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In the immediate aftermath of a disaster, household members may experience lack of support services and isolation from one another. To address this, a common recommendation is to promote preparedness through the preparation of an emergency supply kit (ESK). The goal was to characterize ESK possession on a national level to help the Centers for Disease Control and Prevention (CDC) guide next steps to better prepare for and respond to disasters and emergencies at the community level.
The authors analyzed data collected through Porter Novelli’s ConsumerStyles surveys in fall 2020 (n = 3625) and spring 2021 (n = 6455).
ESK ownership is lacking. Overall, while most respondents believed that an ESK would help their chance of survival, only a third have one. Age, gender, education level, and region of the country were significant predictors of kit ownership in a multivariate model. In addition, there was a significant association between level of preparedness and ESK ownership.
These data are an essential starting point in characterizing ESK ownership and can be used to help tailor public messaging, inform work with partners to increase ESK ownership, and guide future research.
Once an emergency has passed, general attention typically returns to dealing with day-to-day system management, and the opportunity to learn from the crisis and improve is missed. Lessons from the coronavirus disease 2019 (COVID-19) crisis must be learned, and the necessary changes made at all levels, both in terms of improving collaboration and strengthening health systems. This special report provides the conclusion of a workshop held in the European Parliament (EP) in Brussels, Belgium. The event explored the modalities of response and preparation to the COVID-19 pandemic, and to health crises in general. The workshop considered actions at different levels: international organizations (global level), European Union (EU) Member States ([MS] national level), and health services (local level). It provided an opportunity to look back at several initiatives taken during the pandemic, and to draw inspiration from them.
The COVID-19 second wave badly affected India. This study assessed public preparedness and attitude towards a new lockdown in the state of West Bengal (WB) along with perception about the COVID pandemic situation.
An anonymous questionnaire was administered to all willing adult attendees of a COVID vaccination centre in Kolkata, capital city of WB. Logistic regression was applied to find the relationship between attitude towards lockdown and other selected independent variables.
Of the 839 persons analyzed, 72.0% were non-health workers; and 55.4% thought that available vaccines reduce COVID-19 risk. Among them, 54.4% wanted stricter guidelines imposed. For preparedness, 42.6% and 28.8% said they would stock additional food and medicines respectively. On multiple logistic regression, being female, having elderly family members, perceiving the second wave as worse, and favouring stricter restrictions, all had odds of favourable attitude towards the new, proposed lockdown.
A new lockdown was favoured by the majority. However, a well-planned and phased approach for this is needed in the light of many concerns about the previous lockdown. Mental health issues, financial security, medical help at hand, and ease of travel to workplaces are important issues that need to be addressed in case of future lockdown(s).
Infectious pandemics have had a significant negative impact on economies and health-care systems around the world repeatedly throughout history. Patients with advanced age are commonly disproportionately affected by pandemics. Health-care providers for older patients may be the first to recognize emerging infectious emergencies and play a critical role for older patients during infectious threats. This chapter outlines historical infectious outbreaks, epidemics, and pandemics and their impact on older patients. The chapter further outlines the risks of pandemics to older patients, describes key response strategies, and guides preparedness of the geriatric care provider for future infectious public health emergencies.
There are concerns that the South African higher education system is not producing sufficient graduates to meet national needs in respect of economic and social development. Systemic reform such as strengthening the undergraduate teaching and research relationship, which is inextricably tied to curriculum structure, is necessary to meet the goals of equity and development and enhancing graduate quality. This can potentially widen the pipeline into postgraduate studies and produce the next generation of academics. The main argument of this chapter is the need to profoundly change the manner in which teaching is structured in South Africa, in order to shift the prevailing culture of undergraduate students as receivers to one in which they are inquirers. This requires pedagogies that enable inquiry-led learning to be developed, to actively engage students in the research process and for them to make the linkage to their discipline-specific practice. An increased focus on building an undergraduate research culture through pedagogical reforms is still needed.
Decades of research contend with the notion that animals come prepared by evolution to learn about some stimuli and responses better than others. Biological preparedness – and contrapreparedness – can influence how potential information is acquired, processed, and used in decision-making. Theory predicts that preparedness is the result of patterns of reliability of stimuli in predicting reward across the evolutionary history of the lineage. The evolution of preparedness can be tested experimentally, and also by considering the natural history and the pattern of reliability of stimuli and rewards for a given species. We present predictions as well as explanations for how evolution can prepare animals to make choices about their environment. Why animals learn some things better than others is at the heart of what makes behavior adaptive and by working from relatively simple theory it is possible to directly test these hypotheses and analyze traits both underlying and evolving with prepared learning.
