Cyberattacks on healthcare systems are increasing in frequency and severity. Hospitals need to integrate cybersecurity preparedness into their emergency operations planning and response to mitigate adverse outcomes during increasingly likely cyber events. No data currently exist regarding the level of preparedness of United States hospital systems for cybersecurity attacks. We surveyed hospital emergency managers to assess cybersecurity preparedness for these events.

Fifty-seven emergency managers representing hospitals across the United States participated in an online Qualtrics survey regarding current preparedness and response procedures for cybersecurity hazards.

Survey responses between April 2019 and May 2021 demonstrated that a majority of hospital systems surveyed included cybersecurity disasters in their HVA (82.4%; 47/57), and most ranked it as 1 of their top 5 priorities (57.4%; 27/47). However, over half denied specifically mentioning cybersecurity in their Emergency Operations Plans (EOPs; 52.6%; 30/57). Fourteen of the 57 hospital systems (24.5%) endorsed previously activating an emergency response for a cybersecurity incident unrelated to information technology (IT) failure.

The survey results suggest that American hospitals are currently underprepared for cybersecurity disasters. We emphasize the importance of prioritizing cybersecurity in Hazard Vulnerability Analyses (HVAs) and implementing specific EOP annexes for cybersecurity emergencies.

Coronavirus disease 2019 (COVID-19) may affect anybody, and prisoners are a susceptible group in terms of the risk of contracting infectious illnesses owing to a variety of situations such as overcrowding, confinement, and poor cleanliness. Therefore, this study aimed to assess prisoners’ Knowledge, Attitude, and Practice (KAP) of COVID-19 and its determinants in southern Ethiopia.

The Institutional cross-section study was conducted among 404 prisoners selected using simple random sampling obtained from the prisoner’s registration book. To collect data from prisoners, an interviewer-based face-to-face data-collecting technique was used. Multivariate ordinal logistic regression was used to identify determinants of KAP toward COVID-19.

The majority of the prisoners had limited understanding and poor preventive strategies application toward COVID-19. Being male, living in a rural area, having a low educational standing, and being a farmer were related to limited knowledge, negative attitude, and poor practice toward COVID-19. Furthermore, having little understanding was linked with poor practice toward COVID-19. As a result, the focus should be on convicts, creating awareness, and addressing specific socioeconomic features of prisoners, as well as boosting COVID-19 preventive activities that should get attention in the prison.

The Super Bowl is one of the biggest annual sporting events that creates unique challenges for public health preparedness. The objective of this brief is to discuss the successes and challenges of the Joint Information Center (JIC) during Super Bowl LVI.

This study analyzed the JIC within 4 realms: pre-activation planning, public safety and alert messaging, communication, and credentialing and access.

Pre-activation planning was not attended by all agencies, which made it difficult for effective communication during the activation period. Innovative platforms and social media themes were successfully deployed to enhance inter-operational communications and public safety messaging. Lastly, delayed credentialing and access to the Super Bowl Stadium decreased the ability to have context to safety preparedness.

This study recommends that many of the JIC’s successes should be translated to future mass-gathering events. Additionally, we urge that all agencies participate during pre-activation and activation periods to enhance safety operations and communications moving forward.

The objective of this study was to assess recovery of Aransas County, Texas households 2 years after Category 4 Hurricane Harvey made landfall.

A 2-stage cluster sampling method used to conduct a Community Assessment for Public Health Emergency Response (CASPER) on May 3 - 4 and May 18 - 19, 2019. A household-based survey was administered through face-to-face interviews, selected through systematic random sampling using weighted analysis of the county population. Field teams collected 175 surveys (83.3% completion rate).

Approximately 57% households experienced repairable damage, 23% had destroyed homes, and 19% had minimal damage. 38% stated having ‘no need,’ 18% needed financial assistance, 16% needed household repairs, and over 8% had behavioral health needs. 17% experiencing a behavioral health concern were seeking services. Of the 35% of households who did not seek services, 14% felt there was no need, and 4% were not aware of the resources available.

Households reported high levels of preparedness, but gaps remain in evacuation intention and behavioral health care access. CASPERs are effective in assessing long-term recovery of communities impacted by major disasters.

