Using GDACS to anticipate clinical and operational burden after earthquakes: A global event-level analysis (2020–2024)

Ahmet Aykut, Ertuğ Günsoy and Cem Yıldırım

PLOS ONE, 2026, vol. 21, issue 1, 1-13

Abstract: Global Disaster Alert and Coordination System (GDACS) alerts are widely used after earthquakes, yet their clinical relevance is uncertain. We performed a retrospective, global, event-level study spanning 2020–2024. To avoid double counting, alerts were clustered into country-bounded representatives using a 48-hour gap, retaining the alert with the highest GDACS score (n = 85; Red = 17, Orange = 68). Primary outcomes were reported deaths and field-hospital deployment. Associations used Spearman correlation; deployment was modeled with Firth logistic regression. Sensitivity analyses used alternative deployment definitions and composite windows. The GDACS score correlated with deaths (ρ = 0.522, p = 3.0 × 10 ⁻ ⁷). Field-hospital deployment occurred in 52.9% of Red events and 0% of Orange events. The GDACS score strongly predicted deployment (OR=42.7, 95% CI 4.7–385.7), with AUC = 0.98 and Brier = 0.034. An exploratory exposure-normalized subset where GDACS reported population “within 100 km” (n = 19) showed directionally consistent results (ρ = 0.50, p = 0.029).GDACS metrics provide early, scalable indicators for surge planning, but are hazard- and exposure-centric and cannot capture mediators such as collapse dynamics or health-system resilience. Treating GDACS as a first-layer signal, complemented by subnational exposure and rapid damage assessment, can support more timely, evidence-based medical response after major earthquakes.

Date: 2026
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0339018

DOI: 10.1371/journal.pone.0339018

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