Emergency Preparedness Research Articles

Negative and Positive Experiences During the COVID-19 Pandemic in Canadians With Developmental Disabilities: AOne-Year Ontario-Based Survey.

Understanding the experiences of people with developmental disabilities during the initial period of COVID-19 pandemic. Individuals with developmental disabilities and their caregivers completed baseline and up to five follow-up online surveys using the CRISIS-AFAR measures, between July 2020 and September 2021. We used qualitative (thematic analysis) and quantitative (MANOVA) analytic methods. One hundred and eighteen participants (64 caregivers on individuals 6-62 years, 54 self-reporting individuals aged 17-55 years) completed baseline survey; 46 participants (23 caregivers, 23 self-reporting adults) completed ≥1 follow-up. Qualitative themes included uncertainty, and negative and positive influences on behaviours and routines, daily life and mental wellness. Those experiencing positive impacts did not stably perceive so longitudinally. Despite both negative and positive influences on individuals with developmental disabilities and their families, the prolonged pandemic had wide-ranging repercussions. Emergency preparedness planning should consider the disruptive effects of public health measures on routine and support for this vulnerable population.

Risk factors threatening children’s safety in the school environment

School safety encompasses risk reduction efforts to ensure that children act in an environment that is safe and promotes the well-being of the students to achieve their full potential. Therefore, a safe and secure environment is a prerequisite for effective teaching and learning. This scoping review aims to address a range of school safety risk factors and introduce the complexity of school safety. School is believed to be a safe learning and growing environment; however, various conditions can threaten children’s safety in a school setting and lead to injuries caused by accidents, risky or/ aggressive behavior, or environmental exposure. In addition to the physical, psychological, and behavioral characteristics of children that make them particularly vulnerable to accidents, there are several unpredictable risks associated with natural or man-made conditions or disasters that can also put children at extreme risk. A balance between safety, surveillance, and emergency preparedness measures may be beneficial to create a safety culture in schools that will enable student behavioral and intervention support.

Beyond Injuries: February 6th Kahramanmaras Earthquakes and Other Patients Transported by Ambulance.

This study evaluates the Emergency Medical Service system and overall emergency preparedness by analyzing ambulance-transported patients during the February 6, 2023 earthquakes, focusing on those without earthquake-related injuries (medical emergencies and traumas not caused by earthquakes). A retrospective, observational case series was conducted, involving patients aged 18 and above transported by ambulance between February 6 and March 6, 2023. Patient demographic characteristics, vital signs, diagnoses, treatments, and outcomes were recorded. Predisposing factors for ambulance transportation including post-earthquake health facility issues, housing problems, hygiene, heating, and smoke exposure were meticulously analyzed. The study included 1872 patients, with a 55.4% hospitalization rate and a 13.7% mortality rate. Cardiovascular emergencies were the primary reason for admission (28.9%). Patients from the hospital in the study's location form Group 1, whereas those from other earthquake-affected provinces constitute Group 2. Significant predisposing factors for ambulance transportation included post-earthquake health facilities (P < 0.001), housing problems (P < 0.001), hygiene (P < 0.001), heating (P = 0.001), and smoke exposure (P < 0.001). In Group 2, pneumonia (P = 0.001), soft tissue infection (P = 0.002), sepsis (P = 0.004), carbon monoxide poisoning (P < 0.001), and diabetic emergencies (P = 0.013) were statistically significantly more frequent. Analyzing post-earthquake ambulance-transported patients is vital to comprehend the demand for emergency health care and address post-disaster health care challenges.