To describe the importance of community engagement from research projects and research centers in times of disasters or emergencies, using the case of Puerto Rico in recent years (2017 - 2022) as an example.

First, research participants and stakeholders from local community and health organizations were contacted via email and phone calls after each emergency to assess their immediate needs. Second, needs were classified in categories (materials, educational resources, service referrals, and collaborations). Finally, delivery of support was coordinated in a timely manner whether in person or online.

Activities were conducted such as handing out materials, providing educational resources, contacting participants, and stakeholders, as well as coordinating collaboration with community and organizations.

Several lessons were learned from our experiences related to Puerto Rico’s recent emergencies as well as some relevant recommendations for future disasters. The efforts presented illustrate the importance of community engagement from academic institutions in disasters. Research centers and research projects, particularly those with community engagement components, should consider providing support in the preparedness phase as well as the recovery phase if necessary. Community engagement in emergencies is crucial to recovery efforts as well as fostering empowerment and making an impact on individual and societal levels.

Researchers have developed numerous indices to identify vulnerable sub-populations. The Centers for Disease Control and Prevention (CDC) Social Vulnerability Index (SVI) is the most common and highly serviceable, but it has some temporal limitations considering that some variables used in calculating the CDC-SVI were not available before 1980. Changes in societal composition over time can impact social vulnerability. This study defines an alternate, but similar, index that could serve as a surrogate for the CDC-SVI without the temporal limitations.

An inventory analysis of the historical census data (1960-2018) was used to develop a Modified SVI that allows for historic analyses. To consider the chronic effect of social vulnerabilities, a longitudinal SVI was introduced to elucidate how a community’s multidimensional experiences exacerbate vulnerability to disaster events, such as the COVID-19 pandemic. We use Harris County, Texas, in this case study to examine how the Modified SVI performs against the original CDC-SVI.

This Modified SVI was used to generate historical maps, find temporal patterns, and inform a longitudinal SVI measure. The results showed a good agreement among the developed indices and the CDC-SVI. We also observed satisfactory performance in identifying the areas that are most vulnerable to the COVID-19 pandemic.

The Modified SVI overcomes temporal limitations associated with the CDC-SVI, and the longitudinal SVI captures a community’s multidimensional experiences that exacerbate a community’s vulnerability to disaster events over time.

The Western Regional Alliance for Pediatric Emergency Medicine (WRAP-EM) is a multi-state, Administration for Strategic Preparedness and Response (ASPR) funded pediatric disaster center of excellence. WRAP-EM set out to determine the impact of health disparities on its 11 core areas.

We conducted 11 focus groups during April 2021. Discussions were led by an experienced facilitator, and participants could also include their thoughts on a Padlet throughout the discussion. Data were analyzed to determine overarching themes.

Responses focused on health literacy, health disparities, resource opportunities, addressing obstacles, and resilience building. Health literacy data highlighted the need for development of readiness and preparedness plans, community engagement in cultural and language appropriate means, and increasing diversity in training. Obstacles faced included funding; inequitable distribution of research, resources, and supplies; lack of prioritization of pediatric needs; and fear of retribution from the system. Multiple already existing resources and programs were referenced highlighting the importance of best practice sharing and networking. A stronger commitment to mental health-care delivery, empowerment of individuals and communities, use of telemedicine, and ongoing cultural and diverse education were recurring themes.

Results of the focus groups can be used to prioritize efforts to address and improve health disparities in pediatric disaster preparedness.

In a large-scale disaster, medical professionals need to access medication records and provide medicines to people who cannot return home to take their daily medicines. We investigated the proportion of carrying the paper notebook or availability of the smartphone application of the medication record among people who are assumed to have difficulty in taking their medicines during large-scale disasters.

In Japan, a web-based survey was conducted in 2018 by randomly selecting adults ≥ 20 years of age.

There were 2286 medication record owners in 3082 participants. Of the medication record owners, 784 (34.3%) took medicines that could not be missed for even a day. Among them, 724 used paper notebooks alone, 26 used smartphone applications alone, and 34 used both. Among the 724, 208 (28.8%) always carried a paper notebook. Among the 26, 16 (61.5%) could use their applications anytime. Therefore, among the 784, at least 560 (71.4%) could not always access their medication information.

