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This contribution is based on the findings from a ‘living’ systematic literature review seeking to understand the short and long term health impact of the COVID-19-pandemic. Emphasis is placed on the prevalence and risk factors of trauma-related mental health outcomes in the context of the pandemic. Especially when it comes to Post Traumatic Stress Disorder (PTSD), it is questionable whether exposure types that are typical to the pandemic match the essence of the disorder. Our objective is to verify whether the international literature sufficiently distinguishes pandemic related exposure from other risk factors such as social demographic characteristics and non-pandemic related exposure to threats and life events.
Method:
This part of the ‘living’ systematic literature review is conducted under the umbrella of the Dutch Integrated Health Monitor COVID-19. In order to guide a research-driven data collection, several databases were searched for studies published during the pandemic. At the moment of abstract submission the protocol was published in Prospero and screening was in progress. Observational, quantitative studies including a specified exposure/event and a trauma-related mental health outcome measure are included. The included studies will be categorized based on type of exposure/event. Pooled prevalence will be calculated if studies are sufficiently homogeneous.
Results:
In progress.
Conclusion:
The results from this literature review are likely going to confirm that a substantial part of the international literature is polluted with studies promising to contain information on PTSD and other trauma-related health effects of the COVID-19 pandemic, yet running short of linking symptomatology to particular types of exposure and risk factors. If this is the case, a risk exists that public health authorities are being recommended to apply preventive and curative trauma-focused interventions based on an ambiguous knowledge base. The results will be presented during the conference.
There is a consensus that there lacks a standard for primary triage during mass casualty incidents. This is further compounded by a dearth of high quality research on the topic. Some studies suggest the superiority of SALT triage versus other triage systems, however, findings have not widely transitioned to clinical practice. We believe that despite specialized training including that in emergency medicine or emergency medical services (EMS), there will be significant variability amongst triage determination and use of triage methods. This study intends to analyze various provider skill levels and their accuracy of triage determination.
Method:
In a disaster exercise, a group of providers trained to use START triage were expected to triage, treat and determine transport order of the patients from a scenario of a simulated intentional radiological dispersal device (RDD) detonation with multiple casualties. Another group of providers trained to use SALT triage were expected to triage, treat, and determine transport order of patients from a scenario of a building collapse after a hurricane to assess SALT triage with the participating officers. Additional cohorts of EMS clinicians will be given the same case scenarios and asked to triage, treat when necessary, and determine transport order of the patients.
Results:
The initial data from the RDD exercise includes 102 patient case scenarios with 27 minimal (green), 40 delayed (yellow), and 35 immediate (red) patients. The providers involved in the exercise are trained at minimum to NREMT EMT level. Results showed an under-triage rate of 7.8%, an over-triage rate of 20.6% and overall accuracy of 71.6% when using START triage.
Conclusion:
The undertriage rate with START is 7.8% is higher than the generally acceptable rate of less than 5%. Our research is ongoing and we anticipate completion in 2023. We hope that our research provides future direction to improve triage in disaster scenarios.
A prepared and well-trained workforce is essential to reducing the loss of lives from health emergencies. However, it is uncertain what should be included in the common set of core competencies for the health emergency and disaster risk management (Health EDRM) workforce. The objective of the study is to provide evidence mapping for the competencies in existing professional development programs and courses in Health EDRM.
Method:
A survey conducted using an online platform (Survey Monkey) was conducted from October to November 2021. Experts in the Health EDRM Research Network including experts identified for the Delphi studies were invited to join the study. Participants should be ≥ 18 years of age, and had relevant experience in Health EDRM and in disaster education and training programs. A self designed questionnaire containing 28 questions in four domains including competencies; curriculum; evidence gaps; work and personal details were used.
Results:
There were 65 respondents from 20 countries participating in the survey. Most of the respondents worked in academic institutions (60%), followed by government employees (19%), and non-governmental organizations (7%). These organizations have roles throughout the disaster cycle with 95% in the preparedness phase. For management skills, EDRM managers should be competent in planning, organizing, applying management processes, establishing effective communication systems and providing effective leadership. For technical competencies, emergency communications, hazard specific knowledge, communicable diseases were essential for frontline workers. In terms of designing the competency matrix, WHO resources were frequently used for the competencies and the curriculum design.
