In Tokeland, Wash., Charlene Nelson, the chairwoman of the Shoalwater Bay Tribe, said the tribe has been working for about 18 years on escape strategies. Their first recourse was a building up in the hills designed as an evacuation center, with supplies.

They ran practice events to get people to high ground, but one of the many families living on the narrow strip of land jutting into Willapa Bay found it took them 56 minutes by foot to get up to the center. The wave would most likely arrive in 20 minutes.

The tribe recently broke ground on a tower, largely funded by the Federal Emergency Management Agency, with pilings buried 51 feet in the ground and two elevated platforms that could hold hundreds of people.

Even when the structure is completed, Ms. Nelson said, people will need to practice their escape plans and know the routes to possible safety. They need a bag ready to go with key supplies — but not so many that it will slow them down when running for their lives. There won’t be time for hesitation or for figuring out which direction to head.

“You need to be prepared, and you need to know what to do, and you need to do it,” she said.

Aside from whatever damage a tsunami might bring, the earthquake itself would bring widespread devastation, with crumbling buildings, failing bridges, energy disruptions and mass casualties across a 140,000-square-mile area, including Seattle and Portland.

The urgency has been building over the past few years, which in coastal towns have felt like a ticking clock.

The last large quake on the Cascadia fault occurred on Jan. 26, 1700, scientists say. Chris Goldfinger, a researcher at Oregon State University, said geologic evidence from the past 10,000 years indicates that massive quakes with a magnitude of around 9.0 happen on the fault on an average of every 430 years. When including smaller but still powerful quakes on portions of the fault, the timeline in some areas shrinks to every 250 years.

It has been 322 years.

Bringing the expected casualty numbers down is difficult when the response planning has largely been left up to each community, Mr. Goldfinger said. A comprehensive federal solution with accompanying funding is needed, he said, and there is little time for delay given the amount of work needed to prepare.

“It’s going to dwarf the scale of any disaster we have ever had,” Mr. Goldfinger said. “We know it’s coming.”

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