Emergency preparedness in healthcare systems: the “policy-effect” of COVID-19

Abstract The COVID-19 pandemic has highlighted that health services preparedness is crucial. Indeed, effective planning enables streamline operations, optimized resource allocation, and transparent communication during crises. Within this context, our analysis aims to assess EU countries’ healthcare systems preparedness, by policies analysis and capacity factor analysis, and relationship with COVID-19. We reviewed policies regarding influenza, antimicrobial resistance (AMR), and climate change in EU countries, using a web-screening of national and international authorities and institutions. Furthermore, we performed a factor analysis on WHO’s States Party Self-Assessment Reporting (SPAR) and evaluated the results using an iterated principal factor analysis with promax rotation. Few countries updated their policies after the pandemic, particularly regarding influenza plans. Italy stands out as an exception, having updated its national plan in 2021, while other countries maintain pre-COVID plans. Regarding AMR, only few countries, including Sweden, Netherlands, Malta, Germany, Spain, Belgium, and France, updated their plans post-pandemic, while Estonia and Romania lack plans entirely. Addressing the climate crisis and its impacts on health and healthcare resilience, all EU countries aligned with the EC regulation on climate action through National Energy and Climate Plans in 2023. Moreover, EU countries had average preparedness level of 75.77 (SD: 8.23), calculated on SPAR 2022, with significant disparities. Three major factors contribute to preparedness levels: planning, service delivery, and specific subtopics (e.g. food safety, radiation, infectious diseases). Our findings reveal the complexity of preparedness, showing diverse approaches across countries, despite EU regulations and WHO guidelines. International collaboration is crucial to standardize policies and enable countries to leverage successful examples, improving public health outcomes. Key messages • Health services preparedness, underscored by the COVID-19 pandemic, is crucial for effective planning and crisis management. • The analysis demonstrates varying levels of preparedness across EU countries, with differences in policy updates and adherence to international guidelines.

ERIMS assessment Tool Enhances Emergency Response in WHO Europe Region

Abstract Issue/problem The implementation of an Emergency Response Information Management System (ERIMS) assessment tool improves health emergency responses within the World Health Organization - European Region. The tool’s deployment aims to refine data management processes and bolster preparedness strategies. Managing health information systems (HIS) effectively during emergencies is a persistent challenge, as technologies keep innovating and potential challenges are constant. The ERIMS assessment tool addresses this by offering a structured approach, ensuring improved emergency responses and system resilience. Description of the problem Adopting a systems approach, the ERIMS tool was designed to be flexible, allowing adaptation to various HIS architectures and emergency coordination mechanisms. Its design and development process included consultations with digital health and emergency management experts and field testing across three WHO member states. Results Field applications of the ERIMS assessment tool demonstrated its capacity to evaluate, including, digital capability and knowledge management with focus on emergency scenarios. The tool identified systemic gaps, offered strategic guidance on enhancing data processes, and fortified decision-making protocols. These outcomes not only highlighted the tool’s utility in assessing HIS readiness but also its impact in improving emergency response mechanisms. Lessons The deployment of the ERIMS assessment tool enhanced HIS by providing an evaluation of emergency preparedness and response capabilities with a focus at the national perspective level. The tool’s application showcased its role in advancing public health emergency preparedness, illustrating how assessments can lead to substantial improvements in health information management and emergency response readiness. Key messages • ERIMS assessment implementation improves emergency data management. • Better preparedness relies on boosting digital capabilities and knowledge management.

Public Health In Conflict And War: A Response To An Ever Evolving Landscape

Abstract Background The bases for this proposal are the current and ongoing conflict and war situations around the world, causing turmoil for nations and hardship and public health crises for people. We can no longer ignore the critical and time-sensitive need to address issues of Public Health (PH) in conflict and war in our education and training programmes. Objectives To consider appropriate themes and topics in Conflict and War that should be included in PH education and training programmes; and to consider how and where they are best represented. Member schools of the Association of Schools of PH in the European Region (ASPHER) were asked to provide details of their curricula relating PH in Conflict and War. Submissions on this topic were received from over 10 schools. Information was collated into logical themes, to which elements of the curriculum were mapped. In a modified Delphi process, respondents were asked for their level of agreement for inclusion in a curriculum and at what level content should be delivered. Results Findings from the survey allowed identification of seven main themes from topics provided: Contextual Factors; Preventive Strategies; Emergency Preparedness; Impact and Response; Conflict Resolution and Solidarity, Rehabilitation and Recovery. Respondents had high levels of agreement that content should be included in curricula and be delivered at every level in PH education and training. Conclusions PH education and training have been deficient in not including PH in Conflict and War as a subject area in programmes. The knowledge and expertise developed of necessity in some places can be shared across the ASPHER network and beyond to increase awareness of the PH considerations of conflict and war. Key messages • Public health in war and conflict zones is critical due to unique challenges and urgent needs of affected populations. • An Integrated curriculum is vital for addressing conflict’s long-term health impact and preparing skilled workforce for health, resilience, action and laying the path to peace.

