During wartime, Israeli hospitals face significant security challenges, requiring rapid shifts from routine operations to various states of emergency. Even in peacetime, hospitals maintain high levels of preparedness, regularly practicing their response to extreme events. However, since the outbreak of the Iron Swords War, hospitals have been on heightened alert, employing comprehensive strategies to address emerging threats. Those situated within conflict zones are crucial in delivering immediate medical care to the injured while managing risks such as missile attacks, bombings, and other security threats.

As a hospital outside the front-line zone, this presentation outlines our preparation and response strategies to address war-related threats such as rocket attacks and UAV incursions, support front-line hospitals by admitting transferred patients, and mitigate potential damages while saving lives. These efforts are carried out alongside continuous preparedness for and management of mass-casualty incidents (MCIs).

The preparation plan involves a multi-dimensional response strategy, including:

1. 1. Maximizing protected areas within the hospital

2. 2. Increasing stocks of equipment and essential medications

3. 3. Ensuring operational continuity in case of national system failures

4. 4. Addressing human resource challenges by training staff and maintaining resilience

5. 5. Sustaining a constant state of readiness and alert

6. 6. Collaborating with external rescue authorities and supporting hospitals in conflict zones Balancing emergency response with the need to maintain routine operations over an extended period of high alert

A robust contingency plan and preparedness for wartime scenarios are essential to ensure resilience, operational continuity, and an effective response to emerging needs. These efforts are critical to saving lives and supporting both routine and emergency medical operations.

Peace Winds Japan (PW), a Japanese NGO, is working on the Mutual Learning Project for Emergency Medical Support in Disaster-Prone Countries to enhance international cooperation in disaster medicine and improve disaster response capabilities between Taiwan, the Philippines, and Japan. As part of this initiative, PW has conducted joint training with medical teams from each country. Building on these efforts, PW collaborated with a Taiwanese civilian medical team during the Noto Peninsula Earthquake in January 2024 to support affected areas. This presentation reflects on its outcomes and challenges.

On the day of the earthquake, PW dispatched a response team and immediately initiated contact with the Taiwanese team, joining in the field on the second day after the disaster. Over a week, the Taiwanese team provided support not only in healthcare but also in other areas. Specifically, they assisted PW’s medical team with patient consultations, vital sign measurements, organizing shelters, improving sanitary conditions, and distributing supplies.

During the acute phase, when human resources were limited, the Taiwanese team’s support was essential and offered encouragement to those affected. The past training simulations proved effective, enabling smooth procedures, logistics, and communication. However, challenges remained, such as activity restrictions due to the lack of local medical license approval.

This experience reinforced the importance of mutual understanding and relationship-building during non-emergency times. Moving forward, PW intends to address these challenges and further strengthen the acceptance system for international support. It is hoped that this initiative will extend beyond Taiwan and the Philippines, spreading to neighboring countries and having a broader impact across the region.

Austere environment disaster response poses situations and challenges, many child-specific, that differ from disaster response in routine and well-resourced practice settings. Pragmatic and ethical considerations limit feasibility of including children in live disaster drills, especially in an austere environment. As part of the Beth Israel Deaconess Medical Center (BIDMC) Disaster Medicine Fellowship’s (DMF) annual 4-day immersive austere environment Pre-Deployment Course a large-scale simulation drill with pediatrics was conducted.

The Pre-Deployment Course was conducted on private undeveloped property and on the adjacent State Reservation. The 4-day course focused on preparation for and response to a catastrophic flood in a rural agricultural area of a developing country with poor infrastructure. Participants stayed in tents and ate mostly MREs. The hybrid adult live actor, pediatric low fidelity manikin simulation required our multidisciplinary group of fellows to set up their pop-up field clinic; triage 40 pediatric victims; and fully evaluate and manage 6 pediatric victims. Hot wash was conducted immediately after the simulation and cold debrief 1 month after to identify strengths, gaps, and patient care and personal challenges of austere environment disaster response.

The simulation engaged 9 fellows and 3 guest trainees; 7 faculty ran the simulation, 8 faculty acted as adolescent patients and/or caregivers. The simulation scheduled for 2 hours was terminated at 96 minutes when predesignated endpoints were met. Hotwash and 1-month cold debrief identified austere environment pediatric disaster response considerations and challenges including: vulnerabilities; medical, psychosocial impacts; evaluation; management; logistics; and patient, caregiver, and responder ethical and moral hazards. All trainees supported inclusion of pediatric simulation in future courses.

