Comprehensive Emergency Preparedness Research Articles

Organizational contributions to emergency preparedness and response in Varanasi: A comprehensive analysis

India's unique geographical diversity and status as the world's most populous nation make it exceptionally susceptible to a wide array of hazards, both natural and human-induced. This vulnerability is further compounded by the intersection of diverse disasters and the dense population, leading to significant human and material losses. In response to these challenges, effective emergency preparedness plans are indispensable, requiring meticulous risk assessments, strategic resource allocation, capacity building initiatives, and active engagement of community-oriented organizations. Continuous monitoring and adaptation are essential for bolstering resilience and safeguarding socio-economic stability.Furthermore, the examination of developmental and disaster-specific organizations' roles in preparedness and response necessitates a systematic shift towards proactive paradigms, fostering an anticipatory culture rather than a reactive one. This study aims to dissect the intricate web of organizational efforts crucial for emergency preparedness in Varanasi, one of the world's oldest cities. By delving into these critical mechanisms, our goal is to enhance collective readiness against potential emergencies, safeguarding the city's rich heritage and its inhabitants.Through a mixed-method approach, this research illuminates the multifaceted involvement of organizations across various sectors, unraveling a complex tapestry of challenges that impede practical disaster preparedness. We scrutinize the coordination among governmental and non-governmental entities, funding dynamics, and grassroots alliances, revealing untapped resources for disaster resilience. Additionally, we analyze the strategies adopted by the national emergency preparedness and response force, highlighting both successes and shortcomings.Moreover, this study underscores the unique competencies of individuals involved in disaster preparedness, while identifying structural and functional gaps within organizational frameworks. Conversely, non-profit organizations face distinct challenges, including fundraising constraints and donor-imposed limitations, hindering their ability to develop comprehensive emergency preparedness and response capacities compared to public and private entities.In summary, this research serves as a comprehensive exploration of organizational dynamics in emergency preparedness within Varanasi, offering valuable insights into the complexities of disaster management efforts. By addressing these challenges, we aim to pave the way for more effective and inclusive disaster preparedness strategies, ultimately enhancing the resilience of Varanasi and similar communities globally.

In the Cone of Concern: Preparing Stroke Survivors for Extreme Hurricanes.

When disasters strike, individuals living with stroke-related disability experience unique challenges and hardships. Climate change is contributing to the increasing frequency and severity of extreme weather events, including major hurricanes. Cyclonic storms that threaten the health and safety of residents living in coastal and island communities may disproportionately impact stroke survivors. Stroke sequelae may impede individuals' abilities to engage in timely preparedness and self-protective actions when such storms approach. As such, it is imperative that physiatrists and other health care professionals caring for patients living with stroke proactively assist them in identifying their needs and in developing tailored, comprehensive emergency preparedness plans. In this paper, we examine the special needs of and considerations for persons living with stroke sequelae in the times leading up to, during, and after a major hurricane. We also put forward recommendations, specific to the phases of a disaster, regarding how physiatrists can assist patients living with stroke, and their caregivers, to optimize preparedness in advance of a hurricane, and facilitate effective response during storm impact and in the aftermath.

Response to COVID-19 in Lebanon: Update, Challenges and Lessons Learned.

The COVID-19 pandemic remains a public health problem threatening national and global health security. The socio-economic impact of COVID-19 was more severe on developing countries including Lebanon, especially due to the fragile healthcare system, weak surveillance infrastructure and lack of comprehensive emergency preparedness and response plans. Lebanon has been struggling with plethora of challenges at the social, economic, financial, political and healthcare levels prior to the COVID-19 pandemic. The COVID-19 pandemic in Lebanon revealed gaps and challenges across the spectrum of preparedness and response to emergencies. Despite these challenges, the Lebanese response was successful in delaying the steep surge of COVID-19 cases and hospitalisations through imposing strict public health and social measures. The deployment of the national vaccination plan in Lebanon in February 2021 coincided with the reduction in the number of cases and hospitalisation rates. The aim of this manuscript is to advance the epidemiologic evolution of COVID-19 in Lebanon pre- and post-vaccination, the challenges affecting the response and recovery, and the lessons learned.