Conclusion:
Health EDRM managers are expected to master a large number of managerial and technical skills, including the increasingly recognized leadership and decision-making skills for effective planning and implementation. These competencies need to be established for the development of a Health EDRM workforce.
WHO Thematic Platform for Health Emergency and Disaster Risk Management Research Network (Health EDRM RN) is a global expert network, launched in 2018, aiming to strengthen the scientific evidence for managing health risks associated with all types of emergencies and disasters, and to foster global collaboration among academia, government officials and other stakeholders. The Health EDRM RN’s activities are in line with WHO Health EDRM Framework, which support Sendai Framework for Disaster Risk Reduction 2015-2030.
Method:
Health EDRM RN’s strategic direction is discussed and advised by its Core Group that consists of focal points of WHO HQ responsible unit, all six Regional Offices, WHO Center for Health Development (Secretariat), RN co-chairs, and key external stakeholders. Based on the strategic direction, the Secretariat facilitates global, regional, and local collaborative activities with the RN participants and partners. As of 2022, over 250 global experts participate in the network.
Results:
Following the results of the Core Group Meeting in 2019, 2020 and 2021, multiple activities and results were generated including the identification of five Health EDRM key research areas. WHO Guidance on Research Methods for Health EDRM developed in collaboration with over 150 global experts, initiation of the project to establish WHO Health EDRM Knowledge Hub for developing WHO Health EDRM Research Agenda and aligning with UNDRR research agenda on thematic areas including developing a special supplement on mid-term review of Sendai Framework implementation in health. The 2022 Core Group Meeting, held on October 27, 2022, agreed to promote knowledge dissemination and implementation research for better outputs for regions and countries.
Conclusion:
WHO Health EDRM RN will continue its unique function as the platform of global experts and stakeholders to produce, disseminate, and apply knowledge. Participation and engagement by more and broader experts are expected.
October 18, 2017 an unfortunately popular white supremacist brought hate and thousands of protesters to the University of Florida in Gainesville, FL just months after the violent domestic terrorist attacks in Charlottesville, VA. The threats, violent possibilities, and intense planning undertaken by law enforcement and fire-rescue were hugely successful.
Method:
Multi-faceted planning from law enforcement, to crowd control, to medical emergency response, to fire suppression, to hazardous material detection and response, to rescue task forces, to extreme sides to protesting... all proved hugely successful.
Results:
While there was still violence, complex plans of violence among protests were successfully thwarted.
Conclusion:
The coordination between Gainesville Fire Rescue, Gainesville Police Department, Alachua County Sheriff's Office, Florida Highway Patrol, the University of Florida and more was hugely successful and something to be proud of despite such hatred and violence projected while also protecting the first amendment.
The Victorian Compendium of Community-Based Resilience Building Case Studies supports place-based disaster risk reduction by promoting strategies to reduce communities’ risk before, during, and after disasters or emergencies and by strengthening community resilience through shared learning. It grew from Community Resilience Forums at Monash University, where community resilience practitioners presented their programs, explained their evolution, how they solved challenges, and shared unforeseen learnings. Forum attendees expressed an urgency for a sharing platform to help build community expertise, save precious community resources, avoid program duplication to prevent communities from reinventing the wheel. These now represent key tenets of the Compendium.
Method:
International exemplars inform the structure of the Compendium and a thematic analysis identified critical success factors for underpinning disaster risk reduction and resilience strategies.
Results:
As an Australian first, the Compendium gathered 38 programs between 2012 and 2022, which were addressed before (29), during (7), and after (17) events. Programs addressed all hazards (23), bushfires (11), heat (2), fire safety (1), and house fires (1). Twenty programs used a framework. Thirty received funding, with nine receiving less than $20,000 and five receiving more than $100,000. Twenty-nine addressed a whole-of-community perspective.
Critical success factors included: strong governance and Board support; trust, partnerships, commitment, adaptability, stamina, and community leadership; paid facilitator, local government support, external funding; and celebrating often-neglected success.
