Disaster Medicine and Public Health Preparedness

Journal Information
ISSN / EISSN : 1935-7893 / 1938-744X
Published by: Cambridge University Press (CUP) (10.1017)
Total articles ≅ 2,292
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Disaster Medicine and Public Health Preparedness pp 1-13; doi:10.1017/dmp.2021.226

Objective: The purpose of this study is to investigate the efficiency of the Iranian Red Crescent Society in managing their non-monetary resources involved in COVID-19 response. Methods: For this purpose, the data envelopment analysis approach was used to measure the efficiency, considering the number of personnel and vehicles and screened passengers as the input and output parameters, respectively. It was examined the efficiency of 10 IRCS's branches given 17 days of screening operation. For the analysis,the DEA SolverPro software 15a version was used. Results: The results show that only one branch had been full efficient in using the resources while five branches showed less than 50% efficiency. This study reveals that it is unnecessary to use a fixed number of volunteers at different stations with different passenger numbers. Conclusions: Using resources without efficient planning can lead to direct costs such as food, transportation, and maintenance, as well as indirect costs such as burnout, fatigue, and stress when responding to the COVID-19 pandemic. This analysis should support IRCS’s managers to move their valuable resources from inefficient to efficient centers to increase the screening rate and reduce the fatigue of aid workers for the next pandemic rounds.
Sajad Delavari, Zahra Jamali,
Disaster Medicine and Public Health Preparedness pp 1-10; doi:10.1017/dmp.2021.222

Background: Countries are trying several policy options for decreasing the incidence and burden of the COVID-19. One of these strategies is a lockdown, complete closure, to reduce the risk of distributing disease via social interactions. This study aimed to analyze the effect of a three-week lockdown on the mortality and morbidity of the COVID-19 in Iran. Methods: Official daily data on COVID-19 incidence and death reported on the COVID-19 by the World Health Organization (WHO) were extracted from September 1, 2020, to January 14, 2021. Data were analyzed using interrupted time series analysis via STATA 14 software. Results: Lockdown resulted in a significant reduction in the daily death from Covid-19 in the short-term (β=-139, P<0.01) and in the long-term (β=-12, P<0.01). Moreover, lockdown in the short-term insignificantly (β=-21.58, P=0.969), and in the long-term significantly (β=-317.31, P<0.01) reduced the Covid-19 daily incidence. Discussion: The results showed that the lockdown has a significant effect on incidence and death numbers. Therefore, it could be a suitable short-term strategy for controlling the COVID-19 outbreak. On the other hand, its negative effects on households and businesses should be considered.
, Salma Saddique, Shahbaz Ali
Disaster Medicine and Public Health Preparedness pp 1-19; doi:10.1017/dmp.2021.220

The coronavirus disease 2019 (COVID-19) has received various distinct perspectives and responses at the local as well as global levels. The current study pays attention to local perspectives, which have appeared in the Sindh province of Pakistan. Focusing on a small town of the province, we have found that some people consider the disease is a “political” game or a “supernatural test.” The given perceptions then guide further actions: either ignore or adopt the preventive measures or take supernatural preventive measures. Considering it as a test of God, Muslims perform prayers, while Bāgrrī community who practice Hinduism are taking the cow urine to deal with the virus. This study brings these perspectives to the center stage, yet the results cannot be generalized across the country, including the province. Moreover, the study situates these perspectives within the global and socio-cultural, economic, and political contexts and invites more in-depth studies to inquire why such perspectives emerge. We maintain that documenting these various perspectives and analyzing their impacts at the preparedness programs is essential yet understanding the causes behind the stated standpoints—if not more—then is equally essential.
, Alexandra M Uren, Megan K Young
Disaster Medicine and Public Health Preparedness pp 1-21; doi:10.1017/dmp.2021.223