The experience provided team building, technical performance training, psychosocial stress preparation and management training for disaster response in the austere environment. The simulation planning, design, scenarios, and debriefs provide a toolkit for including pediatrics in other austere environment disaster training.

Prehospital care is a health service provided on scene and during the transfer of the patient to a definitive center. It provides life-saving support as soon as possible to enhance survival. The most common modes of transportation include Helicopter Emergency Medical Service (HEMS), Ground Emergency Medical Service (GEMS), jet planes, and fixed-wing aircraft. The General practitioners (GPs) must be competent with multiple skills to provide high-quality prehospital care, and their role starts from the first inquiry call and continues even after the safe transfer of patients to the definitive center.

A retrospective analysis of prehospital services provided by the Grande International Hospital emergency team over the last two and a half years (October 2021 to December 2023).

In total, 421 HEMS cases landed in the Grande International Hospital from October 2021 to December 2023. Among these 228 HEMS cases, a medical team led by General Practitioners (GPs) was present.

General practitioners (GPs) play a vital role as team leaders in providing high-quality pre-hospital/intra-hospital care in the majority of emergency medical service cases in Nepal. Ongoing efforts to improve and expand these services contribute to saving lives and improving healthcare accessibility in Nepal.

Although there have been many case reports of earthquake disasters describing each prevalence rate (PR) of Post-Traumatic Stress Reaction (PTSR) in the disaster-stricken area, few meta-analytic studies have tried to integrate them for preparing for the next tragic disaster. As part of a study titled “Research on Strengthening DPAT Functions and Preparing for the Nankai Trough Earthquake,” we reviewed and analyzed literature on PTSR following earthquake disasters worldwide. The study aims to evaluate the impacts of general earthquake disasters on the occurrence of PTSR and to estimate spatiotemporal PRs of PTSR in the affected area.

A systematic review is conducted by using four search engines, including Ichushi Web, PubMed, CiNii, and CINAHLin by the PRISMA guideline. We searched papers from 1970 to the present with the keywords “earthquake” OR “tsunami” AND “mental health” OR “psychiatry” OR “post-traumatic stress disorder” OR “depression” OR “psychological” OR “stress.” This yielded a total of 2,930 articles. Including criteria is a research study written in English or Japanese reporting PR of PTSD or PTSR in the disaster-affected area.

After excluding duplicates and studies that did not meet our criteria, we focused on 265 articles. Our review covers studies from various regions, with 109 from China, 50 from Japan, 18 from Italy, 16 from Indonesia, 15 from Turkey, and so on. Weighted averages of PRs integrated by periods after earthquakes were 29.0% in 3 months, 19.2% in one year, 18.8% in 3 years, and 20.2% in 10 years. The highest PR integrated by country or affected population was 60.9% in Turkey, and was 80% in the bereaved family for each. However, there were also significant research biases in some of these studies.

This study highlights the substantial psychological impact of earthquake disasters and supports the need for enhanced mental health response strategies.

Ultrasound has become a critical diagnostic tool for emergency medicine physicians, especially in low- and middle-income countries (LMICs) where access to advanced imaging technologies is limited. Despite its potential, training emergency physicians in ultrasound techniques in resource-constrained environments presents unique challenges. This study aims to explore the experiences of emergency medicine physicians undergoing ultrasound training in LMICs, focusing on the barriers faced, the benefits realized, and the impact on clinical practice.

A qualitative, thematic analysis was conducted to examine the experiences of emergency medicine physicians who completed an ultrasound training program in a low-resource setting. Semi-structured interviews were held with participants, and data were analyzed to identify recurring themes related to the training process, challenges encountered, and its effects on patient care. Thematic analysis was used to categorize and interpret the data to provide a comprehensive understanding of the training experience.

The analysis identified three primary themes: adaptability and resourcefulness, learning through practical experience, and the impact of training on patient care. Participants reported challenges related to limited access to high-quality ultrasound equipment, insufficient training materials, and inconsistent mentorship. Despite these challenges, participants noted significant improvements in their diagnostic abilities, particularly in emergency and trauma care. Physicians demonstrated innovative strategies, such as using low-cost portable devices, to overcome resource limitations. Hands-on practice was identified as crucial to skill development, with many participants highlighting the value of real-time feedback and peer collaboration.

Ultrasound training for emergency medicine physicians in LMICs presents both challenges and opportunities. The study underscores the importance of hands-on learning and adaptability in overcoming resource limitations. It also highlights the need for sustained mentorship and support to maximize the impact of training programs. Tailored ultrasound education, along with continued access to affordable and portable equipment, is essential for improving diagnostic capacity and patient care in resource-limited settings.

