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Three Activations, One Plan: Evolving Emergency Preparedness Through Recurrent Sudden-Onset Disasters in Beirut,
Mariana Helou1, Eric S Weinstein2,3, Nour Sarieddine1
1Emergency Medicine, School of Medicine, Lebanese American University, Beirut, Lebanon.
Disaster Medicine and Public Health Preparedness
|June 8, 2026
Summary
Hospitals must continuously refine emergency preparedness plans (EPPs) by analyzing responses to mass casualty incidents. Lessons learned from sequential events, like the 2026 Lebanon airstrikes, highlight persistent vulnerabilities and the need for ongoing EPP evolution.
Area of Science:
- Disaster Medicine
- Emergency Medicine
- Public Health Preparedness
Background:
- Sequential mass casualty incidents (MCIs) test healthcare institutions' resilience.
- Previous events, including the Beirut Port Explosion (2020) and Pager Explosion (2024), informed previous emergency preparedness plan (EPP) revisions.
- The April 8, 2026, airstrikes in Lebanon presented a new large-scale MCI.
Purpose of the Study:
- To describe the emergency preparedness plan (EPP) response of the Lebanese American University Medical Center-Rizk Hospital to the April 8, 2026, airstrikes.
- To examine challenges encountered during this MCI in the context of three sequential MCIs at the same institution.
- To evaluate the effectiveness of iterative debriefing and EPP revision in improving disaster response.
Main Methods:
- Retrospective analysis of the hospital's response to the April 8, 2026, airstrikes.
- Review of debriefing reports and EPP revisions following the Beirut Port Explosion (2020) and Pager Explosion (2024).
- Identification and categorization of challenges during the April 8, 2026, event.
Main Results:
- The hospital received 42 casualties in two waves following the April 8, 2026, airstrikes.
- Persistent vulnerabilities included unassigned trainees in the red zone and premature code deactivation.
- Newly identified issues included surgical resident resource constraints and lack of a regional interfacility transfer network.
Conclusions:
- Iterative debriefing and plan revision are crucial for developing an evolving EPP.
- Despite previous revisions, the April 8, 2026, response revealed ongoing and new vulnerabilities in mass casualty incident management.
- Enhancing regional coordination and optimizing resource allocation are critical for future MCI preparedness.
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