Emergency Stockpile Research Articles

Examining organizational collaboration and resource flows of disaster response system based on a time-dynamic perspective

Increasing the efficiency of organizational collaboration and resource flows is key to improving the emergency response performance. Given that previous studies did not consider the interactions and dynamic characteristics of emergency response organizations and resources, this study divided the emergency response into four stages and analyzed the relationship between organizational collaboration and resource flows by combining the network attributes of emergency response goals at each stage. The 2022 Luding earthquake was selected as a case study, and a multisource mixed data method was used to identify 381 organizations and 2496 organizational relationships. Using the social network analysis, the dynamic evolution characteristics of the emergency response networks (ERNs) and organization-resource two-mode networks were analyzed. The results showed that the ERNs generally exhibited the following trends: a more compact structure, balanced distribution, evolution from decentralization to centralization, and homogenous organizational collaboration. A correlation existed between changes in the organizational status and ERN attributes, with government organizations always at the core and non-profit organizations gradually rising. The evolution of the resources was closely related to the network attributes and organizational relationships. We identified the strengths of China's current emergency management system, such as enhanced performance, improved information infrastructure, and emphasis on the engagement of the military and social organizations. We recommend the following for future practice: enhancing the information technology system, establishing a mechanism for the participation of social forces, and strengthening the management of emergency stockpiles. These will help improve the disaster emergency management performance and reduce casualties and losses.

A structured methodology for essential medicines lists and health emergency stockpiles: Experience with the Emergency Medicines Buffer Stock in the United Kingdom

IntroductionFormularies of essential medicines, such as Essential Medicines Lists (EMLs) and health emergency stockpiles, are intended to be always available, including in emergency situations, acting as important tools for access to medicines. The Emergency Medicines Buffer Stock (EMBS) in the United Kingdom (UK) was a stockpile of critical medicines managed by the UK Department of Health and Social Care (DHSC). We propose a new methodology for selecting and including medicines in EMLs and health emergency stockpiles and empirically apply it for selecting medicines in the case of the UK EMBS. MethodsWe used Multi-Attribute Value Theory and Portfolio Decision Analysis to develop a three-phase methodological framework for medicines selection, involving: (i) the decision context definition and selection of evaluation criteria, (ii) the therapeutic area prioritisation, and (iii) the medicines value-for-money evaluation and product selection. The EMBS application took place in 2018–2019 and focused on therapeutic area prioritisation, involving primary data collection through expert interviews (n = 4), a workshop with DHSC decision-makers (n = 13), and an online survey with National Clinical Directors and relevant experts (n = 24). A Monte Carlo simulation supported therapeutic area prioritisation using the British National Formulary (BNF) classification. FindingsTwo criteria sets were selected for i) therapeutic area prioritisation, reflecting the value concerns of population need and shortage severity, and ii) medicines evaluation, reflecting magnitude of clinical benefit and supply vulnerability, among others.Primary evidence was collected for “national need” and “shortage severity”, based on which a “population health loss” index was developed. A total of 51 therapeutic areas were ranked using their index value while assessing the robustness of the ranking. The top ranked therapeutic area was antisecretory drugs and mucosal protectants, closely followed by diabetes drugs. ConclusionsThe methodological application generated a ranking of therapeutic areas based on expected “population health loss” index, while addressing evidence uncertainty. The methodology can be adapted for other EMLs and emergency stockpile contexts to inform medicines selection.

Distributionally robust optimization of a Canadian healthcare supply chain to enhance resilience during the COVID-19 pandemic