Conclusion:
Offering an innovative contribution to resilience practice and research, the Compendium supports and enables locally-led and owned place-based disaster risk reduction efforts. It supports the Sendai Framework and augments principles in the National Framework for Disaster Risk Reduction by connecting people from diverse sectors to deliver distinct, adaptable actions to help reduce communities’ risk before, during, and after disasters or emergencies. The Compendium enables communities to preserve valuable community resources offering opportunities to extend to a national or international Compendium.
The Virtual Interprofessional Education program is a multi-institutional consortium collaborative formed between five universities across the United States. As of January 2022, the collaborative includes over 60 universities in 30 countries. The consortium brings healthcare students together for a short-term immersive team experience that mimics the healthcare setting. The VIPE program has hosted over 5,000 students in healthcare training programs. The VIPE program expanded to a VIPE Security model to host students across multiple disciplines outside the field of healthcare to create a transdisciplinary approach to managing complex wicked problems.
Method:
Students receive asynchronous materials ahead of a synchronous virtual experience. VIPE uses the Interprofessional Education Competencies (IPEC) competencies (IPEC, 2016) and aligns with The Health Professions Accreditors Collaborative (HPAC) 2019 guidelines. VIPE uses an active teaching strategy, problem or case-based learning (PBL/CBL), which emphasizes creating an environment of psychological safety and its antecedents (Frazier et al., 2017 and Salas, 2019, Wiss, 2020). Following this model, VIPE Security explores whether the VIPE model can be tailored to work across multiple sectors to discuss management of complex wicked problems to include: climate change, disaster, cyber attacks, terrorism, pandemics, conflict, forced migration, food/water insecurity, human/narco trafficking etc. VIPE Security has hosted two events to include professionals in the health and security sectors to work through complex wicked problems to further understand their roles, ethical and responsible information sharing, and policy implications.
Results:
VIPE demonstrates statistically significant gains in knowledge towards interprofessional collaborative practice as a result of participation. VIPE Security results are currently being analyzed.
Conclusion:
This transdisciplinary approach to IPE allows for an all-hands-on-deck approach to security, fostering early education and communication of students across multiple sectors. The VIPE Security model has future implications to be utilized within multidisciplinary organizations for practitioners, governmental agencies, and the military.
Emergency medical teams (EMT) are utilized during national and international disasters to improve the response capabilities and provision of quality of care to those impacted. The inclusion of rehabilitation professionals on EMTs is slowly increasing but still has not become standard on Type I teams. The goal of rehabilitation is to optimize function and reduce disability for patients of all ages and in all treatment locations. SPHERE humanitarian standards mandate country emergency response frameworks should include rehabilitation in disaster starting at the acute phase of the incident, but services are typically not provided at the right time or the right place, if at all. After an injury, early education and intervention by rehabilitation can reduce long term injury and improve function. Rehabilitation services continue to be limited to post-acute care and available only to those who have required hospitalization or long-term rehabilitation services. There is a growing body of evidence for the use of physiotherapy in prehospital medical management of acute urgent and emergency injuries and within the emergency department to improve access to care, reduce imaging, reduce use of opioid use.
Method:
Literature review was conducted regarding prehospital injuries and rehabilitation services using Google Scholar and University of South Florida library access services.
Results:
No reports or documentation for prehospital or emergency department care during natural disasters or conflict response are available from the World Health Organization or other NGOs.
Conclusion:
There is a recognition from the medical community of the value and necessity of rehabilitation services across the disaster continuum but remains an under-utilized resource for improving patient care. Conclusion: Rehabilitation should not be available to only those with the most severe long-term injury but should be included at all levels of response with integration into all EMTs.
Infection countermeasures that consider patient characteristics are needed at psychiatric hospitals.
Method:
Based on the experience of implementing countermeasures against infection by COVID-19, which has become a pandemic disaster over the past few years. This report is on the current situation and issues of infection countermeasures in psychiatric hospitals.
Results:
Reasons for why it is difficult to take COVID-19 countermeasures in psychiatric hospitals included the following: for patient predispositions–it is difficult to promote understanding and practice of infection countermeasures such as proper wearing of masks, hand hygiene enforcement, zoning, etc. For environmental predispositions–it is difficult to ventilate because windows and doors cannot be opened, and it is difficult to isolate infected individuals as there are few private rooms. Countermeasures included the following: recreation should be limited to that which does not involve speaking and having everybody face the same direction, ensuring sufficient space between people during meals, installing ventilation equipment in hospital wards, handle care in private rooms until the hospitalized patient is judged to be not infectious, and conducting zoning and isolation on a hospital ward level. Results showed that although COVID-19 outbreaks occasionally occurred in hospital wards, this did not result in spread throughout the hospital.