Ready or not? The state of emergency preparedness among Italian Public Health medical residents

Abstract Background Italy frequently experiences major events like earthquakes, floods, and migrant shipwrecks, reflecting global concerns that also include climate change, pandemics, and wars. This study aims to assess the role of public health experts and the current state of Italian post-degree Public Health schools in addressing these challenges. Methods In June 2023, a cross-sectional online survey was administered to all Italian Public Health residents enrolled in the Italian Society of Hygiene, Preventive Medicine, and Public Health (SItI). The survey investigated the availability and frequency of training and updates related to emergencies, measured the interest and perceived importance of these topics among residents, examined the impact of the COVID-19 pandemic on their awareness, and identified their primary sources of information in the subject. Results Out of 289 respondents, a significant majority (86.2%) acknowledging the importance of being trained in emergency management and 74.4% expressed interest in topic (p &amp;lt; 0.001). A 90.1% of residents indicated a lack of dedicated courses and 93.1% reported an absence of specialized master’s programs (p &amp;lt; 0.001). There was a strong correlation between recognizing the importance of the topic and the desire to attend specialized conferences (p &amp;lt; 0.001). The COVID-19 pandemic had a noticeable impact: 24.6% recognized the importance of the topic pre-pandemic, while 50.9% raised awareness during (p &amp;lt; 0.001). Conclusions The findings highlight a critical gap in the training of public health professionals in Italy, particularly in the domain of emergency preparedness and management. There is a pressing need to establish enhanced, uniform training programs across different public health training networks in Italy. Implementing such programs would ensure a more robust and effective response to future emergencies, thereby safeguarding public health and improving outcomes during crises. Key messages • Significant gap in specialized training and awareness among health professionals. • Urgent need for emergency preparedness training in public health.

11.P. Scientific session: Behavioural Science of Emergency Preparedness across Europe

Abstract The COVID-19 pandemic highlighted the critical role of human behaviour in times of crisis. However, it also revealed that the behavioural sciences were not optimally prepared to provide actionable insights to policy makers to support preventive and coping behaviours in a crisis context. To ensure that the behavioural sciences can provide timely and effective advice to policy makers during future emergencies, it is key to act before a crisis occurs. The current workshop chaired by the Behavioural and Cultural Insights Unit of the WHO, will offer five perspectives to explore how behavioural science as a discipline is being applied to our understanding of pandemic and emergency preparedness and what concrete actions can and are already being taken now. Following five short presentations, a discussion with the panel and the audience will take place. The Dutch National Institute of Public Health and the Environment (RIVM) will start by presenting their approach toward embedding behavioural science of pandemic preparedness: the organisation of a national stakeholder network, the development of a conceptual framework, and3) development of a quantitative survey monitor for individual level behaviour. monitoring pandemic preparedness. f The Spanish Carlos III Health Institute and Slovenian Public Health institute will present insights about operationalising this monitor in their given context. They will present results of the first two rounds of this monitor on behalf of the four European member states, focusing on comparative insights on perceptions and states of preparedness, vaccination, citizen wellbeing and resilience with respect to their context. Next, the Competence Centre on Behavioural Insights of the European Commission will present an experimental approach toward preparedness. They will present results based on a scenario study, focused on understanding behaviours in the broader context of pandemic and disaster preparedness. The last two presentations will reflect on qualitative approaches. The Behavioural and Cultural Insights Unit of the WHO will present their qualitative study on health-service access, needs and behaviours of Ukrainian refugees in neighbouring countries, and reflect on operating under emergency constraints. In the final presentation the RIVM will present their findings of qualitative methods to study perceived emergency readiness. In particular, their study focuses on what citizens understand by pandemic preparedness, and to what extent they perceive their government as prepared for a future pandemic. Overall, the workshop aims to equip participants with a comprehensive understanding of the importance of behavioural science in pandemic and disaster preparedness and inspire collaborative action towards building resilient and effective strategies for future crises. Key messages • The workshop underlines the importance of behavioural science in preventing and responding to infectious disease outbreaks. • Participants learn how behavioural sciences can already be applied now to prepare citizens and organisations for future pandemics and crises.