By the end of 2019, about 75.9 million people – 26 million refugees, 4.2 million asylum seekers and 45.7 million internally displaced persons (IDPs) – had been forcibly displaced worldwide as a result of persecution, armed conflict, other situations of violence or human rights violations (United Nations High Commissioner for Refugees, 2020). In addition, millions of migrants are forcibly displaced as a result of extreme poverty, discrimination, climate change, forced evictions and other situations.
Running exercise courses in different sectors of the health system is one of the important steps to prepare and deploy disaster risk management programs. The present study aimed to identify and explain the components affecting the design of preparedness exercises of the health system in disasters.
This study was a qualitative content analysis. Data were collected by purposeful sampling through in-depth and semi-structured individual interviews with 25 health professionals in disasters who had experience in designing, implementing, and evaluating an exercise. The data were analyzed using the content analysis method.
The data analysis resulted in the production of 50 initial codes, 12 subcategories, 4 main categories of “Coordination, Command, and Guidance of Exercise,” “Hardware and Software Requirements of Exercise,” “Organizational Exercise Resources,” and “Communication and Exercise Public Information” with the original theme of “Exercise Design.”
This study provides a clear picture and rich, constructive information on the concept of designing health system preparedness exercises in disasters. The findings of this study can greatly increase the attention of senior managers in all areas of health, especially managers of prehospitals and hospitals who are in the front line of the response to disasters to design standard and scientific preparedness exercises.
Preparedness in different sections of a society can improve the reactions of individuals at the time of disasters and strengthen the cooperation and coordination between people and organizations. The present study aimed to investigate the preparedness of households in Ardabil Province of Iran in the face of disasters in 2020.
This descriptive, cross-sectional study was conducted in Ardabil Province in Iran in 2020. The target population included the households living in Ardabil Province. The study was conducted on 10 502 participants. The data were collected using a questionnaire completed by trained questioners by referring to the participants’ houses. It should be noted that the questionnaires were completed by one of the household parents. The questionnaire contained 15 questions related to taking and not taking disaster preparedness measures at specific times. EXCEL 2016 (Microsoft, Redmond, WA) and SPSS 23 software (IBM Corp, Armonk, NY) were used for data analysis.
Considering the score of 1 for each action, the mean score of households’ disaster preparedness in Ardabil Province was 31.09%. The preparedness level of 51.4%, 42.31%, and 6.29% of the households in the province against disasters was at low, moderate, and good levels, respectively. Among the items of preparedness in the face of disasters, the highest value was related to the familiarity of family members with the initial warnings of significant hazards (5162 households, 49.15%) followed by planning for coping with disasters (43.12%) and assessing the non-structural vulnerability (38.93%). Furthermore, the results showed that the level of household preparedness was higher in the center of the province compared to other cities.
Evaluating the level of preparedness of different societies in the face of disasters can be very useful in identifying the challenges to improve preparedness and, consequently, achieving sustainable development. This assessment can be considered a resource for provincial policy-making and planning to achieve the priorities set out in the Sendai framework. However, such assessments should be performed periodically, for example, annually, to reflect the effectiveness of the interventional measures in improving preparedness. Considering the low level of households’ preparedness in the present study, there is a gap between what people know and what they do, and comprehensive studies are needed on various factors that encourage people to take preparedness measures.
The chapter explores whether high-income countries are ready for the first disease-modifying Alzheimer’s disease (AD) treatment, approved in the USA in February 2021. It looks at the capacity to provide diagnostic services relative to the expected demand, institutional preparedness, and potential solutions to overcome capacity constraints. Wait times are projected to differ substantially. Initial average wait times range from 5 months in Germany to 28 months in Canada. In France, Canada, and Taiwan, we project it will take over a decade to clear the backlog of prevalent cases and to make a treatment accessible with little delay, because of scarcity of dementia specialists, and aggravated by the lack of financial and structural plannin. Potential solutions include broadening the dementia workforce by integration of primary care clinicians and other specialists, care models that leverage specialist time, and telecare-supported models. Better diagnostic technology to detect cognitive decline and the AD pathology in primary care settings and predictive models to triage patients show potential to improve access.
With the advancement of technology, disaster preparedness related to hurricane hazards can be taught through an app. This study aimed to examine the effect of using an android-based disaster preparedness app on community knowledge and intentional behavior in hurricane risk areas.