Examining radiation emergency preparedness among the citizens of Busan, South Korea: Based on the IDEA framework

Developing a comprehensive radiation emergency preparedness plan is as crucial as effectively communicating it to the public. This study used a survey of citizens in Busan, South Korea, where seven nuclear power plants (NPPs) are located in close proximity, to examine their radiation emergency preparedness levels. Specifically, on the basis of the internalization, distribution, explanation, action (IDEA) model, this study investigated the public's risk perceptions, frequent and trusted communication sources, and awareness of the radiation emergency preparedness plan designed by their local government. Results showed that all these variables are significantly associated with individuals' radiation emergency preparedness levels. Finally, the theoretical and practical implications of the results are discussed.

Promoting equity in health emergencies through health systems strengthening: lessons learned from disability inclusion in the COVID-19 pandemic

Discriminatory health systems and inequalities in service provision inevitably create barriers for certain populations in a health emergency. Persons with disabilities have been disproportionately affected by the COVID-19 pandemic. They commonly experience three increased risks - of contracting the disease, of severe disease or death, and of new or worsening health conditions. These added risks occur due to a range of barriers in the health sector, including physical barriers that prevent access to health facilities and specific interventions; informational barriers that prevent access to health information and/or reduce health literacy; and attitudinal barriers which give rise to stigma and exclusion, all of which add to discrimination and inequality. Furthermore, national health emergency preparedness and planning may fail to consider the needs and priorities of persons with disabilities, in all their diversity, thus leaving them behind in responses. This commentary discusses the importance of inclusive health systems strengthening as a prerequisite for accessible and comprehensive health emergency preparedness and response plans that reach everyone. Lessons learned relating to disability inclusion in the COVID-19 pandemic can inform health systems strengthening in recovery efforts, addressing underlying barriers to access and inclusion, and in turn improving preparedness for future health emergencies.

Computational modeling of first responders' willingness to accept radiation exposure during radiological or nuclear events.

Since the events of 9/11, a concerted interagency effort has been undertaken to create comprehensive emergency planning and preparedness strategies for the management of a radiological or nuclear event in the US. These planning guides include protective action guidelines, medical countermeasure recommendations, and systems for diagnosing and triaging radiation injury. Yet, key areas such as perception of risk from radiation exposure by first responders have not been addressed. In this study, we identify the need to model and develop new strategies for medical management of large-scale population exposures to radiation and examine the phenomena of radiation dread and its role in emergency response using an agent-based modeling approach. Using the computational modeling platform NetLogo, we developed a series of models examining factors affecting first responders' willingness to work (WTW) in the context of entering areas where radioactive contamination is present or triaging individuals potentially contaminated with radioactive materials. In these models, the presence of radiation subject matter experts (SMEs) was found to increase WTW. Degree of communication was found to be a dynamic variable with either positive or negative effects on WTW dependent on the initial WTW demographics of the test population. Our findings illustrate that radiation dread is a significant confounder for emergency response to radiological or nuclear events and that increasing the presence of radiation SME in the field and communication among first responders when such radiation SMEs are present will help mitigate the effect of radiation dread and improve first responder WTW during future radiological or nuclear events.

The impact of radiation dread on mass casualty medical management during a radiological or nuclear event.

Since the events of 9/11, a concerted interagency effort has been undertaken to create comprehensive emergency planning and preparedness strategies for management of a radiological or nuclear event in the US. These planning guides include protective action guidelines, medical countermeasure recommendations, and systems for diagnosing and triaging radiation injury. Yet, key areas such as perception of risk from radiation exposure by first responders have not been addressed. In this article, we identify the need to model and develop new strategies for the medical manage-ment of large-scale population exposures to radiation, examine the phenomena of radiation dread and its role in emergency response, and review recent findings on the willingness to work of first responders and other personnel involved in mass casualty medical management during a radiological or nuclear event.

