Road network disruptions during extreme flooding events and their impact on the access to emergency medical services: A spatiotemporal vulnerability analysis.

The impact of extreme floods can be significant, affecting humans, the environment and any type of human-built infrastructure. A further consequence of flooding is restricted access to medical facilities, including constraints to access more dedicated emergency medical services (EMS). To date, there has been a lack of investigation into EMS accessibility dynamics during extreme floods. The objective of this study is to gain a deeper understanding of the spatiotemporal changes in accessibility-based vulnerability related to EMS during a representative extreme flood event, which was simulated over a period of six days. The study assesses the spatial accessibility of EMS centres to populations located within 15-, 30-, 45-, and 60-minute travel time thresholds in Canton Bern, Switzerland, and applies floating catchment area method. The dynamic aspects of EMS access vulnerability during extreme floods were assessed in two different ways. Firstly, the ratios between accessibility change and accessibility under normal conditions in 1 km grid cells were calculated at hourly moments, t. Subsequently, the resulting values were used to calculate the average vulnerability score. Secondly, percentage changes of affected populations were evaluated for different accessibility classes during the flood event and under all-time high static flood conditions. Varied spatial patterns of accessibility were generally observed with respect to the road network and population distributions in the hilly and mountainous landscape. Extending evaluations to consider temporal dynamics revealed a complex pattern of accessibility gains and losses in different regions of the study area, including those where no direct flood impacts occurred on the road network. The application of a static, all-time high flood condition resulted in an overestimation of accessibility limits to EMS centres. While this overestimation was not considered to be critical, the application of a spatiotemporal accessibility-based vulnerability analysis method to EMS is considered to be more holistic. Insights from this study can be used to evaluate the effectiveness of EMS risk management plans with respect to evolving extreme flood scenarios.