As mass shootings and terrorist threats continue to rise, Mass Casualty Incident (MCI) planning has become critical for hospitals. However, there is often a chasm between the planning and implementation phases of MCI preparedness. To be successful, an MCI plan needs to be functional for and familiar to the clinical and ancillary staff who must use it. Involving these individuals in the planning and training processes is key to creating an MCI plan that works on paper and in practice. This presentation discusses strategies for creating an MCI plan and training schedule for Emergency Departments and hospitals. It shares ideas for creating planning teams, explains key concepts for MCI planning in the healthcare setting, and shares templates that can be tailored to the needs of other facilities interested in creating or modifying their plans. It also shares lessons learned by the presenters and encourages an exchange of ideas, challenges, and successes in MCI planning amongst participants.

During initial emergency response for the Noto Peninsula Earthquake occurred on 1 January, 2024, liaison officers from Division of Infectious Disease Prevention and Control, Ministry of Health, Labour and Welfare (MHLW) were deployed to support to Disaster Infection Control Team (DICT) and faced various barriers to implementing pre coordinated national strategy of supply chains, which has not well described pull-type emergency supplies procurement for Infectious Disease Control (IPC), resulted in organizing new supply chains.

A descriptive study was conducted based on the reports about IPC supplies procurement between 5 January 2024, when the first MHLW liaison officer from the division was deployed, and 9 January 2024, listing stakeholders including ordering parties, suppliers, carriers, relevant ministries, storage locations/staging posts, and final destinations. Furthermore, the Delphi method with a two-round questionnaire to stakeholders is planned towards identifying the challenges for the pre-coordinated national strategy of supply chains.

By the ninth day of the disaster, ten routes for procuring supplies related to IPC had been identified. Of these, five routes were coordinated with the prefectural government. The MHLW’s liaison worked horizontally to connect the various divisions of the prefectural government and urged them to determine who would be in charge, and with the cooperation of MHLW’s other liaisons from other divisions. Then, the pull-type route was established on 6 January, followed by DICT’s logistic system on January 9th.

Identifying both public and private health supply chains during initial disaster response had reduced disruption in the affected local government in the early stage of the Noto Peninsula Earthquake. In this study, stakeholders and supply chains were listed, and the barriers as challenges to implementation for the pre-coordinated national strategy of supply chains were described, which would contribute to protecting the health and security of disaster victims in future disasters.

Information management for large-scale disasters is at the heart of logistics. When there is a disaster, the MHLW issues a notification document regarding the measures to be taken by the MHLW and the relevant local governments, depending on the damage situation. However, it takes time to summarize and understand the notification documents. Therefore, we developed a system using Gemini to search for notification documents issued in the event of a disaster.

Gemini is a multimodal AI that can make advanced decisions by combining various types of information and can quickly summarize and search information from Google Drive. Notification documents were stored in Google Drive, and questions were created from keywords such as “dispatch of medical professionals” and “handling of insurance treatment,” and the search results were verified.

As a result of searching for the question, “I want to know about the dispatch of medical personnel when there is a disaster,” three materials were matched. In addition, the search results included a summary of the materials and links to all related materials stored in Google Drive.

The advantages of the notification document retrieval system are as follows: it is possible to check the notifications that are common to multiple disasters at once, anyone can use it free of charge by sharing an account, and it is possible to summarize the contents of the materials as well as extract related materials. Conversely, as an improvement, it was mentioned that since it is not an exact match, documents that are not necessary are extracted, and only a part of the required documents is extracted. Although it is necessary to devise ways to share accounts and update data, a notification document retrieval system using multimodal AI can be expected to manage information in the event of a disaster.

The vastness of the Pacific Ocean stretches out to the east and south of Japan. If a ship crew at high sea suddenly experiences trauma or illness, transporting them to appropriate medical facilities poses significant challenges compared to on-land situations. In these contexts, research and analysis by the Japan Self-Defense Force (SDF) on evacuation activities from the high seas provide useful information to international personnel engaging in sea rescue and research.

Documents published by the Ministry of Defense and Marine Rescue Japan Team were utilized. Cases from 2019 to 2023 were examined in terms of age, gender, nationality, and disease classification.