The Impact of Health Threats on the Security of Peacekeeping and Stabilization Missions

Soldiers are currently one of the largest professional groups treated as long-term travelers. They are stationed in difficult environmental conditions for many months. The purpose of this article is to present the scale of health threats faced by participants in peacekeeping and stabilization missions / operations. Today's security challenges encompass a huge mass of complexes and evolving threats such as pandemics, international terrorism, organized crime, cyber threats, environmental degradation and natural disasters. The thesis of the article is that in the era of modern threats, health problems of soldiers include transmission diseases, zoonoses, combat and non-combat injuries. The Central and South Asian region has the highest rate of infectious and invasive diseases in the world. Afghanistan and Pakistan are the reporting countries for poliomyelitis. Taking into account the following issues, it is extremely important to monitor the scale of health threats to participants in military operations, to conduct appropriate risk assessments so that control measures reflect the latest scientific knowledge in the field of protection against the risk of infection, disease or injury management. A comprehensive emergency preparedness plan enables military operations to be better prepared for a swift, coordinated and effective response, while tailoring resources to the specific situation.

Medical Emergency Management in the Dental Office (MEMDO): A Pilot Study Assessing a Simulation-Based Training Curriculum for Dentists.

In the event of a medical emergency in the dental office, the dentist must be able to identify a patient in distress, assess the situation, and institute proper management. This study assessed the impact of a simulation-based medical emergency preparedness curriculum on a resident's ability to manage medical emergencies. This interventional and pre-post educational pilot study included 8 participants who completed a standard curriculum and 8 who completed a modified curriculum (N = 16). The intervention consisted of a comprehensive medical emergency preparedness curriculum that replaced lecture sessions in a standard curriculum. Participants completed performance assessments using scenario-based objective structured clinical examinations (OSCEs) that were recorded and evaluated by calibrated faculty reviewers using a customized scoring grid. The intervention group performed significantly better than the control group on their summative OSCEs, averaging 90.9 versus 61.2 points out of 128 (p = .0009). All participants from the intervention group passed their summative OSCE with scores >60%, while none from the control group received passing scores. Completion of a simulation-based medical emergency preparedness curriculum significantly improved resident performance during simulated medical emergencies.

Assessment of environmental radioactive surface contamination from a hypothetical nuclear research reactor accident

The environmental surface contamination by radioactive elements following a nuclear research reactor hypothetical accident is evaluated employing the hotspot code, IAEA safety guide, and NRC guidelines. Gaussian plume depositions of radioactive contaminants are calculated under very conservative assumptions for a worst-case accident scenario, and site most probable wind speed and metrological conditions. Results reveal that the contamination strongly decreases with distance, dropping seven orders of magnitude from 2.2E+09 kBq/m2 at the reactor site to 9.5E+2 kBq/m2 60 km from the reactor at the plume centerline. In rainy weather, the wet deposition is depleted to 6.0E+2 kBq/m2 after 50 km, limiting the spread of contaminants to a much smaller area. Although the results of this work tend to overestimate the surface deposition of radionuclides, they present a clear insight into the radiological consequences of nuclear accident worst-case scenario. Thus, it assists with the development of a comprehensive emergency preparedness program by identifying all areas with potential risk to contamination.

The 2017 Hurricane Public Health Responses: Case Studies Illustrating the Role of Centers for Disease Control and Prevention's Public Health Emergency Preparedness Program - Erratum.

The Centers for Disease Control and Prevention (CDC), Division of State and Local Readiness (DSLR), Public Health Emergency Preparedness(PHEP) program funds 62 recipients to strengthen capability standards to prepare for and respond to public health emergencies. Recipients use these PHEP resources in addition to CDC's administrative and scientific guidance to support preparedness and response program planning and requirements. It is expected that public health agencies develop and maintain comprehensive emergency preparedness and response plans in preparation for disasters such as hurricanes. The 2017 historic hurricane season highlighted how emergency planning and collaborative operational execution is important for public health agencies to effectively prepare for and respond to both the immediate and long-term population health consequences of these disasters. In 2017, the southeastern United States (US) and US Caribbean territories experienced 3 Category 4 or higher Atlantic hurricanes (Harvey, Irma, and Maria) within a 5-week period. This paper highlights selected case studies that illustrate the contributions and impact of jurisdictional emergency management planning and operational capacity supported by capability standards during the 2017 hurricane season. Although the magnitude of the 2017 hurricanes required public health officials to seek additional assistance, the following case studies describe the use of public health preparedness systems and recovery resources supported by the PHEP program.