OBJECTIVE Analyze COVID-19 related call data at Metro North Public Health Unit, Brisbane Australia, over the 2020 calendar year to assist surge preparedness. METHODS Call data was retrieved by call category or reference to ‘COVID’ in summaries from the call management system at a large metropolitan public health service. Under a mixed-methods approach, qualitative data (caller, call purpose, and call outcome) was categorized with categories arising de novo. Resulting variables were numerically analyzed to identify trends by categories and time. RESULTS Of the 3,468 calls retrieved, 160 duplicates and 26 irrelevant calls were excluded. Of 3,282 included calls, General Practitioners, followed by the public, contributed the greatest call volumes. Healthcare-related callers and the public made 84.2% of calls. Calls most frequently related to patient testing (40.7%) and isolation/quarantine (23.2%). Education provision accounted for 29.4% of all outcomes. 11.8% of all call outcomes involved applying relevant case definitions. 49.1% of calls were identified as potentially preventable through effective ERC and targeted call-handling. CONCLUSIONS This study identified key drivers of public health unit phone service utilization related to the COVID-19 pandemic throughout 2020. The results highlighted where risk perception influenced call volume and provided important insights for future public health preparedness.
Benling Hu, Le Yang, Chan Wei, Min Luo
Disaster Medicine and Public Health Preparedness pp 1-17; doi:10.1017/dmp.2021.218

Objective: To evaluate the management mode for the prevention and control of coronavirus 2019 (COVID-19) transmission utilized at a general hospital in Shenzhen, China, with the aim to maintain the normal operation of the hospital. Methods: From January 2, 2020 to April 23, 2020, Hong Kong–Shenzhen Hospital, a tertiary hospital in Shenzhen, has operated a special response protocol named comprehensive pandemic prevention and control model, which mainly includes six aspects: 1) human resource management; 2) equipment management; 3) logistics management; 4) cleaning, disinfection and process reengineering; 5) environment layout; 6) and training and assessment. The detail of every aspect was described and its efficiency was evaluated. Results: A total of 198,802 patients were received. Of those, 10,821 were hospitalized; 26,767 were received by the emergency department and fever clinics; 288 patients were admitted for observation with fever; and 324 were admitted as suspected cases for isolation. Under the protocol of comprehensive pandemic prevention and control model, no case of hospital-acquired infection with COVID-19 occurred among the inpatients or staff. Conclusion: The present comprehensive response model may be useful in large public health emergencies to ensure appropriate management and protect the health and life of individuals.
Disaster Medicine and Public Health Preparedness pp 1-25; doi:10.1017/dmp.2021.225

Objectives: This study sought to identify COVID 19 risk communication materials distributed in Jamaica to mitigate the effects of the disease outbreak. It also sought to explore the effects of health risk communication on vulnerable groups in the context of the pandemic. Methods: A qualitative study was conducted including a content analysis of health risk communications and in-depth interviews with 35 purposively selected elderly, physically disabled, persons with mental health disorders, representatives of government agencies, advocacy and service groups, and caregivers of the vulnerable. Axial coding was applied to data from the interviews and all data were analyzed using the constant comparison technique. Results: Twelve of the 141 COVID 19 risk communication messages directly targeted the vulnerable. All participants were aware of the relevant risk communication and largely complied. Barriers to messaging awareness and compliance included inappropriate message medium for the deaf and blind, rural location, lack of Internet service or digital devices, limited technology skills, and limited connection to agencies that serve the vulnerable. Conclusion: The vulnerable are at increased risk in times of crisis. Accessibility of targeted information was inadequate for universal access to health information and support for vulnerable persons regardless of location and vulnerability.
, Akshat Patel, Ava Pierce, Ray Fowler
Disaster Medicine and Public Health Preparedness pp 1-23; doi:10.1017/dmp.2021.224