The Japan Coast Guard (JCG) is responsible for command and control in the area of Japan. Furthermore, as requested by the chief officer of the JCG regional branch, the SDF helps with high-sea evacuations. A total of 55 cases were referred to the SDF by the JCG. Among these, 35 (64%) were evacuated by the Japan Maritime SDF, and 20 (36%) by the Japan Air SDF. In 11 cases, long-distance evacuation was conducted more than 500 miles away from land using new aircraft capable of landing on the sea surface. All cases of Japan Air SDF evacuations used search-and-rescue helicopters. Documents confirm that in 29 cases, most evacuees were male, aged 50–59, followed by ages 30–39 and 40–49. Trauma or neurovascular disease was the most common cause, followed by acute abdominal issues. All 29 cases were attended by civil medical staff.

To complete evacuation missions from the high seas, cooperation between civil medical facilities and JCG or SDF officials is crucial. This system must be essential to maintain maritime security, including evacuations for safety and freedom of the seas.

Mass gathering (MG) events should be an opportunity to strengthen the host city/country’s public health capacity and improve compliance with the International Health Regulations (2005). This legacy should be built into the planning for the event and receive investment; the evidence to support this happening is limited. This lack of evidence on the legacy of MGs was highlighted in the recent literature review undertaken to update the Public Health for Mass Gatherings: Key Considerations (KC2) (2015).

A systematic literature review methodology was used to search for relevant publications and grey literature of a wide range of MGs globally, focusing on evaluations, legacies, and impacts. This also included searches for specific technical areas, e.g., emergency response.

The literature review identified a small number of peer-reviewed publications that explicitly address the health legacy and evaluation from MGs or the host city/country population (11 papers met criteria from 399 identified). This makes the justification of hosting major MGs challenging. There remains a significant barrier to building and sharing the evidence base for the health legacy and benefits of hosting an MG. Linking this to legal instruments such as the IHR (2005), which requires countries to prevent, detect, and respond to public health risks, could help gain host country/city investment, as it is recognized that MGs can increase this risk.

It was hoped that this updated literature review would identify new evidence for viable and sustainable legacies from MGs. However, the findings were limited and did not look at longer-term benefits. Legacy is often neglected due to a lack of funding, capacity, short-term thinking, and being overlooked by the focus on the smooth running of the event. Event organizers and host cities/countries should better incorporate and implement planning to reduce the risk to the event and provide sustainable legacies.

Armed conflict can be described as human development in reverse. Outside of the direct consequences of violence, there are numerous ways that an armed conflict may have indirect effects on people’s health and well being. Studies give varying results, and the health impact seems to differ from context to context. We aimed to determine how conflict intensity is associated with health outcomes, accounting for existing vulnerabilities and functioning of healthcare services in countries going through armed conflict.

The study is based on panel data on conflict intensity, vulnerability, functioning of healthcare services, and health outcomes in 42 conflict-affected countries between 2000 and 2019, using fixed-effects panel regression analysis to determine the association between conflict intensity and health outcomes.

Conflict intensity was positively associated with the health outcomes included in this study. As the conflict intensity increased, the mortality and prevalence due to these outcomes also increased, albeit this was not statistically significant for half the outcomes (8/16). After adjusting for vulnerabilities and functioning of healthcare services, this positive association became significant for all the health outcomes. Vulnerabilities and functioning of healthcare services were stronger predictors of the outcomes. Sub-group analysis showed that conflict intensity was more significantly associated with outcomes in countries with high- and medium vulnerability scores.

Existing vulnerabilities and the condition of healthcare systems are known to impact health outcomes. The association between conflict intensity and health outcomes strengthens when existing vulnerabilities and the state of healthcare services are considered. This underscores the importance of incorporating strategies to address socioeconomic inequities and strengthen healthcare system capacity in interventions for conflict-affected regions. It also raises additional concerns for the long-term negative health effects related to the increasing trend of attacks on health care in contemporary conflicts.

Pandemics, unlike other disasters, extend over prolonged periods, requiring continuous responses from both public and private sectors. The term “dual disaster” describes the occurrence of a pandemic alongside other emergencies. However, little research has explored how COVID-19 impacted non-pandemic emergencies.

This study analyzed emergency data from Taiwan’s Emergency Medical Resources Management System (EMRMS) between 2018 and 2023. EMRMS is a web-based platform where hospitals report details such as date, age, sex, transport mode, triage level, disposition, and diagnosis during emergencies. We examined COVID-19-related policies from 2020 to 2023, categorizing them into four phases: Imported COVID (IC), Regional Epidemic (RE), Regulatory Relaxation (RR), and Extensive Community Transmission (ERT). Pre-pandemic data served as the non-COVID (NC) baseline. To compare emergency trends, annualized emergency rates were calculated for each phase, and casualty data, including triage levels, ICU needs, and mortality, were reviewed.

