its facility Saturday night.

At Sutter, Purvis and his staff began the evacuation process by finding other hospitals with space that could take their patients. Administrators coordinated with transfer centers and called other hospitals directly, trying to find the right match of services for each person. Some patients went 35 minutes south to Sutter’s Novato hospital, which was running on generator power as the rest of the town was largely without electricity due to PG&E’s massive preventive outages. Other patients were moved further away, to San Francisco, Solano County and Modesto, as far as 140 miles away.

Some needed advanced life support, others just basic life support. Several infants needed to be transported from the neonatal intensive care unit, as well as newborns with their mothers. A few women in active labor were taken to the nearest hospitals possible. All the hospital’s patients made the trips in ambulances, which had to be found and scheduled.

Even with the extra time and more orderly process, the situation was stressful for Sutter Santa Rosa Regional Hospital’s employees. Many live in evacuation zones themselves had lost their homes in previous fires, including Purvis.

“There’s the tension of the impeding fire” said Purvis. “Even though it’s three or four miles away you can see the glow at night, and it creates a great deal of stress and pressure on the team.”

By Sunday afternoon, the smoke from the Kincade Fire had blown down enough to hover almost directly above the hospital, which still had electricity but its own generators for backup power if necessary. Security guards were posted at the entrance to make sure no new patients tried to come in. And inside, the remaining hospital workers were busy getting everything ready for the return of patients when the evacuation order eventually lifts.

It’s unclear how soon that will be.

Correction: Eighty-six patients were evacuated from Sutter Santa Rosa Regional Hospital, not 99. A previous version of this story also incorrectly said California was the country’s largest state. It is the most populous. This story has been updated.