The concurrent challenges of the COVID-19 pandemic and a significant earthquake in Izmir on October 30, 2020, presented a unique scenario for disaster management and response. This study focuses on the impact of the earthquake, which resulted in 117 fatalities, including 1 due to drowning, and injured 1034 individuals, alongside widespread structural damage including to the Izmir Democracy University Buca Seyfi Demirsoy Training and Research Hospital. The objective is to assess the activation and implementation of the hospital disaster plan amidst the ongoing pandemic. Through a retrospective evaluation of all actions undertaken as per the Hospital Disaster Emergency Plan within the Disaster Management cycle, this study examines the decision-making process for the hospital evacuation on October 30, 2020, the evacuation of COVID-19 patients, and the strategies employed to increase hospital capacity. Of 216 patients hospitalized at the time of the earthquake, 65 were transferred to other facilities under COVID-19 protocols. The prolonged nature of pandemics and the likelihood of secondary disasters underscore the importance of comprehensive risk assessments and dynamic disaster planning, considering simultaneous multiple hazards. This study suggests the inclusion of multi hazard scenarios and diverse evacuation methods by using types of ambulances, such as ground, helicopter, and boat.

Even though places of worship are protected by the Hague Convention for the Protection of Cultural Property in the Event of Armed Conflict, they often become targets. To safeguard the cultural property of religious communities, it is necessary to plan for wartime protection under peaceful conditions, but studies of how this planning was conducted after 1945 are largely missing. This Article compares how the cultural property of the Church of Sweden (Lutheran) has been planned for protection up until 2023. Cultural property protection was first introduced in World War II, but the Church had to plan and carry out most protective measures without state support. During the Cold War, a system for protecting movable property was developed that lasted until it was replaced in the 1980s by cultural protection plans that employed a more holistic approach to risk mitigation in peace as well as in war. Finally, the recent development and future challenges are discussed in relation to the 1954 Hague Convention and the reconstruction of a Swedish total defense due to the Russo-Ukrainian War.

On July 7, 2023, at 1:21 am, a fire was declared in a retirement home in Milan, Italy. The number of casualties (n = 87) according to the Simple Triage and Rapid Treatment (START) triage system was categorized as 65 green, 14 yellow, 2 red, and 6 black; 75% were women, and the mean age was 85.1 years (± 9). Most patients were unable to walk. A total of 30 basic life support (BLS) ambulances, 3 advanced cardiac life support (ACLS) teams on fast cars, 2 buses, and 1 coordination team were deployed. A scoop and run approach was adopted with patients being transported to 15 health care facilities. The event was terminated at 5:43 am. Though the local mass casualty incident (MCI) response plan was correctly applied, the evacuation of the building was difficult due to the age and comorbidities of the patients. START failed to correctly identify patients categorized as minor. Communication problems arose on site that led to the late evacuation of critical patients.

Dispersal does not only mean moving from one environment to another, but can also refer to shifting from one social group to another. Individual characteristics such as sex, age and family structure might influence an individual's propensity to disperse. In this study, we use a unique dataset of an evacuated World War II Finnish population, to test how sex, age, number of siblings and birth order influence an individual's dispersal away from their own social group at a time when society was rapidly changing. We found that young women dispersed more than young men, but the difference decreased with age. This suggests that young men might benefit more from staying near a familiar social group, whereas young women could benefit more from moving elsewhere to find work or spouses. We also found that having more younger brothers increased the propensity for firstborns to disperse more than for laterborns, indicating that younger brothers might pressure firstborn individuals into leaving. However, sisters did not have the same effect as brothers. Overall, the results show that individual characteristics are important in understanding dispersal behaviour, but environmental properties such as social structure and the period of flux after World War II might upend the standard predictions concerning residence and dispersal.

Social media summary: Individual characteristics influence dispersal away from social group after a forced migration in a Finnish population

Following the Taliban influx in August 2021, several Western countries repatriated nationals and evacuated others from Kabul Airport in Afghanistan. This report aimed to describe medical experiences from the consular repatriation and evacuation operation.

Memos from personal conversations with seven professionals involved in these operations formed the basis for this report.

Minor trauma, gastrointestinal symptoms, dehydration, fever, and mental distress were common. Bandages, oral rehydration solution, and the administration of paracetamol were needed, in addition to medical evaluation of acuity. In consular repatriation and humanitarian evacuations, medical attendance should be prioritized to manage medical needs of individuals being evacuated, but also from a public health perspective. The medical needs covered a broad specter of infection disease symptoms, trauma, and mental health problems among patients of all ages. Since the nature of consular repatriations and evacuations can be challenging from safety and infrastructural aspects, general medical emergency awareness with an ability to effectively evaluate and manage both somatic and mental health emergencies on the ground and in the air, among both children and adults, is needed.