Serial Hurricanes The 2017 Hurricane Public Health Responses: Case Studies Illustrating the Role of Centers for Disease Control and Prevention's Public Health Emergency Preparedness Program.

The Centers for Disease Control and Prevention (CDC), Division of State and Local Readiness (DSLR), Public Health Emergency Preparedness(PHEP) program funds 62 recipients to strengthen capability standards to prepare for and respond to public health emergencies. Recipients use these PHEP resources in addition to CDC's administrative and scientific guidance to support preparedness and response program planning and requirements. It is expected that public health agencies develop and maintain comprehensive emergency preparedness and response plans in preparation for disasters such as hurricanes. The 2017 historic hurricane season highlighted how emergency planning and collaborative operational execution is important for public health agencies to effectively prepare for and respond to both the immediate and long-term population health consequences of these disasters. In 2017, the southeastern United States (US) and US Caribbean territories experienced 3 Category 4 or higher Atlantic hurricanes (Harvey, Irma, and Maria) within a 5-week period. This paper highlights selected case studies that illustrate the contributions and impact of jurisdictional emergency management planning and operational capacity supported by capability standards during the 2017 hurricane season. Although the magnitude of the 2017 hurricanes required public health officials to seek additional assistance, the following case studies describe the use of public health preparedness systems and recovery resources supported by the PHEP program.

Allocation of pharmaceutical resources in maternal and child healthcare institutions during the COVID-19 pandemic.

Since the outbreak of a cluster of patients with pneumonia of unknown cause in Wuhan, Hubei Province, China, in December 2019, the disease was later officially named coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus (SARS-CoV-2), quickly spreading globally. Pregnant women and children are particularly vulnerable during disasters and emergencies. Comprehensive and applicable emergency preparedness and response are definitely important methods to prevent and contain the COVID-19 pandemic. The rational allocation of pharmaceutical resources plays an important role in the medical emergency plan. This paper aimed to share experiences for the allocation of pharmaceutical resources in hospitals focusing primarily on women and children during the COVID-19 pandemic.

Impact of Natural Disasters on Health Outcomes and Cancer Among Older Adults.

There is growing evidence that older adults exposed to natural disasters are at disproportionate risk for adverse health events such as all-cause mortality, injury, hospital admissions, stroke, displacement, cardiopulmonary distress, stress-related mental health problems, and exacerbation of chronic illnesses. Typically, analyses of the health consequences of natural disasters focus only on the populations impacted for the duration and immediate aftermath of the disaster. With few exceptions, the long-term effects of natural disasters on older adult health have not been examined. This article describes the potential consequences of exposure to natural disasters that contribute to cancer and disruption of cancer care treatment systems for older adults. It is argued that exposures to floods and wildfires in particular present an underestimated threat to the onset and/or progression of cancer and cancer care management in older adults. We propose that these impacts should be examined not only from an emergency preparedness perspective during the event but also from a public health focus that prospectively assesses risks for cancer and other health disparities. Recommendations for comprehensive longitudinal risk assessment and emergency preparedness models that address the full impact of natural disasters on the health and well-being of vulnerable, at risk, older adults are offered.

Arctic in Russia's Emergency Preparedness System

Recent and projected developments in the Arctic call for improving emergency preparedness in the region. Arctic emergency preparedness is facing traditional challenges on a new scale as well as new, non-traditional challenges. There is political will on the part of Russian leadership to create a comprehensive emergency preparedness system in the Arctic, a system that integrates non-traditional alongside traditional emergency preparedness. This paper examines the formal institutional foundation for developing an emergency system in the Russian Arctic that includes counterterrorism as well as search and rescue and oil spill response. The paper concludes that the strengthening of Russian counterterrorism in recent years has produced a parallel specialized structure that operates autonomously and in isolation from the emergency preparedness structures responsible for handling traditional challenges. Differences between the national system for countering terrorism and the unified state system for prevention and liquidation of emergencies hinder comprehensive emergency preparedness in the Russian Arctic. That being said, there is considerable overlap in central actors between the two systems. This may serve as a window of opportunity for cooperation in Arctic emergency preparedness.