Conclusion:
Future challenges include improving the quality of infection countermeasures in hospitals through thoroughly educating hospital personnel who are unaccustomed to taking infection countermeasures.
The Health Information and Quality Authority (HIQA) Tallaght Report of 2012 found care of lodged admitted patients on ED trolleys was undermined in terms of quality and safety. HIQA advised the practice of lodging in ED adjacent hospital corridors should be discontinued entirely. This message was reiterated during the pandemic. Some lodged patients may spend the total duration of their admission on an ED trolley. ED has 15 Adult rooms, seven pediatric rooms, two minor injury rooms, one procedure room and two resus bays. The aim was to calculate the annual number of days when no admitted patients were lodged on trolleys in ED.
Method:
A descriptive study using data available from nationally issued reports on patients allocated to trolleys to the ED of Wexford General Hospital from January 2019-September 2022. Data was collected from national HSE daily SBAR reports. “Lodged patients” were those present in ED admitted but for whom no ward bed existed at 0745 daily.
Results:
Data was collected for 1,369 days, 90 days were excluded due to missing data sets, and data were included for 1,279 days. 290 days were recorded in 2019 with no lodged patients, 126 in 2020, 55 in 2021, and only 11 days in 2022 with no lodged patients. In 2022 the average number of lodged patients was six (Range 0-19). A total of 47 days had a lodged count of ten or greater.
Conclusion:
Despite a strong recommendation from HIQA to terminate the practice of ED patient lodging, this has not been implemented. During the COVID-19 pandemic, there had been a reduction in the overall number of patients visiting the ED. This contributed to the reduction in trolley-lodged patients however post-COVID pandemic there has been a surge in attendance with a clear deficit in bed capacity.
Patients refusing transportation is common EMS practice with potentially fatal outcomes. Determining which patients are at high risk for poor outcomes is poorly defined. This study described patients who experienced an out-of-hospital cardiac arrest (OHCA) within 24 hours of refusing transportation.
Method:
This is a retrospective, descriptive study of patients who had an OHCA within 24 hours of refusing EMS transportation between 2019 to 2021. Data was obtained from a large, urban medical control authority seeing 175,000 EMS calls annually. We reviewed patient demographics, EMS events when transportation was refused, and cardiac arrest outcome.
Results:
There were 6, 30, and 28 EMS refusals resulting in OHCA in 2019, 2020, and 2021. Patients who had OHCA were 65.7 (range 28-103) years old, and African American (54/64). Patients had HTN (36/64), diabetes (19/64), COPD (11/64), and CHF (7/64). Common complaints included breathing problems (17/64), near syncope (8/64) however chest pain was uncommon (4/64). One (28/64) or two (13/64) abnormal vital signs were present and missing vital signs (28/64) were common. Tachycardia (32.8%, 21/64), HTN (29.7%, 19/64), and hypotension (17.2%, 11/64) were more prevalent in the OHCA population compared to all refusal patients (Tachycardia 0.33% [1,978/598,416], HTN 2.27% [13,601/598,416], and hypotension 0.04% [218/598,416]). Patients were seen by both ALS (29/64) and BLS (35/64) providers. Most providers documented risk including death (38/64) though few contacted medical control (14/64). Return encounter for OHCA resulted in obvious deaths (23/64) or field termination (20/64). Few patients achieved ROSC (7/64).
Conclusion:
Patients who had an OHCA within 24 hours of refusing transport had underlying comorbidities and abnormal or missing vital signs. The patients experienced tachycardia, hypertension, and hypotension at a higher rate than the overall refusal population. Few patients obtained ROSC. Further research is needed to determine methods to mitigate poor outcomes and decrease refusals.
This presentation provides a review of a case report regarding the often unrecognized emotional support experienced among leaders during crisis management.
Method:
Members of a statewide COVID-19 advisory group were surveyed as to their level of participation and perceived emotional wellness benefit resulting from group membership.