This paper presents a multi-period multi-objective distributionally robust optimization framework for enhancing the resilience of personal protective equipment (PPE) supply chains against disruptions caused by pandemics. The research is motivated by and addresses the supply chain challenges encountered by a Canadian provincial healthcare provider during the COVID-19 pandemic. Supply, price, and demand of PPE are the uncertain parameters. The ∊-constraint method is implemented to generate efficient solutions along the trade-off between cost minimization and service level maximization. Decision makers can easily adjust model conservatism through the ambiguity set size parameter. Experiments investigate the effects of model conservatism on optimal procurement decisions such as the portion of the supply base dedicated to long-term fixed contracts. Other types of PPE sources considered by the model are one-time open-market purchases and federal emergency PPE stockpiles. The study recommends that during pandemics health care providers use distributionally robust optimization with the ambiguity set size falling in one of three intervals based on decision makers’ relative preferences for average cost performance, worst-case cost performance, or cost variance. The study also highlights the importance of surveillance and early warning systems to allow supply chain decision makers to trigger contingency plans such as locking contracts, reinforcing logistical capacities and drawing from emergency stockpiles. These emergency stockpiles are shown to play efficient hedging functions in allowing healthcare supply chain decision makers to compensate variations in deliveries from contract and open-market suppliers.

Design and performance testing of a novel emergency ventilator for in-hospital use.

BackgroundThe rapidly evolving COVID-19 pandemic has led to increased use of critical care resources, particularly mechanical ventilators. Amidst growing concerns that the health care system could face a shortage of ventilators in the future, there is a need for an affordable, simple, easy to use, emergency stockpile ventilator.MethodsOur team of engineers and clinicians designed and tested an emergency ventilator that uses a single limb portable ventilator circuit. The circuit is controlled by a pneumatic signal with electronic microcontroller input, using air and oxygen sources found in standard patient rooms. Ventilator performance was assessed using an IngMar ASL 5000 breathing simulator, and it was compared with a commercially available mechanical ventilator.ResultsThe emergency ventilator provides volume control mode, intermittent mandatory ventilation and continuous positive airway pressure. It can generate tidal volumes between 300 and 800 mL with <10% error, with pressure, volume, and waveforms substantially equivalent to existing commercial ventilators.ConclusionsWe describe a cost effective, safe, and easy to use ventilator that can be rapidly manufactured to address ventilator shortages in a pandemic setting. It meets basic clinical needs and can be provided for emergency use in cases requiring mechanical ventilation because of complications due to respiratory failure from infectious diseases.

COVID‐19 and the Case for a National Food Emergency Stockpile

Food insecurity in the United States is not a new challenge, but the coronavirus pandemic has revealed that the current system to support Food Assistance Providers (FAPs) is incredibly brittle and vulnerable to supply chain disruptions. Many FAPs use just‐in‐time models to support their operations, relying heavily on donations from restaurants and grocers. However, COVID‐19 has demonstrated that when a disaster causes increased food demand and widespread destabilization of food supply chains, jurisdictions are severely constrained from obtaining and delivering food to populations in need. Recent events have further amplified a potential danger to current food security strategies in terms of regions experiencing multiple events, such as a pandemic coupled with hurricanes, wildfires, or other catastrophes.After exploring the current governmental food security measures, their long‐term deficiencies, and other lessons learned through the COVID‐19 response, we call for a major policy shift in how the country addresses food insecurity following a disaster. Rather than relying on after‐the‐fact spending and hastily created infrastructure, the nation should proactively stockpile shelf‐stable food. To this end, we propose establishing a national stockpile of shelf‐stable foods to help protect against future food supply destabilization.

Triage in the Nation's Medicine Cabinet: The Puzzling Scarcity of Vaccines and Other Drugs

For a variety of reasons, vaccines and other critical pharmaceutical products have become increasingly scarce in the last few years, and persistent shortages involving dozens of essential drugs may imperil the public health. Pressures emanating from regulatory agencies, the courts, and insurers have conspired to make some lines of the pharmaceutical business less than attractive. Although concerns about unpredictable tort liability received most of the blame in the past, two other factors may help to account for the latest round of drug shortages: stringent federal control of manufacturing facilities and aggressive cost-containment efforts that further erode profit margins. Whatever the cause, scarce supplies necessitate efforts at rationing that pose their own difficulties for health care providers. Policymakers could avoid putting physicians to such tough choices regarding patients by focusing on ways to ensure the production of adequate quantities of these highly cost-effective medical technologies. Some commentators have called for greater public sector involvement, but this Article concludes that, in addition to bolstering its emergency stockpiles, the federal government instead needs to take steps designed to encourage private manufacturers to continue supplying critical pharmaceuticals. To this end, the government should adopt more flexible regulations governing manufacturing facilities, provide companies with greater protection from the vagaries of tort liability, and avoid pursuing excessive cost-control strategies. Otherwise, patients may continue to lose access to important therapeutic products.