A quasi-experimental study was conducted from October to November, 2020 and a total of 80 respondents were recruited using cluster sampling. The treatment group was given the intervention in the form of the disaster preparedness app for 2 weeks. Meanwhile, the control group received home visits and conventional education about hurricane disasters twice throughout the same period. We then used a Wilcoxon Signed Rank test to analyze the pre-test and post-test and a Mann-Whitney U test to compare between treatment and control groups.
After the implementation of the SiBen app, we found a statistically significant difference in knowledge between treatment and control groups (P < 0.003) and intentional behavior between treatment and control groups (P < 0.001).
The findings indicate that the disaster preparedness app was an effective educational program able to improve the knowledge and intentional behavior among community members in a hurricane risk area.
This study aimed to explore how deployed healthcare workers (HCWs) perceived personal preparedness for response, and their main avenues for coping to maintain resilience during the prolonged COVID-19 (SARS-CoV-2) pandemic.
Semi-structured interviews were conducted with 25 HCWs deployed to the frontline for an extended period to provide acute COVID-19 related care. Interviews were audio-recorded, transcribed verbatim, and analyzed thematically.
HCWs demonstrated heightened self-confidence and readiness to deal with public health emergencies owing to the ramped-up efforts in infrastructure for outbreak management and pre-emptive infectious disease training. Despite overall confidence, deployed HCWs had to adopt various coping mechanisms to sustain resilience during the prolonged pandemic. Main themes on coping centred around the value of team leaders and support from family members as an effective buffer for work-induced stress while institution-based counseling services and welfare were viewed as important for fostering the internal locus of control and wellbeing.
Our findings suggest that strategies such as on-the-job training, continuous education and improved communication would be essential to maintain resilience of deployed HCWs. Considerations should be also given to the swift implementation of blended wellness support comprising digital and in-person counseling to sustain wellbeing and prepare for endemic COVID-19.
This contribution marks a dual milestone at the intersection of public health law and JLME: my 50th publication of a substantive manuscript in the 50th anniversary of the Journal in 2022. In recognition of these coinciding landmarks, this installment of the Public Health Law column for JLME features observations and reflections of the field based largely on prior publications.
The aim of this study was to assess and compare nurses’ and physicians’ knowledge of disaster management preparedness. An effective health-care system response to various disasters is paramount, and nurses and physicians must be prepared with appropriate competencies to be able to manage the disaster events.
This is a cross-sectional study. A total of 636 nurses and 257 physicians were recruited from 1 hospital in Saudi Arabia. Of them, 608 (95.6%) nurses and 228 (83.2%) physicians completed self-administered, online questionnaires. The questionnaire assessed participants’ sociodemographic data, and disaster management knowledge.
The findings revealed that participants had more knowledge regarding the disaster preparedness stage than mitigation and recovery stages. They also reported a need for advanced disaster training areas. A total of 10.1% of nurses’ and 15.6% of physicians’ overall knowledge is explained by their demographic and work-related characteristics.
Both nurses and physicians had to some extent knowledge regarding the information and practices required for disaster management process. It is proposed that hospital managers must look for opportunities to effectively adopt national standards to manage disasters and include nurses and physicians in major-related learning activities because experience has suggested a somewhat low overall perceived competence in managing disaster situations.
As disasters become more frequent and severe worldwide, disaster planning as a human endeavor is more important than ever, with the potential to save millions of lives globally. In this important new book, the author offers a practical, step-by-step guide for writing, implementing, and measuring the quality of your own disaster plan to address any threat with an approach that has been tested in public health and medical settings worldwide. Filling a significant gap in the existing literature, this book offers a comprehensive reference for both the principles and the practice of disaster planning. Access to a 25-lecture training course provides ancillary teaching materials for college level courses, offering added value for academic readers. An essential resource for public health graduates and anyone responsible for the management of disasters, primarily public health professionals, emergency physicians, first responders, and emergency managers.
Category A agents are biological pathogens that could pose a threat to health and human safety if used as bioweapons. The exploration and possibility of these threats must be comprehensively reviewed to create a preparedness plan to recognize outbreaks, to educate the public, and to offer vaccinations and/or treatment options, if available. A scoping review using PRISMA guidelines was performed to categorize current information on Category A biological agents as well as understand their potential for future threats. The results used 34 articles and found that while botulin neurotoxins were the most lethal, anthrax posed the most likely threat for use as a bioweapon. Most research was conducted on plague, though it is not the most likely threat. Smallpox is the most likely agent to vaccinate against as there is already a working vaccine that has proven effective and the issue at hand is the need for a larger stockpile. Ultimately, preparedness efforts should include vaccinations and continued research and development of them. Category A agents are a serious public health concern; updated and reformed bioterrorism preparedness plans could greatly minimize panic and mortality.