Results:
A majority of members across all disciplines and agencies reported a benefit of emotional wellness from group membership.
Conclusion:
It is important in disaster settings, regardless of the labeled group function, to be mindful of the potential benefits to group members from not only a task standpoint but a process standpoint as well. In addition, it is important to recognize the multiple benefits of interdisciplinary interaction and inclusion.
In lower- and middle-income countries (LMIC), 45% of deaths could be prevented by implementation of emergency care systems. Prehospital care is critical for emergency medical services (EMS) worldwide, and basic affordable training improves EMS systems. This study conducted a needs assessment in addition to a tailored prehospital training intervention. Subsequent changes in prehospital care as well as patient outcomes were measured.
Method:
Thirty providers identified through the prehospital medical command office participated. A prospective, nonrandomized interrupted time-series approach was utilized for a needs assessment and training intervention. Data collected included age, gender, training level, and a knowledge assessment, and was used to create an 18-hour training, with immediate and 11-month posttests. Prehospital process indicators evaluated on-the-ground application of skills, including airway intervention, intravenous fluid administration, and glucose administration. Linked prehospital and hospital care datasets allowed for evaluation of patient outcomes.
Results:
Of 30 providers, 60% (n=18) female and 40% (n=12) male, 19 were nurses and 11 were nurse anesthetists. Median age was 36 and median years providing care was 10 (IQR: 7,11). 24 (80%) participants completed immediate and post-test assessments, showing a 56% (95%CI: 36.2, 75.8) relative increase in mean knowledge score across 12 core skills that was maintained across post-tests. 324 of 572 total patients transported to the ED during the study were transported during the pre-training period (56.4%). Prehospital oxygen administration for patients with a saturation level of <95% increased pre- to post-intervention (66.7% to 71.7%; Δ = 5.0%; Δ95%CI: 1.9, 8.1%).
Conclusion:
This study is the first LMIC-based prehospital provider training efficacy study that includes analysis of patient outcomes and clinical process indicators. Results offer important insights on Rwanda’s prehospital care system and demonstrate that affordable, tailored educational interventions targeting process indicators have positive impacts on provider knowledge and practice.
According to the Climate Change Advisory Council, Ireland is woefully unprepared for future extreme weather events such as heatwaves, flooding, and coastal surges, which are going to be more extreme and frequent in the future. Met Éireann issued numerous red weather warnings since the inception of the severe weather forecasting system. Storms Ophelia (Ex. Hurricane) and Emma (Snow Storm) proved to be extremely challenging weather events for the Health Service across Ireland.
Method:
A comprehensive review of debriefs and lessons identified processes completed across the health system was conducted, in connection with lived experiences of emergency management staff, following Storm Ophelia and Storm Emma.
Results:
As part of the emergency management life cycle and an attempt to enhance severe weather preparations, this study lists over 50 actions (development of specific HR policies, creating 4X4 capacity, severe weather preparations sessions, development of service-specific red weather event action cards, development of severe weather care plans for community palliative care and renal dialysis patients, sharing critical health care facilities with Local Authorities for road salting and gritting etc.) that were taken across the Health Service Executive South (Cork and Kerry) to enhance the preparations for severe weather events,
Conclusion:
The frequency and intensity of severe weather events will increase in Ireland over the coming years, as a result, it is essential that healthcare facilities and services have learned from previous severe weather events to ensure that the necessary plans and procedures are in place for future events, ensuring the delivery of safe and effective patient care and staff safety.
In Singapore, disaster training and preparation are taken seriously. Many exercises and training sessions have been planned and run yearly with the hope of being able to respond effectively to an emergent disaster. This presentation aims to evaluate the effectiveness of our training programs to determine if the learner participants are equipped to manage disasters when they happen based on their learning objectives.
Method:
The disaster training programs that Singapore General Hospital participates in, both nationally and internally, were analyzed based on Bloom’s taxonomy for educational objectives. At the lowest level, the learner demonstrates the ability to remember the facts that he learned, followed by understanding the concepts, applying the information, analyzing the learning undertaken, evaluating his performance, and creating new methods to learn or train to improve his performance.