Canada's National Emergency Stockpile System: time for a new long-term strategy.

KEY POINTS Recent media reports identified that millions of personal protective equipment (PPE) supplies in Canada’s National Emergency Stockpile System (NESS) have expired and gone to waste.[1][1] Government officials and health care organizations are also trying urgently to secure new stock to

A Chimeric Japanese Encephalitis Vaccine Protects against Lethal Yellow Fever Virus Infection without Inducing Neutralizing Antibodies.

Recent outbreaks of yellow fever virus (YFV) in West Africa and Brazil resulted in rapid depletion of global vaccine emergency stockpiles and raised concerns about being unprepared against future YFV epidemics. Here we report that a live attenuated virus similar to the Japanese encephalitis virus (JEV) vaccine JE-CVax/Imojev that consists of YFV-17D vaccine from which the structural (prM/E) genes have been replaced with those of the JEV SA14-14-2 vaccine strain confers full protection in mice against lethal YFV challenge. In contrast to the YFV-17D-mediated protection against YFV, this protection is not mediated by neutralizing antibodies but correlates with YFV-specific nonneutralizing antibodies and T cell responses against cell-associated YFV NS1 and other YFV nonstructural (NS) proteins. Our findings reveal the potential of YFV NS proteins to mediate protection and demonstrate that chimeric flavivirus vaccines, such as Imojev, could confer protection against two flaviviruses. This dual protection may have implications for the possible off-label use of JE-CVax in case of emergency and vaccine shortage during YFV outbreaks. In addition, populations in Asia that have been vaccinated with Imojev may already be protected against YFV should outbreaks ever occur on that continent, as several countries/regions in the Asia-Pacific are vulnerable to international spread of the YFV.IMPORTANCE Efficient and safe vaccines against yellow fever (e.g., YFV-17D) that provide long-lasting protection by rapidly inducing neutralizing antibody responses exist. However, the vaccine supply cannot cope with an increasing demand posed by urban outbreaks in recent years. Here we report that JE-CVax/Imojev, a YFV-17D-based chimeric Japanese encephalitis vaccine, also efficiently protects against YFV infection in mice. In case of shortage of the YFV vaccine during yellow fever outbreaks, (off-label) use of JE-CVax/Imojev may be considered. Moreover, wider use of JE-CVax/Imojev in Asia may lower the risk of the much-feared YFV spillover to the continent. More generally, chimeric vaccines that combine surface antigens and replication machineries of two distinct flaviviruses may be considered dual vaccines for the latter pathogen without induction of surface-specific antibodies. Following this rationale, novel flavivirus vaccines that do not hold a risk for antibody-dependent enhancement (ADE) of infection (inherent to current dengue vaccines and dengue vaccine candidates) could be designed.

Гибкое управление запасами: страхование поставок лекарственных средств

Healthcare systems across the world are looking at ways of maintaining the continuity of supply of medicines to patients in times of crisis.Whilst this is not a new phenomenon, the additional burden placed on the supply chain during COVID-19 has meant it has come more into the spotlight. The need to use a stockpile can be caused by an interruption to supply, a rapid and unexpected peak in demand, or when both an interruption to supply and a peak in demand occur simultaneously. The objectives of a stockpile will guide the portfolio breadth and depth to be held. Stockpile objectives are broadly driven either by government requirements to protect public health or by organisations seeking toachieve commercial gain. These drivers are not mutually exclusive as in the case of holding safety stock and Public Service Obligation stock. An Emergency Stockpile is Public Health driven and held in order to supply essential medicines during a signifcant or catastrophic event. Emergency stockpiles can be split into three categories — preparation for imminent event, disease specifc response and general contingency stockpiles. Governments and authorities determine which products and volumes should be held in an emergency stockpile which may be guided by the World Health Organizations (WHO) l ist of essential medicines.

