“Multiple cascading failures” led to the outdoor warning sirens not sounding in St. Louis ahead of and during the May 16 tornado, according to an outside investigative report.
“When public systems fail, the public deserves to know how and why, and we as a city take responsibility to fix the issue,” Mayor Cara Spencer said in a statement Monday that accompanied the release of the report. The external review was conducted by the law firm Carmody MacDonald.
“This investigation makes it clear that there were breakdowns on several levels on May 16, but also before and after,” Spencer said. “I am committed to putting this report to work so the City of St. Louis can respond at the highest possible levels in any future disaster.”
She plans to address the findings Tuesday afternoon at a briefing with reporters.
The city acknowledged May 19 that City Emergency Management Agency staff were not in the office to be able to activate the sirens. CEMA Commissioner Sarah Russell was placed on leave on May 20. They were a longtime CEMA employee before taking over as commissioner in 2021 and had served as a deputy commissioner since 2012. Fire Capt. John Walk has been interim CEMA commissioner since.
But the report found that the problems went deeper than Russell and their staff being at a seminar off-site on the day of the tornado. Even if the sirens had been activated, more than a third of them were not functional for a variety of reasons. And the city had not updated its emergency operations plan since 2003, when Francis Slay was mayor. That led to a lack of coordination and organization in the immediate response.
Spencer said the city has taken several steps to improve its emergency response, including fixing most of the broken sirens and automating them to sound when alerts are issued by the National Weather Service.
The findings
As did Spencer in her initial assessment, the report places blame for the siren failure and a chaotic initial response to the tornado squarely on Russell.
“While it was clear CEMA was understaffed, underfunded, and under-resourced leading up to the May 16, 2025 tornado, nothing we have discovered suggests that the lack of staff, funding, and resources explains the failures,” the report read. “Instead, it appears that CEMA’s leadership did not correctly prioritize CEMA’s responsibilities, opting to focus too much on external networking rather than training, policy creation and maintenance, and relationships with city agencies, namely the Fire Department and the Police Department.”
Russell, the report said, was often not at the Emergency Operations Center, located at police headquarters, in the days after the tornado and was “frequently unreachable by phone.” Their absence, combined with the failure to update the emergency operations plan and the fact that Spencer had only recently taken over as mayor, made a fully functional emergency operations center next to impossible.
The report also found that Russell failed to use a federal emergency response template or keep proper documentation. Complete implementation of those best practices, the report said, “did not occur until after Commissioner Russell was removed from day-to-day oversight and outside emergency management professionals were brought in to organize operations.”
The report confirms confusion over who had primary responsibility to activate the sirens. It also notes that a decision to move a necessary piece of equipment from a location near downtown to south St. Louis could have prevented the fire department from taking over that job.
Investigators interviewed Russell on July 23, more than two months after they had been placed on leave. Russell defended the decision to remain at the off-site workshop, saying that policy placed the fire department in charge of sounding the sirens.
CEMA cannot be a 24/7 agency because it doesn’t have the staff, Russell told investigators. At the time of the storm, the agency had the budget for just seven full-time employees, though Russell had requested enough funding for 13. The St. Louis Board of Aldermen was able to find enough money in the current budget to allow the agency to hire an additional employee and purchase additional software.
The report recommends the agency be fully staffed as soon as possible. Until that happens, it said, the city itself needs to establish a command structure that can be used during natural disasters. The city also needs to draft a clear policy about who has control of the sirens and make sure that both activation points are functional.
It also recommended that CEMA be integrated into either the police or fire department, rather than remain a standalone agency.