Strengthening data management skills amongst public health professionals during the war in Ukraine

Abstract Background The current war in Ukraine has led to disturbances in public health surveillance and epidemiological data flow, which impacts timely decision-making at regional and national levels. The five-year USAID project “Public Health System Recovery and Resilience Activity” (PHS R&amp;R) aims to strengthen the Public Health system of Ukraine, including through the training of specialists in data management and disease surveillance. Objectives An innovative mixed-method, multi-module course was piloted in January 2023 to provide epidemiologists and other public health professionals with up-to-date knowledge and practical skills in disease surveillance and data management. The course was designed based on a needs assessment study carried out across the regional Centres for Disease Control (CDCs) in 2022. Modules were delivered both in person and online to reach a wider audience. Results 1,540 public health specialists attended the first module on Excel skills, online. A further 26 completed a second module, covering disease surveillance methods, data management, and data flow across regions, in person. Over 85% of participants in the second module reported that it was highly relevant to their day-to-day work, especially practical sessions on data analysis and reporting. The second module is currently under revision based on participants’ feedback before being scaled up. A more advanced module on data management is being developed and aimed to launch at the end of 2024. Conclusions The course was timely and relevant for Ukrainian public health specialists in need of enhanced surveillance and data management skills to detect and respond to public health threats. Its innovative format allowed it to train a large cohort of specialists across a variety of essential public health functions despite the full-scale war. This experience would be relevant for any country aiming to strengthen its preparedness for potential public health emergencies, especially in fragile settings. Key messages • The comprehensive training course on epidemiological surveillance and data management will equip Ukrainian public health specialists with data-driven decision-making skills in the war context. • The described training approach would be relevant for the countries which seek sustainable workforce development solutions to strengthen public health systems in fragile settings.

6.I. Round table: Strengthening preparedness for public health emergencies: lessons learned and future perspectives

Abstract In the face of intensifying global health threats, robust health security measures in Europe and worldwide have never been more pressing. The COVID-19 pandemic has underscored the critical need for coordinated action, adaptive strategies, and robust collaborative mechanisms to effectively respond to emerging infectious diseases and other public health emergencies. This workshop serves as a platform to examine the multifaceted landscape of health security actors, focusing on collaborative initiatives and lessons learned from recent crises. By convening experts and stakeholders from across Europe, the workshop aims to achieve several key objectives: i) To provide an overview of collaborative initiatives established to strengthen European and international health security. By showcasing successful models of cooperation, participants will gain insights into effective strategies for fostering collaboration among diverse stakeholders. ii) Emphasize the role of European and international institutions, such as the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO), in supporting states both in coordinating regional response efforts and in developing the necessary health workforce competencies and capabilities to respond to health emergencies. iii) Drawing on experiences from recent health emergencies, including outbreaks of high-risk pathogens, such as Ebola, the workshop will facilitate a critical examination of lessons learned. Through interactive discussions, participants will identify challenges, best practices, and opportunities for enhancing preparedness and response capacity. iv) By interactive presentations and panel discussions, the workshop will provide a platform for knowledge exchange and networking among participants. By sharing experiences, expertise, and innovative approaches, participants will contribute to a collective understanding of the challenges and opportunities in strengthening health security. This workshop seeks to illuminate key strategies, capacity-building efforts, and real-world lessons learnt that contribute to enhancing response capabilities to public health emergencies. Participants will gain a deeper understanding of emergency participation mechanisms, essential skills required, and available training resources to enhance preparedness. Key messages • Collaboration and adaptive strategies are essential for strengthening international health security in the face of emerging infectious diseases and other public health emergencies. • Lessons learned from recent crises provide valuable insights into effective response strategies and opportunities for enhancing preparedness and response capacity.