Objective: To assess variations in presentation and outcomes of COVID-19 across race/ethnicity at a large Texas metroplex hospital. Methods: Retrospective cohort study. Results: Although COVID-19 patients demonstrated significant socioeconomic disparities, race/ethnicity was not a significant predictor of ICU admission (p=0.067) or case fatality (p=0.078). Hospital admission varied by month, with incidence among Black/African-American and Hispanic/Latino patients peaking earlier in the pandemic timeline (p<0.001). Patients reporting Spanish as their primary language were significantly more likely to be admitted to the ICU (OR: 1.75, p=0.007). Conclusions: COVID-19 patients do not demonstrate significant racial/ethnic disparities in case fatality, suggesting that state-wide disparities in mortality rate are rooted in infection risk rather than hospital course. Variations in admission rates by race/ethnicity across the timeline and increased ICU admission among Spanish-speaking patients demonstrate the need to pursue tailored interventions on both a community and structural level to mitigate further health disparities throughout the pandemic and after.
Disaster Medicine and Public Health Preparedness pp 1-14; doi:10.1017/dmp.2021.219

Objective: COVID-19 screening stations set up by Iranian Red Crescent Society have been available for seventeen days with the aim of identifying and treating people with coronavirus, reducing road trips, and sensitizing people to the problem. This study aims to investigate the challenges of the procedure. Methods: A qualitative study was used to find the challenges of the COVID-19 screening centers. Volunteers, branch managers, and headquarter managers of the Iranian Red Crescent Society participated in this study applying snowball sampling. Data were collected via in-depth semi-structured telephone interviews in April 2020 after completion of the fever screening plan. All interviews were recorded and transcribed verbatim, always with prior permission of interviewees. Results: The interviews with 20 participants in the plan indicated six relevant challenges including logistics, lack of planning, lack of coordination, legal challenges, mental health, and ethical challenges. Conclusions: The results indicated that although establishing fever detection centers in Iran was a rapid response to COVID-19, it had significant flaws in the structure and adversely affected volunteers and staffs’ health and financial resources. Therefore, well-structured protocols are required for similar responses in the future.
Christopher Tedeschi, Angela M. Mills, Rahul Sharma, Emme Deland, Benjamin Johnston, Emy Schwimmer, Katherine L. Heilpern
Disaster Medicine and Public Health Preparedness pp 1-18; doi:10.1017/dmp.2021.216

The COVID-19 pandemic has stressed the U.S. healthcare system in unprecedented ways. In March and April 2020, emergency departments (EDs) throughout New York City experienced high volumes and acuity related to the pandemic. Here we present a structured after-action report of a coalition of nine EDs within a hospital system in the New York City metropolitan area, with an emphasis on best practices developed during the prolonged surge as well as specific opportunities for growth. We report our experience in six key areas using a framework built around lessons learned. This report represents the most salient concepts related to our institutional after-action report, and those seemingly most relevant to our peer institutions dealing with similar circumstances.
Semih Korkut, Selim Altinarik, Osman Türk, Fatih Türkmen, Yusuf Uğurlu, Erdal Yilmaz, Hasan Mutlu,
Disaster Medicine and Public Health Preparedness pp 1-5; doi:10.1017/dmp.2021.147

Objective: The objective of this study was to determine whether coordination of prehospital emergency health services and Disaster and Emergency Management Presidency (DEMP) and being prepared for disasters, such as building collapses, allow quick evaluation and fast intervention. Methods: The information flow, hierarchy, treatment, and rehabilitation processes, and rescue organization and planning during the rescue attempt for 35 people who needed help due to this building collapse were reviewed. Results: Of the 43 people who lived in this 8-story building, 35 were inside the building during the collapse; 40% of them were assessed as injured and 60% as exitus. Almost two-thirds (64.3%) of the injured individuals who were rescued were women. The mean duration until rescue was 330 (57.0-512.0) min. Conclusions: Leading and important factors that can increase the success rate in search and rescue interventions are informing official authorities as first early warning by individuals who can clearly define the situation, early security measures by security forces arriving before the health and search-rescue teams, accurate identification of estimated numbers of injured victims, and identifying and informing appropriate hospitals which victims rescued from the debris will be transferred to there.
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