Results:
Based on the analysis of the various exercises and training sessions, most learning objectives are pegged to the remembering to application levels (90%) while very few participants, especially the instructors and evaluators (<10%) may achieve learning objectives of being able to analyze and evaluate the training sessions. As disaster training involves multiple interprofessional teams there is also a risk of rapidly diminishing retention of knowledge and skills over time because of the high turnover of manpower especially from residents and medical officers who are attached to the departments for a few months.
Conclusion:
There is room for more targeted disaster training aimed at more participants and with learning objectives determined at the higher level of Bloom’s taxonomy, at least to achieve the ability to analyze and evaluate one’s performance for improvement. Creating opportunities for more participants to be able to do that would be a challenge.
Accidental hypothermia occurs very rarely. Japan experienced hypothermic victims in the 2011 earthquake and tsunami disaster. In northern Japan, where the largest class of earthquakes and tsunamis are estimated, study for countermeasures has been advanced. The progression of hypothermia varies significantly by individual differences and environmental factors, and it is considered to be challenging to assess its damage. We present the findings that can be the basis for damage estimation from the data of hypothermia victims experienced in mountain rescue.
Method:
From 2002 to 2020, we examined ten fatal cases of hypothermic witnessed respiratory arrest (HWRA) by companions, which led to subsequent cardiac arrest among 164 cases from mountain rescue. We collected the time course of the deceased from rescue records and calculated the time from cold exposure to symptom, exposure to incapable, and exposure to HWRA. Temperature and wind speed data were extrapolated from nearby AMEDAS and upper-air weather records, and the wind chill index (WCI) was calculated.
Results:
We obtained the time course data in seven cases of ten, five males and two females between 21 and 67 years old. The weather conditions where the seven cases were placed were -5 to -30°C of WCI. The shortest time from cold exposure to incapacity was 65 minutes, 42.9% (3/7) within 180 minutes, and the fastest time to HWRA was 90 minutes, with 57.1% (4/7) between 10 and 12 and half hours.
Conclusion:
For disaster evacuation measures, both evacuees and rescuers need specific indicators to refer to. From very little but valuable data, we consider that rescue within 10 hours is necessary for lifesaving in similar conditions. Additionally, increasing the number of cases that become incapacitated within 1-3 hours can be valuable information for considering the location of the evacuation shelter and evacuation plan.
Behaviors to avoid infection are key to minimizing casualties of the COVID-19 pandemic. Even so, infection-avoidance behavior may also cause distant health impacts like immobility and obesity. This research aims at identifying behavioral patterns associated with SARS-CoV-2 infection, exercise habits, and being overweight in the Japanese population.
Method:
Nationwide online questionnaires were conducted five times from October 2020 to October 2021. Individuals who answered with consistency to have been diagnosed with SARS-CoV-2 at a medical facility were categorized into a SARS-CoV-2 group. The difference in lifestyle is compared using multiple regression and inverse probability weighing. In addition, the change in exercise habits, body mass index (BMI), and status of overweight (BMI>25kg/m2) were compared between the first questionnaire and the later ones. Risk factors of losing exercise habits or developing overweight were analyzed using multiple regression.
Results:
Diagnosis of SARS-CoV-2 was negatively correlated with crowd avoidance, mask wearing, hand washing behavior. On the contrary, the diagnosis was positively correlated with some behaviors that appear as preventive actions against the infection, such as changing clothes frequently, sanitizing belongings, and remote working. Regarding exercise habit and overweight, people with high income and elderly females showed higher risk of decreased exercise days. The proportion of overweight was increased from 22.2% to 26.6% in males and from 9.3% to 10.8% in females. Middle-aged males, elderly females, males who experienced SARS-CoV-2 infection were at higher risks of developing overweight.
Conclusion:
It is important to conduct an evidence-based intervention on people’s behaviors and to avoid excessive intervention that is less effective so that people can minimize indirect harm such as exhaustion, economic loss, and other chronic health impacts. Our findings suggest that high-risk groups of COVID-19 infection and immobility and/or overweight are quite different. Further research may enable us to establish more effective interventions for each group.
Both prevention and preparedness are essential to avoid casualties and deaths in mass gathering disasters (MGDs). What countermeasures should be taken?