The 2021-2023 Italian influenza pandemic plan: a critical evaluation of its regional implementation

Abstract Background Influenza pandemic preparedness plans should be adopted, regularly updated in every country, and comply with international guidelines to ensure proper management of public health emergencies. In Italy, each region develops its pandemic plan based on a National Plan. This study, conducted within a project funded by the Italian Ministry of Health, aims to assess the level of compliance of these plans with the national guidelines. Methods The assessment was based on a checklist of 192 items reporting the actions prescribed by the national plan. The items were divided into macro-areas by pandemic phase: general, alert, inter-pandemic, pandemic, and transition. The compliance regarding the presence and contextualization of each item in the regional plans was evaluated. Each macro-area was further assessed for easy identification of actions, congruence with the National Plan, and contextualization in the regional healthcare system. Some analyses grouped the regions into North, Centre, and South/Islands. Results Some macro-areas, such as ‘Communication’ and ‘Prevention and Control measures,’ showed some weaknesses in all phases, especially in the northern regions, which reached levels of full compliance below 50%. Central regions were highly compliant in almost all macro-areas, especially in ‘Strategy/Governance’ (100%), ‘Supplying’ (75-100%), and ‘Surveillance’ (75-100%). Overall, contextualization was the weakest aspect in all phases, while easy identification and congruence were mainly better achieved. Only three regions fully met all the assessed parameters. Conclusions A strict surveillance and monitoring process of planned activities is necessary to strengthen the country’s preparedness. This study identified critical issues and key areas for improvement at the regional level. This might allow us to verify the correct implementation of national guidelines and define the best strategies for improving readiness for public health emergencies in the future. Key messages • Implementation of the Italian influenza pandemic plan was uneven across regions. • Identification of lacking areas of the regional implementation is essential to improving national preparedness.

Exploring Health Professionals’ Views on Hive: A Digital collaborative space for Health Emergencies

Abstract Background The rapidly changing media landscape has significantly affected how information is consumed, particularly during health emergencies. Conflicting information shared or information lacking in scientific rigour can be exploited nefariously online to undermine the health response and damage trust. Digital platforms have become increasingly vital for facilitating communication, and in response, the WHO developed the Hive digital space to provide a safe environment for public health professionals to convene, share information, ask questions, and learn from each other. This study aims to explore the experiences of public health professionals in health emergencies to assess the added value of the Hive platform to coordinate and connect health expertise globally. Methods This study uses a cross-sectional online survey distributed to Hive users focusing on their experiences of working in health emergencies. The responses will undergo descriptive and thematic analysis, as well as inferential statistics such as one-way ANOVA and post-hoc analysis. The survey will emphasize the practical application, value, satisfaction, perceptions, and strategy for the Hive platform to be utilised for global health emergency coordination. Expected Outcomes Insights from this study will delineate how the Hive platform is used by public health experts at all levels in emergency management. It will also highlight the challenges, needs and demands for digital tools to connect skills, experience and knowledge in one place. These insights will demonstrate how the Hive can streamline these processes and provide a safe space for information exchange for a coordinated response to health emergencies. Conclusions Understanding the needs and perceptions of Hive users involved in health emergency prevention, preparedness, response, and resilience will provide critical insights into optimizing the platform’s usability, connectiveness across emergency teams and sustainability of the platform. Key messages • Connecting communities, fostering collaboration and co-creation for improved health emergency management. • Hive enhances collaboration among health professionals, providing a safe environment for knowledge and information sharing.