Community's Emergency Preparedness for Flood Hazards in Dire-dawa Town, Ethiopia: A Qualitative Study.

Background:Emergency preparedness at all levels (individuals and communities) is the corner stone of effective response to the increasing trends of global disasters due to man-made and natural hazards. It is determined by different factors, including (among others) past direct and indirect exposures to hazards. This study was carried out in Dire Dawa town, Ethiopia, which in the past experienced frequent flooding events, yet dearth of information exists about preparedness in the area. The aim of the study was to assess the levels of emergency preparedness for flood hazards at households and communities levels.Methods:The study was conducted in a qualitative approach and was conducted in Dire Dawa town, which has been divided into nine administrative-units called Kebeles. Two focus group discussions were held in two of these units (Kebele-05 and 06), each focus group comprising twelve people (all above 18 years of age), and in total 24 people (13 females and 11 males) took part in the study. Open ended questions were used that could guide the discussions, and the discussions were audio-taped and transcribed. The results were translated from local language to English and qualitatively presented.Results:The findings of focus group discussions showed that the local government in collaboration with the federal government built the flood protection dams in areas where flood hazards have been thought to be repeatedly wreaking havoc, specifically after the flood disaster of the year 2006. In addition, in Kebele-05, where one Non-Governmental Organization (NGO) was operating on flood hazards prevention and mitigation program, some non-structural emergency preparedness measures were undertaken by the communities. These non-structural measures (the major ones) entailed: establishment of committees recruited from residents and training them to raise awareness among communities on emergency preparedness; some residents made changes to their own houses (retrofitted) and put sandbags around their houses to temporarily protect the flooding; establishment of communication channels between communities to alarm each other in the event of flood disaster; and reforestation of the already deforested mountainous areas surrounding the town. However, concerns were raised by study participants about strengths of the constructed flood protection dams. Furthermore, the non-structural emergency preparedness measures identified by this study were not comprehensive; for example, residents were not trained in first aid, first aid kits were not provided, there was no linkage being established between communities and health facilities so as to provide emergency medical care to victims in the event of flood disaster. Discussion: The findings of this study concur with some of the previous quantitative studies’ results in that the past direct and indirect disaster experiences invoke preparedness intention and actual preparedness for flood hazards at individuals, communities and organizations levels. The only one quantitative and behavioral based study conducted thus far in Dire Dawa town reported the strong association of past flood disaster experience with household emergency preparedness. Among the residents there was a tendency to rely on the dams to be constructed with “good quality” and “higher strength” than making preparedness efforts on their own at their households. Structural measures such as building of dams, dikes, levees, and channel improvements could be means of mitigation measures; however, solely relying on these measures could have far reaching consequences.Conclusions: To mitigate flood hazards, dams were built and in addition, in Kebele-05 where an NGO was operating, some non-structural emergency preparedness measures were undertaken. In the course of construction of flood protection dams, ensuring communities’ involvement is needed; and at the same time undertaking comprehensive non-structural emergency preparedness measures in all Kebeles is highly recommended.Key words: Emergency, Preparedness, Flood, Dire Dawa, Ethiopia.

Sources of Organizational Resilience for Sustainable Communities: An Institutional Collective Action Perspective

Scholars in the field of sustainability have often argued that the purpose of establishing and maintaining interorganizational collaboration is to overcome internal limitations of organizations and to strengthen organizational capacity. To examine structural effects of inter-organizational collaboration regarding the ability of networked organizations to effectively manage disasters, this study uses an institutional collective action framework to design a critical lens to objectively analyze collective action issues in inter-organizational collaboration networks. Results, based on the Heckman selection model with two stages, provide evidence that networked organizations holding a central position between two other actors perceive a higher level of disaster resilience. The finding implies that local organizations with a bridging strategy can enhance their capacity to recover from a catastrophic event by securing access to critical resources and information through comprehensive emergency preparedness such as joint response and recovery planning.