Japan has repeatedly suffered from natural disasters. A number of temporary evacuation shelters have been opened for the benefit of evacuees. Although the operation of such evacuation shelters has improved after the Great Hanshin-Awaji Earthquake (1995), a number of operational difficulties were encountered during the Great East Japan Earthquake in 2011 and the Kumamoto Earthquake in 2016. A systematic literature review was conducted to identify the medical concerns encountered in temporary evacuation shelters by focusing on unsanitary environment, food and nutrition, and shortage of medication. Actual sanitary conditions have been found to be below the standards stipulated by the Japanese government as per international guidelines. Food aid in evacuation shelters was neither nutritionally balanced, nor was the distribution to different shelters balanced. Furthermore, evacuees with chronic diseases feared that there may be a shortage of medication. Crowding in evacuation shelters increased the risk of outbreaks of infectious diseases (e.g., tuberculosis). Malnutrition and shortage of medication exacerbated the risk of deterioration of chronic diseases (e.g., diabetes mellitus, hypertension) among evacuees. Therefore, it is recommended that healthcare professionals should be promptly deployed to evacuation shelters, to promote sanitary control and education, as well as address limited space availability, and food and medication shortage.

More than 100,000 people from the city of Tianjin were evacuated to the countryside in a civil defense program during the 1970s. Many evacuees refused to submit to state migration mandates, instead sneaking back to the city illegally or petitioning to regain urban residency. City officials responded flexibly to the evacuees’ pleas, sympathizing with family reunification and treating suburban districts (jiaoqu) on the outskirts of Tianjin as a buffer zone between city and countryside. Dominated by agriculture but home to a growing number of factories, workshops, and offices during the 1970s, jiaoqu became a solution to evacuation headaches. When compared with the recent coerced movement of hundreds of thousands of Chinese citizens on national security grounds, the civil defense evacuations of the 1970s suggest that it may be misguided to think of the Mao Zedong years as a faraway time that was more radical or repressive than China today.

After Japan’s major nuclear accident in 2011, approximately 150,000 Fukushima residents were ordered to evacuate. Beginning in 2015, the evacuation orders have been systematically lifted. However, the health impacts of allowing residents to return to homes in areas previously uninhabitable due to nuclear radiation remain poorly understood.

Declaring radiation levels to be safe does not necessarily eliminate the concerns of residents about the effects of radiation exposure. Rebuilding medical, welfare, and commercial infrastructure and services takes time. Nontangible community elements, such as mutually dependent social networks, also require time to be re-established. Nevertheless, the Japanese government prioritizes policies that encourage evacuees to return home as soon as it is safe to do so.

Post-disaster evacuation situations and subsequent return home pose substantial—and as yet relatively unknown—mental and physical health threats for those affected, especially those in vulnerable groups, such as the sick, the elderly, and children.

Here we report a case of an elderly female evacuee with dementia, who was prevented from returning home after her hometown evacuation order was lifted, began exhibiting marked behavioral abnormalities. Loss of emotional ties that were created while she was housed in temporary accommodation appeared to be a critical contributing factor.

The co-occurrence of the 2020 Atlantic hurricane season and the ongoing coronavirus disease 2019 (COVID-19) pandemic creates complex dilemmas for protecting populations from these intersecting threats. Climate change is likely contributing to stronger, wetter, slower-moving, and more dangerous hurricanes. Climate-driven hazards underscore the imperative for timely warning, evacuation, and sheltering of storm-threatened populations – proven life-saving protective measures that gather evacuees together inside durable, enclosed spaces when a hurricane approaches. Meanwhile, the rapid acquisition of scientific knowledge regarding how COVID-19 spreads has guided mass anti-contagion strategies, including lockdowns, sheltering at home, physical distancing, donning personal protective equipment, conscientious handwashing, and hygiene practices. These life-saving strategies, credited with preventing millions of COVID-19 cases, separate and move people apart. Enforcement coupled with fear of contracting COVID-19 have motivated high levels of adherence to these stringent regulations. How will populations react when warned to shelter from an oncoming Atlantic hurricane while COVID-19 is actively circulating in the community? Emergency managers, health care providers, and public health preparedness professionals must create viable solutions to confront these potential scenarios: elevated rates of hurricane-related injury and mortality among persons who refuse to evacuate due to fear of COVID-19, and the resurgence of COVID-19 cases among hurricane evacuees who shelter together.