Large scale system transformation: Ukraine

Abstract In the context of the EU-Ukraine Accession agreement, Ukraine started large scale public health systems reform back in 2015. The COVID-19 pandemic tested the response capacity of the national public health system and led to some improvement during the pandemic such as on laboratory capacity. It also generated lessons for strengthening national and subnational health emergency preparedness and response. Multiple interventions, including a Joint External Evaluation led to the adoption of the Public Health System Law in 2022, laying the foundation to bolster health promotion, disease prevention, and health protection. The Ukrainian Public Health Centre was substantially strengthened, partly oriented on models in other European countries. Corresponding centers for diseases control and prevention at the oblast level were reformed and a subnational network of these centers was created. While the war has a significant impact on the public health system, infrastructure, people and more, decision makers and professionals keep working on sustaining and moving forward the achievements on public health reforms, for example with the adoption of the National Health Strategy 2030 and the adoption of the National Health Security Plan. Further legal and strategic preparations are afoot to strengthen public health services governance capacity, financing, institutional innovation and development, and public health workforce development.

3.X.2. Integrating trust as a key component of pandemic preparedness and resilience

Abstract Trust is a key component of pandemic preparedness, which impacts the success of response measures during the public health emergency. Trust is built during preparedness, however the drivers and dimensions of trust are complex and context-specific. What is required is a collaborative, inclusive approach that provides a platform for communities to express their questions and concerns. The proposed workshop will begin with a presentation from a global expert on trust in the content of epidemics and pandemics and the current knowledge about how trust can be built during preparedness. This will be followed by interactive group-work, designed to encourage collaborative discussions and decision-making. Finally, introducing the WHO Hive digital platform that provides a safe space for public health communities to share information and ask questions. Attendees will then reconvene in plenary to discuss these approaches and interventions that can be implemented to build and maintain trust prior to and during an epidemic or pandemic. This workshop has the following objectives: 1. To demonstrate how trust is an important determinant of successful pandemic response; 2. To enable attendees to explore how the implementation of public health and social measures, infodemic management and digital community partnerships and engagement can build trust during pandemic preparedness for both online and offline communities; 3. To provide opportunity for attendees to workshop how the different features of the Hive digital space can enhance trust building, and to develop actionable strategies for health emergency preparedness, response and resilience. The workshop will deliver these objectives through an interactive simulation activity. Attendees will be placed into small groups to work through a scenario, having to decide on the actions that need to be taken, considering budget constraints, other health priorities, and the current local context. The teams will co-create actionable strategies for building and maintaining trust. While there is not a one size fits all approach to trust building, this workshop will aim to increase understanding of the drivers and determinants of trust to encourage participants to consider how they can be applied in their local context. It will be interactive and hands-on requiring active participation from participants. Key messages • Trust as a construct is an important component of pandemic preparedness and readiness that impacts on response. • A multidimensional approach to building and sustaining trust needs to considered across a range of drivers and determinants, where actionable strategies are vital.

7.I. Skills building seminar: Beyond the jargon: an interactive workshop for effective risk communication

Abstract Risk communication plays a central role in epidemiology to provide information for disease surveillance and outbreak control. It is one of the of the eight core functions that WHO Member States must comply with as part of the International Health Regulations (2005) ensuring national and global preparedness for health threats. It refers to the timely and accurate exchange of information between public health experts or authorities and individuals who are confronted with a threat to their survival, health, economic or social well-being. At its core, risk communication is about empowering people exposed to a risk to make well-informed decisions in order to mitigate potential risks and adopt preventive actions and measures. Risk communication considers political, social, and economic factors; it analyses risk and risk perception; and it places a great emphasis on dialogue with impacted and targeted populations to help them make the best decisions they can. Therefore, it requires an understanding of stakeholders’ perceptions, concerns, and beliefs, as well as their knowledge and practices. In the context of the COVID-19 pandemic, the need for effective and efficient risk communication has become even more evident than before. Risk communication should be able to recognise and deal with rumours and disinformation, and reach the most vulnerable groups, who have a higher risk of contracting the virus and suffering from COVID-related consequences. Lately, increasing attention has been given to this topic. The WHO set-up, in April 2023, a technical Advisory Group for Risk Communication, Community Engagement and Infodemic management (TAG-RCCE-IM) to provide independent review and technical advice in the context of emergency preparedness and response in Europe. The Joint Action PreventNCD aims to also build a framework for country-specific communication strategies for non-communicable diseases (NCD) patients in health crises in one of the Work Packages, by collecting and analysing health communication strategies in different European countries targeting NCDs. In this interactive skills-building seminar, we will share with the participants the knowledge, skills, and process of effective risk communication by using case studies from experts in the field. The session will start with a presentation on the core elements of risk communication followed by examples from the field. This workshop will foster an inclusive interactive environment where participants will hear from panellists sharing their experiences from different settings such as international organisations and national public health institutes. Participants will be split into groups and will be provided with a piece of scientific output, such as a research study or epidemiological report and encouraged to translate this technical message into a clear, concise message that can effectively communicate the key points to the general public. Key messages • Risk communication is essential to fight disinformation while empowering the public to make informed decisions related to their health and well-being. • Epidemiologists and researchers should be encouraged to employ efficient and targeted communication strategies when disseminating their findings. Speakers/Panelists Stefan Schaub Bundeszentrale für gesundheitliche Aufklärung (BZgA, Cologne, Germany Federica Rossetti Sciensano, Brussels, Belgium Stefan Adrian Voinea WHO/Europe, Copenhagen, Denmark