The aim of this study was to examine emergency preparedness behaviors among women with a recent live birth in Hawaii.
Using the 2016 Hawaii Pregnancy Risk Assessment Monitoring System, we estimated weighted prevalence of 8 preparedness behaviors.
Among 1010 respondents (weighted response rate, 56.3%), 79.3% reported at least 1 preparedness behavior, and 11.2% performed all 8 behaviors. The prevalence of women with a recent live birth in Hawaii reporting preparedness behaviors includes: 63.0% (95% CI: 58.7-67.1%) having enough supplies at home for at least 7 days, 41.3% (95% CI: 37.1-45.6%) having an evacuation plan for their child(ren), 38.7% (95% CI: 34.5-43.0%) having methods to keep in touch, 37.8% (95% CI: 33.7-42.1%) having an emergency meeting place, 36.6% (95% CI: 32.6-40.9%) having an evacuation plan to leave home, 34.9% (95% CI: 30.9-39.2%) having emergency supplies to take with them if they have to leave quickly, 31.8% (95% CI: 27.9-36.0%) having copies of important documents, and 31.6% (95% CI: 27.7-35.8%) having practiced what to do during a disaster.
One in 10 women practiced all 8 behaviors, indicating more awareness efforts are needed among this population in Hawaii. The impact of preparedness interventions implemented in Hawaii can be tracked with this question over time.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative treatment associated with high morbidity and mortality. It is often necessary for family caregivers to become highly involved in the care, especially when patients return home after a long period of inpatient care. Family caregivers’ preparedness for the tasks and demands of the caregiving role prior to allo-HSCT might help them during this distressing time. The aim of this study was to explore whether demographic factors are associated with preparedness for caregiving prior to allo-HSCT and if such preparedness for caregiving is associated with caregiver outcomes in terms of caregiver burden, anxiety/depression, competence, self-efficacy, and general health among family caregivers.
This correlational cross-sectional study included 86 family caregivers of patients to undergo allo-HSCT, who completed a self-administered questionnaire on preparedness, caregiver burden, anxiety/depression, competence, self-efficacy, and general health. Descriptive statistics and multiple regression models (linear and ordinal) were used to analyze the data.
Family caregivers with a higher education and those who were the patient's partner were significantly associated with a higher level of preparedness for caregiving, while gender and age were not significant. Higher preparedness was significantly associated with higher competence and self-efficacy and lower symptoms of depression, even after the model was adjusted for education, relationship to the patient, gender, and age but not for anxiety or caregiver burden. Higher levels of preparedness were also significantly associated with better general health.
Significance of results
A higher level of preparedness for caregiving prior to allo-HSCT was associated with better family caregiver outcomes. Assessing family caregivers prior to allo-HSCT to identify those with insufficient preparedness might enable the provision of individually tailored psycho-educational support to help them cope with their caregiving role and prevent potential negative consequences.
The present study aimed to give an overview of research publications on health system preparedness against viral infectious disease outbreaks.
A bibliometric method was implemented from 2001 to 2020. The studied pathogens were dengue, Ebola, influenza, Zika, Middle East respiratory syndrome (MERS), Severe acute respiratory syndrome (SARS), and coronavirus disease 2019 (COVID-19).
The search query returned 501 documents. The growth of publications showed a sharp peak in 2020 for COVID-19 and 3 small peaks in 2006, 2009, and 2015 for SARS, influenza, and Ebola, respectively. Of the retrieved documents, 208 (41.5%) were on influenza, 164 (32.7%) were on COVID-19, and 83 (16.6%) were on Ebola. Countries in the region of the Americas (n = 221; 44.1%) returned the majority of the documents, while countries in Latin America and the African region returned the least. The United States (n = 197; 39.3%) had a leading role in this field. The US Centers for Disease Control and Prevention (n = 51; 10.2%) ranked first, followed by the Johns Hopkins University (n = 16; 3.2%). The Disaster Medicine and Public Health Preparedness journal (n = 21; 4.2%) ranked first. International research collaboration was relatively inadequate.
Research on preparedness against infectious diseases was episodic. Research collaboration needs to be prioritized for countries with a history of fatal outbreaks.