An awareness campaign to carry paper notebooks and install applications for medication records should be held, since only a limited number of people carry their medication records and always have access to their medication information.

Pandemics generate such a significant demand for care that traditional triage methods can become saturated. Secondary population-based triage (S-PBT) overcomes this limitation. Although the coronavirus disease (COVID-19) pandemic forced S-PBT into operation internationally during the first year of the pandemic, Australian doctors were spared this responsibility. However, the second wave of COVID-19 provides an opportunity to explore the lived experience of preparing for S-PBT within the Australian context.

The aim of this study is to explore the lived experience of preparing to operationalize S-PBT to allocate critical care resources during Australia’s second wave of COVID-19 in 2020.

Intensivists and emergency physicians working during the second Victorian COVID-19 surge were recruited by purposive non-random sampling. Semi-structured interviews were hosted remotely, recorded, transcribed, and coded to facilitate a qualitative phenomenological analysis.

Six interviews were conducted with an equal mix of intensivists and emergency doctors. Preliminary findings from a thematic analysis revealed 4 themes: (1) threat of resources running; (2) informed decision requiring information; (3) making decisions as we always do; and (4) a great burden to carry.

This is the first description of this novel phenomenon within Australia and, in doing so, it identified a lack of preparedness to operationalize S-PBT during the second wave of COVID-19 in Australia.

Those affected by the Fukushima disaster have reported a decline in well-being. Although listening to music is expected to promote well-being, no study has revealed this association after a disaster. This study’s objective is to clarify the association between well-being and music listening habits in the aftermath of the Fukushima disaster.

A self-report online survey was conducted with 420 residents who were asked to rate 5 types of well-being: life satisfaction, positive emotion, negative emotion, psychological distress, and mental health changes after the Fukushima disaster. To meet inclusion criteria, the participants had to be research company monitors between the ages of 20 and 59 and living in Fukushima Prefecture at the time of the survey. Their music listening habits (eg, recent favorite music) and demographic information (eg, evacuation experience due to the disaster: 20.7%) were also collected. We examined the associations between well-being and music listening habits by univariate analysis followed by a logistic analysis with an adjustment for covariates.

Positive emotions were significantly associated with any type of music listening habits that participants practiced. We also observed gender and age differences between the associations.

This study provides foundational insights into the role of music in improving post-disaster well-being.

Coronavirus disease 2019 (COVID-19) and future pandemics have become a reality, and planners must understand how attitudes during COVID-19 may influence future preparedness activities. This study explores how personal experiences of Americans during the pandemic, attitudes about institutions, and views of social change could either pose challenges or help with planning for the next pandemic.

A longitudinal survey capturing health attitudes and COVD-19-related experiences was fielded 3 times over the course of the pandemic among historically underserved individuals in US society (racial/ethnic minority and low-income populations).

COVID-19-related experiences increased over time. Attitudes about federal and state government and businesses’ ability to respond to the pandemic varied by COVID-19-related experience and having any COVID-19-related experience was associated with a lower likelihood of reporting positive attitudes about institutions. Respondents generally perceived that COVID-19 presented an opportunity for positive social change, and those with COVID-19-related experiences had the greatest likelihood of selecting “reduce income inequality” as their top prioritized change. Those with COVID-19-related experiences were less likely to endorse other policy priorities such as protecting freedoms.

Anticipating potential backlash or other sentiments could improve pandemic responsiveness. Strengthening public institutions is crucial to ensuring their effectiveness during a pandemic. Pandemic planning could exploit opportunities to take other social policy actions where views seem to converge.

Historically, the child care industry has been unprepared for emergencies. A previous study identified gaps in Michigan’s child care programs’ emergency plans. Study objectives were to reassess programs’ preparedness plans after introduction of state-mandated emergency plans and to examine the effect of the coronavirus disease 2019 (COVID-19) pandemic on programs’ operations.

A 29-question survey was sent to ∼500 child care programs across Michigan in 2020 to assess emergency plans and response to COVID-19. Data were analyzed using descriptive statistics and qualitative methods.