Informing infodemic management capacity building by piloting an adaptable capability tool

Abstract Background Infodemic management competencies and indicators have been included in key WHO pandemic preparedness documents and guidance such as the Preparedness and Resilience for Emerging Threats (PRET) initiative, the Health Emergency preparedness and response (HEPR) framework and in the WHO benchmarks for strengthening health emergency capacities. Training and capacity building is needed to strengthen infodemic management skills and capacity, and a tool to define capabilities and inform training needs was needed. Objectives An adaptable tool was developed and piloted to measure infodemic management capacity to inform training and capacity building needs. The tool was informed by previous work and adapted to cover a wide set of capabilities. It was piloted in March - May 2024. Results The tool was developed to cover the breadth of infodemic management work practice and structural support and included: who is conducting infodemic management work; structures in place to support; main activities; health topics focus areas; partnerships with other organisations; social listening and infodemic insights generation; as well as challenges, opportunities and training needs. The tool can be adapted to the specific situation, with a full survey able to be disseminated via an online survey platform as well as a modified interview guide for key informants or settings where that is more appropriate. Conclusions Preliminary results show that this tool can be a useful way to measure infodemic management competencies and to inform training and capacity building needs. The ability to adapt to specific settings is important to ensure the results are as useful and tailored as possible. As further testing in different setting continues the tool will continue to be iterated upon. Key messages • Infodemic management is an important component of pandemic preparedness and resilience and across the whole emergency response cycle. • A new adaptable tool to measure capabilities can help inform infodemic management trainings and capacity building.

The Preparedness Paradox in Climate Attitudes: Democrats Worry, Republicans Prepare

ABSTRACT Political partisanship is one of the strongest correlates of climate change attitudes in the United States, with Democrats expressing greater concern than Republicans. As the climate crisis progresses, surveys increasingly examine preparedness for environmental emergencies, instead of climate attitudes alone. Does partisan identification associate with environmental preparedness actions as it does other climate attitude measures? We find a paradox: Republicans are more likely to say they have taken preparedness actions than Democrats. We replicate this finding in three survey samples (n = 1,053; n = 1,201; n = 2,318) and provide two sociological explanations. Theoretically, a culture of emergency preparedness integrated with conservative belief systems could strengthen the partisanship association, especially if preparedness is not closely tied to other climate attitudes. Empirically, household income is associated with specific types of preparedness actions, possibly introducing bias based on social class. We discuss the importance of measuring climate preparedness for the future of climate opinion research and climate policy and call for preparedness measures that are applicable to the general population.

