Hard to imagine horrific losses like that happening here, felt bad for the Japanese nation. But it could happen in the NorthWest USA, in the Cascadia Subduction Zone (from northern Vancouver Island into Northern California). If that rips with a mega-earthquake, there will be many thousands dead from the resultant tsunami along our West Coast. We shouldn't worry about our nuclear power plants, however, shutdown procedures will prevent problems.
There was a very well-written article in the New Yorker (I think) about the Cascadia fault zone. Lots of interviews with locals, etc.
One small town 11 minutes or so from the tsunami was interesting to hear about. The mayor or somesuch talked about their plans, but with only 11 minutes of warning there is only so much they could do.
He said the had plans for the schools where the kids might make it out quick enough. For the little hospital and two small nursing homes he said the workers would attempt to flee by themselves leaving the patients behind. If they tried to move the sick and elderly there wouldn’t be time for anybody to live. At least the plan hoped that the workers would live and be able to treat other survivors.