A total of 734 emergencies involving 6,734 casualties were reported. The annualized emergency incidences were 172.8 (NC), 154.8 (IC), 85.9 (RE), 78.2 (RR), and 105.2 (ERT). Emergencies declined during the pandemic phases, though the proportion of patients transported by EMS remained stable. However, casualty severity increased, with more ICU admissions, surgeries, and deaths observed.

COVID-19 shifted emergency patterns, reducing incidence but increasing severity. Infection control and crowd management lowered emergency numbers, but resource-limited periods heightened the burden on healthcare systems. Preparedness for severe emergencies remains critical in dual disaster scenarios.

The COVID-19 pandemic had a profound global impact, including numerous indirect consequences on healthcare systems. Acute orofacial infections are prevalent across all age groups. While most of these infections are mild and can be managed without hospitalization, they carry the potential to become life-threatening. Infections in the head and neck regions can spread deeper into the orofacial and neck areas, potentially compromising the airways.

This study aimed to assess the impact of pandemic control measures on orofacial and respiratory infections in oral and maxillofacial surgery (OMFS) and ear, nose, and throat (ENT) emergency units.

Records of patients with orofacial or respiratory infections based on patient ICD-10 codes diagnosed at the Oral and Maxillofacial Surgery (OMFS) or ENT Emergency Departments of Helsinki University Hospital (HUS), Helsinki, Finland, from March 1st to October 30th, 2020, were reviewed. Data was compared to corresponding periods in 2018 and 2019.

The study included 7,900 patients. There was a significant mean reduction of 37% in infection cases in 2020 compared to previous years (1,894 vs. 2,929 and 3,077, respectively, p<.001). ENT patients were 51% less likely to be admitted to the ward in 2020 compared to previous years (p=.013), and patients from rural areas were less likely to visit OMFS or ENT emergency departments during the 2020 study period compared to 2019 and 2018 (26.8% vs. 29.0% and 30.3%, p=.031).

There was a notable decline in emergency department visits for orofacial and respiratory infections during the COVID-19 pandemic in 2020. These findings provide valuable insight for decision-making during future health crises.

In Japan, temporary information is issued about disasters to reduce damage. On 8 August 2024, the Japan Meteorological Agency issued the first temporary information bulletin (Caution: Major Earthquake) about the possibility of a large-scale earthquake occurring in the assumed epicentral region of the Nankai Trough Earthquake. Although this kind of temporary information is useful for disaster prevention, we believe that it may have an impact on the mental health of many people, so we will conduct a survey and propose ways to intervene.

A psychological survey was conducted on web monitors before and after the 8 August 2024 Nankai Trough Earthquake Special Information (17 April; 22 August). A psychological survey was conducted on web monitors before and after the 8 August 2024 Nankai Trough Earthquake Special Information (T1: 17 April; T2: 22 August). The number of people surveyed was 300 for T1 and 1,400 for T2. The psychological test forms used were the Depression Anxiety Stress Scales (DASS)-21 and the Impact of Event Scale-Revised (IES-R). The scores are shown as the median (25th percentile - 75th percentile).

The Depression score on the DASS-21 changed from T1 0 (0-1) to T2 2 (0-8), the Anxiety score from T1 2 (0-12) to T2 2 (0-10), and the Stress score from T1 2 (0-16) to T2 2 (0-6). The PTSD score, as indicated by the IES-R, also changed from T1 3 (0-9) to T2 4 (0-17). Mann-Whitney’s U test showed a significant difference in Depression, Stress, and PTSD scores (P < 0.05).

Although this is temporary information for disaster prevention, it may affect the mental health of many people. To maintain the mental health of these many people, our team would like to propose the introduction of smartphone apps such as the me-fullness® app.

Emergency Department (ED) evaluation of suspected Viral Hemorrhagic Fever (VHF) patients can significantly disrupt an institution’s ED operations. Given the significant risk of contamination, best practice is to close off areas where the patient has been present. While designed to protect healthcare workers and other patients, this can have unintended consequences, such as closing off access to critical areas and supplies. A full-scale disaster drill was conducted at a New York City (NYC) designated Ebola Receiving Center. A fictitious patient suspected of VHF was taken to the designated VHF treatment area through EMS and walk-in triage. The impact on normal patient/staff flow and access to critical resources was documented by trained observers.