Method:
Retrospective analysis of a MGD at Akashi City Fireworks Festival in 2001; discussion of countermeasures at Kobe Luminarie, an annual light festival to commemorate the Great Hanshin Earthquake. Retrospective analysis of mass casualty incidents (MCIs) between 2003 and 2022 in which the alert function of EMISHP (Emergency Medical Information System in Hyogo Prefecture) was activated. Duration from emergency call to activation of alert function (activation time), number of casualties, and number of destination hospitals were evaluated.
Results:
More than 200 persons were injured and eleven people died in the Akashi Fireworks crowd crush. The main cause of this MGD was lack of gateway control and one-way flow control of visitors. With such measures in place, no MGD has occurred at Kobe Luminarie. In the past nineteen years in Hyogo, the alert function has been activated for 288 MCIs, such as vehicle accidents and fires. Activation time ranged from 1 to 73 minutes (median value=12). The casualty count ranged from 0 to 662 (median value=5). The number of destination hospitals ranged from 0 to 54 (median value=2). In all cases, emergency medical coordinators at Hyogo Emergency Medical Center, a principal hub hospital for disasters, directly or indirectly contributed to the medical response, e.g. securing hospital capacity, dispatching doctor-attending cars/helicopters and other medical teams to the scene, sharing information on the MCI between fire departments and hospitals.
Conclusion:
Prevention of MGDs requires taking proactive measures, such as gateway restriction and one-way flow control without bottlenecks. Preparedness is made possible by the alert function of EMISHP; it enables smoother patient transport to hospitals and contributes much in securing sufficient time and resources for medical response in MCIs, including MDGs.
The current war in Ukraine and the subsequent deployment of Non-Governmental Organizations (NGOs) from around the world has highlighted the many potential dangers faced by humanitarian aid workers operating in conflict zones. Humanitarian aid workers may face both direct and indirect threats and aggression whilst on deployment, and given the rising number of global conflicts, the authors postulate a need to incorporate threat awareness training as part of pre-deployment training.
Method:
A list of the top 22 rated NGOs providing international aid was obtained from CharityWatch. All 22 were contacted via their public email addresses or website contact pages to find out if they provide any form of security, tactical, or threat awareness training.
Results:
Seven of the 13 NGOs that responded did not deploy staff into recent conflict zones or surroundings. All six NGOs who deployed staff into Ukraine or surrounding border countries, provided either security, tactical, or threat awareness training to their staff.
Conclusion:
With the rising number of conflicts and disasters around the world, humanitarian aid workers are increasingly exposed to hostile environments and there is a compelling need for NGOs to ensure staff are adequately trained and prepared to handle any dangers and threats they may face.
In order to promote useful and usable scientific evidence for health emergency and disaster risk management (Health EDRM), the World Health Organization (WHO) Health EDRM Knowledge Hub has been established as part of the WHO Thematic Platform for Health EDRM research network (Health EDRM RN). The Knowledge Hub aims to extend scientific knowledge; strengthen evidence-based practice in the management of health risks in emergencies and disasters; create and develop a competent network in the Health EDRM community; and integrate research, policy and practice.
Method:
To begin with, the Knowledge Hub has five interconnected research themes: (1) health data management; (2) psychosocial support; (3) health needs of sub-populations; (4) health workforce development; and (5) research methods. Systematic literature reviews and expert consultations have assessed current research under each theme and identified potential knowledge gaps. The work of the Knowledge Hub is advised by members of the Health EDRM RN and staff in WHO regional offices.
Results:
The WHO Health EDRM Knowledge Hub will be a platform for providing and exchanging up-to-date evidence. This will include information on validated methods for managing health data and identifying health needs in specific subpopulations. The Knowledge Hub will raise awareness of psychosocial support, health workforce development and research before, during and after disasters. It is targeted to policy-makers, researchers, practitioners and the broader community with the aim of accelerating evidence-informed policy and programs. This will support implementation of the Sendai Framework for Disaster Risk Reduction 2015–2030, the WHO Health EDRM Framework, and other related global, regional and national agendas.
Conclusion:
This paper introduces this new initiative and describes its objectives, design, and implementation. Additionally, it provides an overview of the Knowledge Hub and invites session participants to provide insights into their current needs and to make recommendations for improvement.