Integrating the six C’s of disaster response: Lessons from the mega terrorist attack on October 7, 2023

Abstract

On October 7, 2023, over 2,500 Hamas terrorists infiltrated Israel from Gaza and killed over 1,400 people and injured 2,800, resulting in the largest terrorist attack in Israel’s history. Several models describe the principles of managing a mass casualty event. One of them is an Australian construct known as the six C’s. While command, control, and coordination are familiar concepts, the six C’s emphasize the importance of communication and community (consequences and community connection). We describe how two emergency departments in Israel—Assuta Ashdod and the Hadassah Medical Center-Ein Kerem—responded to this disaster in the context of the six C’s.