The following areas were unintentionally blocked due to patient transport to the designated VHF treatment room:

1. 1. Arrival via EMS: a) critical elevators to OR, MICU, SICU, and Labor and Delivery, b) ED Radiology including X-Ray, CT, and ultrasound.

2. 2. Arrival via walk-in: a) waiting room, b) triage area, c) the entirety of the non-critical adult emergency department, approximately 81 patient treatment locations.

This drill highlighted the potential for significant disruptions to ED operations when managing VHF patients, even when using a pre-identified VHF treatment room. By identifying feasible access to appropriate care areas, hospitals can mitigate these challenges and ensure the continuity of daily operations. EDs should consider similar strategies when developing their VHF response plan. The Division of Disaster Preparedness & ED administrators assessed the ED’s architectural blueprint to locate areas of entry/egress and the ED’s treatment/diagnostic areas. Multiple attempts to find a space within the emergency department to care for VHF patients without closing the ED proved difficult. However, after reviewing the blueprint, an ideal area outside the ED treatment areas was identified.

In times of disaster in rural settings, helicopter rescue is crucial. Since the 1990s, helicopters without any medical support have been used to transport patients from remote areas to tertiary care centers. In 2013, private organizations improved pre-hospital care by adding medical teams and equipment, making Helicopter Emergency Medical Services (HEMS) a critical part of emergency care, particularly in remote areas.

This retrospective observational study analyzes patients who were transferred by helicopter to Grande International Hospital (one of the tertiary centers in Kathmandu, Nepal) between May 10, 2018, and May 9, 2024. Patient’s demographics (age, gender, ethnicity), medical conditions/outcomes, and geographic origins were analyzed. Data was analyzed using SPSS version 25.

The 782 helicopter rescues show that 68.8% of the participants were men, with a mean age of 47.21 years. Of them, 90.92% were Nepalese, and the majority of cases (42.23%) were transferred from Province 4 of the country. Pneumonia (211 cases), trauma (107), neurological emergencies (85), cardiovascular emergencies (44), and COVID pneumonia (140) were among the major medical reasons for transfer. The COVID pandemic highlighted the importance of HEMS. 40.4% of cases were self-landed, whereas 59.6% of cases were accompanied by HEMS physicians. Interhospital transfers and a sizable portion of high-altitude operations were part of many rescues. With an average hospital stay of 13.73 days and a 14.3% mortality rate, the majority of patients were admitted to the intensive care unit.

HEMS has significantly saved lives over the years at a particular tertiary hospital. This data allows for advancing HEMS use in a rural setting like Nepal, especially during times of disaster, to provide acute medical and rescue care. It is imperative to address and evaluate HEMS accessibility and its importance regarding infrastructure, cost, geographic diversity, and the country’s vulnerability to disaster.

The Israeli healthcare system was responsible for spearheading the battle against SARS COV-2 as a medical necessity, concurrently confronting the imperative to fully utilize all accessible medical resources, encompassing hospitals and community medicine facilities. The complete and effective management of patients, particularly during emergencies, is of utmost importance for the Israeli nation. This study endeavors to elucidate the essentiality of community medicine during emergencies, exemplified by the COVID-19 pandemic.

A cohort of thirteen influential officials from the Israeli healthcare system, actively leading the nation’s response to COVID-19, underwent in-depth interviews. These interviews were subjected to thorough scrutiny by a panel of peers. The participants were accessed through in-person meetings or virtual interactions via Zoom. The participants were given the questionnaire in advance, enabling them to familiarize themselves with its format. Subsequently, employing ATLS.In TI 22, six themes emerged. Among these themes, one particularly highlighted the significant role of community medicine as an indispensable component of the medical response, particularly in emergencies. These themes were derived by identifying recurrent concepts present within the quotes provided by the participants.

Numerous compelling instances were unveiled, demonstrating the utmost importance of community-level medical care during the COVID-19 pandemic. All thirteen interviewees explicitly emphasized the impact of medical teams operating within community medicine, substantiating their viewpoints with concrete examples. The primary discovery revolved around the Israeli HMO’s capacity to provide hospitalization services at patients’ homes and to effectively reduce the number of individuals seeking emergency room care. In addition, HMOs were seen as significant in fostering public trust.

This study provides a comprehensive understanding of the approach employed by the Israeli healthcare system in tackling the pandemic, accompanied by recommendations about the integration of community medicine. The abundance of lessons presented in this study may also be relevant to other countries, suggesting the potential for broader application.