Emergency Capability Evaluation of Port-Adjacent Oil Storage and Transportation Bases: An Improved Analytic Hierarchy Process Approach

The large-scale storage and stable supply of oil products are essential for national energy security and economic development. As the economy expands and energy demands rise, centralized storage and supply systems become increasingly vital for ensuring the efficiency and reliability of oil product distribution. However, large oil storage depots present substantial safety risks. In the event of fires, explosions, or other accidents, emergency response efforts face stringent demands and challenges. To enhance the emergency response capabilities of oil storage and transportation bases (OSTBs), this paper proposes an innovative approach that integrates the improved analytic hierarchy process (IAHP) with the Entropy Weight Method (EMW) to determine the combined weights of various indices. This approach reduces the subjective bias associated with the traditional analytic hierarchy process (AHP). The emergency response capabilities of OSTBs are subsequently evaluated through fuzzy comprehensive analysis. An empirical study conducted on an OSTB in the Zhoushan archipelago quantitatively assesses its emergency preparedness. The results show that the base excels in pre-incident prevention, demonstrates robust preparedness and response capabilities, and exhibits moderate recovery abilities after incidents. These findings provide a theoretical foundation for reducing the likelihood of accidents, enhancing emergency response efficiency, and mitigating the severity of consequences. Practical recommendations are also offered based on the results.

Assessment of nursing managers’ awareness and hospital preparedness for disasters: a cross-sectional study

IntroductionPreparedness, focused on planning, training, and research, is one of the primary stages of the disaster management cycle. Accordingly, this study was conducted to determine the level of awareness in nursing managers and the preparedness of hospitals for disasters in the hospitals of Sanandaj, the capital of Kurdistan Province.MethodsThis cross-sectional study was conducted in 2023, with a total of 167 Nursing Managers in Sanandaj selected as the research sample using a census approach. Data were collected using a demographic information form, WHO Hospital Emergency Response Checklist, and managers’ emergency awareness questionnaire. Data were analyzed using Chi-square tests, Fisher’s exact test, independent t-tests, analysis of variance (ANOVA), and Pearson correlation. Data analysis was performed using SPSS v26 (P < 0.05).FindingsThe results indicated that the overall mean score of managers’ awareness was 77.89%, categorized as good. The assessment of hospital preparedness showed that the overall emergency preparedness level of hospitals in Sanandaj was 69.23%, considered strong. Among the dimensions of hospital preparedness, the highest score was in the command-and-control dimension at 83.33%, while the lowest was in the human resources dimension at 56.66%.ConclusionThe findings indicated a high level of awareness among nursing managers and a strong level of hospital preparedness in Sanandaj. However, improving and enhancing specific dimensions may require targeted educational and organizational approaches.

Key stakeholders’ perspectives of public health emergency preparedness in Palestine: A qualitative exploratory study

ObjectivesPalestine continues to face emergencies and a series of humanitarian crises. This study aims to comprehend emergency planning and response including the recent COVID-19 pandemic. Comprehending and recording these experiences will facilitate on-going improvement of Palestine's Public Health Emergency Preparedness (PHEP). Study designA qualitative exploratory study. MethodsFifteen semi-structured interviews were conducted with key informant decision-makers representing various sectors of the Palestinian health system. The data collection period took place from April 2022–December 2022. A convenient purposive sample was chosen based on identifying important stakeholders in the West Bank's health sector. Every interview was transcribed. Major themes and subthemes were identified using content thematic analysis. ResultsThe study demonstrates Palestine's inadequate preparation for emergencies, instead there is a focus on response once a crisis has occurred. No national entity or mechanism is leading the collective preparedness efforts, which might ultimately result in a stronger emergency response. Instead, the efforts are dispersed across several entities, and decisions are not made cooperatively. As for resources, the study indicates that an emergency budget has not been allocated. The study showed a good degree of multi-sectoral collaboration with some reservations regarding the creation of various committees and their efficacy in handling crises. ConclusionThe findings made it abundantly evident that significant efforts are needed to improve Palestine's level of preparedness and planning. One of the study's primary conclusions is that the health sector must shift from a reactionary to a preparedness-oriented mindset. Additionally, it is necessary to keep an eye on any changes in the nation's health and analysis must take place to strengthen the health system's response plans. Moreover, the activation of the emergency operation center in Palestine is one of the key advancements of the preparedness system.