A total of 346 programs (70%) responded. Most (92%) reported having a written plan, but one-third reported having no infectious outbreak plan pre-pandemic. One-third of programs lacked plans for special needs children (vs 40% in 2014); 62% lacked plans for child reunification (vs 60% in 2014); 46% reported staff received no preparedness training. COVID-19 impacted programs substantially: 59% closed, 20% decreased capacity, 27% changed disinfecting protocols. Several themes related to the pandemic’s effect on programs were identified: (1) changes in learning, (2) changes in socialization, (3) increased family burden, (4) financial challenges, (5) lack of guidance.

Significant preparedness gaps remain among Michigan’s child care programs, suggesting the need for increased support and addition of emergency preparedness to programs’ quality ratings.

To assess individual variation in anxiety, stress disorder, depression, insomnia, burnout, and resilience in health care workers (HCWs), 12 and 18 months after the beginning of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.

Prospective longitudinal study.

A total of 207 HCWs (74% female, 46% physicians, 44% nurses) answered; 50% scored over the cut-off for anxiety (GAD-7), 66% for PCL-C, 41% for depression (PHQ-9), 25% for ISI, and 15% started sleep inducers; 52% showed emotional exhaustion (EE), 68% detachment (DE), 39% professional efficacy (EF) at MBI; 27% completed the follow-up questionnaire 6 months later, showing a significant reduction in nearly all scores (GAD-7 median 11[5-15] vs 7[4-12] (P < 0.001); PCL-C 43[30-58] vs 37[24-50] (P < 0.05); PHQ-9 10[4-16] vs 6[3-12] (P < 0.001); ISI 10[4-15] vs 7[5-12](NS); MBI EE 25[16-35] vs 23 [15-31] (NS), DE 13[8-17] vs 12[8-17], EF 29[25-34] vs 30[25-34]. Living in a flat (OR 2.27 [1.10-4.81], high-intensity-of-care working (2.83 [1.15-7.16] increased risk of anxiety (GAD-7); age between 31-40 y (OR 2.8 [1.11-7.68], being a nurse (OR 3.56 [1.59-8.36] and high-intensity-of-care working (OR 8.43 [2.92-26.8] increased risk of pathological stress (PCL-C).

Nearly half of HCWs showed psychological distress, especially nurses, women, and the youngest. A mandatory job change, increasing intensity of care, working in a COVID-19 department, and being infected were negative factors; having a partner and living in a detached house were protective. Six months later, all the psychological domains showed individual improvement.

The evidence shows that the need for emergency evacuation in hospitals has arisen. Designing an emergency evacuation decision making tool increases the confidence of hospital managers in the decision made. Therefore, this study was aimed at the development, and the psychometric properties, of the decision-making scale for emergency hospital evacuation in disasters.

This study was done in 2 phases of qualitative study and literature review and designing and psychometric properties of the instrument. After development of the primary item pool, the psychometric properties of the questionnaire were evaluated. In this regard, face and content validity, internal consistency (Alpha’s Cronbach), reliability (ICC), and stability were assessed.

In the validity stage of the instrument, 4 items were removed. Also, 4 items were modified and 2 items were merged. The number of items was thus decreased to 64. After CVI calculation, 5 items were removed, 4 items were modified, and 2 items were merged. As a result of this, the number of items decreased to 58 items. The scale has good reliability and stability.

It seems that the instrument could be useful in decision-making for emergency hospital evacuation in disasters.

Previous studies have shown that parental attachment was associated with higher levels of posttraumatic growth (PTG) in individuals who have experienced traumatic events. The aim of the current longitudinal study is to investigate resilience as one pathway through which parental attachment is related to PTG among Chinese adolescents following the Yancheng tornado.

A total of 351 adolescent survivors participated in this longitudinal study. Participants completed the revised version of Inventory of Parent and Peer Attachment (IPPA-R) at 12 months (T1), and the revised Chinese version of the Post-Traumatic Growth Inventory (PTGI-R) and the Connor and Davidson’s Resilience Scale (CD-RISC) at 18 months (T2) after the tornado, respectively.

It indicated that parental attachment at T1 has direct and positive effect on PTG at T2, and resilience at T2 fully mediated the relationship between parental attachment at T1 and PTG at T2.

The findings revealed that parental attachment and resilience are two key resources that promote adolescent’s PTG, and parental attachment acts through resilience to promote PTG in adolescents.