Strengthening community emergency preparedness and response in threats and epidemics disasters prevention and management in Saudi Arabia

Background: Increasing natural and man-made threats to communities and disaster vulnerabilities have been linked to globalisation, increasing urbanisation and climate changes. This review paper analyses the changing trend and pattern in natural and man-made evolving emergencies threats and disasters vulnerability, towards robust and effective emergency community-based preparedness, emergency response policy and programs in Saudi Arabia. Method: A systematic review was performed to assess community emergency readiness in man-made or natural threats and epidemics disasters in the Kingdom. Findings: Our results showed that man-made disasters were the most reported cause of fatality with over 3979 deaths from 1975 to April, 2016. Substantially, Saudi Arabia government commitment and investment efforts have been devoted to ensure adequate emergency management. However, the level of community emergency preparedness culture for all types of risk assessment and management still requires urgent attention in the context of emerging global health threats and epidemics. This paper provides a set of lessons learnt that are useful to foster and scale-up further policy-makers and emergency planners proactive emergency preparedness capacity, and communities resilience initiatives. Leveraging on aggregate annual Hajj and Umrah pilgrimage or mass gathering lessons learnt, global emergency response experiences and best practices are assets in scaling-up proactive and practical community/public and regional emergency security resilience. Conclusion: Strengthening evidence-based comprehensive sustained Saudi innovative community-based emergency partnerships, community surveillance and preparedness, resilient measures and best practices against threats and disasters is advocated.

Nursing Home Self-assessment of Implementation of Emergency Preparedness Standards.

Introduction Disasters often overwhelm a community's capacity to respond and recover, creating a gap between the needs of the community and the resources available to provide services. In the wake of multiple disasters affecting nursing homes in the last decade, increased focus has shifted to this vital component of the health care system. However, the long-term care sector has often fallen through the cracks in both planning and response. Problem Two recent reports (2006 and 2012) published by the US Department of Health and Human Services (DHHS), Office of Inspector General (OIG), elucidate the need for improvements in nursing homes' comprehensive emergency preparedness and response. The Center for Medicare and Medicaid Services (CMS) has developed an emergency preparedness checklist as a guidance tool and proposed emergency preparedness regulations. The purpose of this study was to evaluate the progress made in nursing home preparedness by determining the level of completion of the 70 tasks noted on the checklist. The study objectives were to: (1) determine the preparedness levels of nursing homes in North and South Carolina (USA), and (2) compare these findings with the 2012 OIG's report on nursing home preparedness to identify current gaps. A survey developed from the checklist of items was emailed to 418 North Carolina and 193 South Carolina nursing home administrators during 2014. One hundred seventeen were returned/"bounced back" as not received. Follow-up emails and phone calls were made to encourage participation. Sixty-three completed surveys and 32 partial surveys were received. Responses were compared to data obtained in a 2010 study to determine progress. Progress had been made in many of the overall planning and sheltering-in-place tasks, such as having contact information of local emergency managers as well as specifications for availability of potable water. Yet, gaps still persisted, especially in evacuation standards, interfacing with emergency management officials, establishing back-up evacuation sites and evacuation routes, identification of resident care items, and obtaining copies of state and local emergency planning regulations. Nursing homes have made progress in preparedness tasks, however, gaps persist. Compliance may prove challenging for some nursing homes, but closer integration with emergency management officials certainly is a step in the right direction. Further research that guides evacuation or shelter-in-place decision making is needed in light of persistent challenges in completing these tasks. Lane SJ , McGrady E . Nursing home self-assessment of implementation of emergency preparedness standards. Prehosp Disaster Med. 2016;31(4):422-431.

ECMO as an emergency medical countermeasure

The survival benefit for patients with acute respiratory distress syndrome (ARDS) due to extracorporeal membrane oxygenation (ECMO) treatment invites consideration of whether ECMO might provide an important medical countermeasure for ARDS resulting from natural hazards or acts of terrorism. Anthrax spores, bioengineered or native avian flu strains, or chemical agents (such as chlorine gas and its derivatives) can all lead to lung injury with resulting ARDS. A framework is needed for ECMO if it is to be incorporated into our comprehensive emergency preparedness programmes.