Preparedness of Pharmaceutical Services in Military Organizations: Learning from an Assessment in Brazil.

The participation of armed forces in humanitarian operations and in disaster response is common in many countries. In Brazil, the armed forces have had history in providing health support to victims in emergencies, which also includes the provision of pharmaceutical services (PS). Even though being essential for the provision of health care in disaster response, the preparedness of PS is not well-addressed in the literature. The use of a comprehensive approach to evaluate preparedness of PS in military institutions may subsidize preparedness measures. The goals of this work were to analyze the preparedness of PS for disaster response and humanitarian aid in military units of a Brazilian armed force institution, and to propose a framework to improve the preparedness of PS in operational medicine. An investigation of a cross-sectional design was performed. A logic model and indicators to evaluate preparedness of PS were applied. Data were obtained from official documents, interviews with key stakeholders, and observation of good storage practices (GSP). Identified were: lack of specific budget for medicine procurement in case of disaster, absence of emergency stockpile, proper means for medicine transportation, and records of trained health professionals. An emergency plan, a list of selected medicines, adaptable mobile health care units, and a system for mobilization of health professionals were some of the positive aspects recognized. Different aspects for improvement were acknowledged and recommendations to favor the efficiency and the quality of PS in emergencies were proposed. The investigation provided valuable results for the planning and execution of responses to disasters and humanitarian aid. The findings and proposed recommendations may be useful for other military organizations similar to those in Brazil.

Freezing time, preparing for the future: The stockpile as a temporal matter of security

This article analyses stockpiling as a security device that hoards time, stores power and buffers disruptions. The stockpile is a temporal matter of security by virtue of its ability to freeze time and to prepare for future emergencies. Stockpiling is informed by anticipations of threats but also materially underpins expectations. After unpacking the temporal ontology of stockpiling, the article traces its history as a security device and technology of power. Stockpiling enabled the emergence of the earliest states by establishing the means to store surpluses and centralize power. In modernity, stores became more dispersed as money, commodity exchange and new infrastructures made it possible to procure resources through circulation. In the 20th century, stockpiling became a reflexive security device reactive to risks associated with the disruption of these circulations. Finally, the article illuminates the role of reserves in contemporary German catastrophe preparedness to show that stockpiling remains an important security technique. Yet fiscal austerity and budgetary constraints limit security stockpiling. To compensate for the absence of public security stores, the government is prompting citizens to establish emergency stockpiles. The article offers a theoretical, historical and empirical engagement with stockpiling and thereby further elucidates the material politics of anticipation.

Bacteriological warfare and bioterrorism: still a public health challenge

Introduction: According to the American CDC, bioterrorism is defined as "release of viruses, bacteria and other agents with the aim of causing disease or death in the population, as well as animals and plants". Since ancient times, the potential of biological agents as a weapon was recognized, but it was not until the discoveries of Kock and Pasteur in the 19th century that it became possible to speak more properly of "bacteriological warfare". The purpose of this work was to study and compare all the most modern scientific evidence on bioterrorism, to assess the state of the art in the field and provide a useful tool for the prevention and management of a possible biological threat. Methodology: The study was conducted by searching the scientific literature through the PUBMED database. It was based on the use of different search strings using keywords that could well center the topic of interest. This was also supplemented by consulting Centers For Disease Control and Prevention databases that focused on the topic. Results: The case of the "anthrax letters" demonstrated how bioterrorism still remains a danger to the entire community, and must be taken seriously at the individual and policy level. The basic requirement for a biological attack is first of all the availability of the pathogen or toxin in sufficient quantity to affect the human organism and cause disease. Terrorists, however, do not need agents of mass destruction for their purposes and this opens up a wider range of possibilities, preferring readily available agents, first of all castor bean toxin. Adequate preparation for clinical microbiologists and health care personnel to identify and treat implicated biological agents in a timely manner, and maintenance of emergency stockpiles of drugs, is therefore necessary. Conclusions: Although bioterrorism represents a marginal form when compared with traditional forms of terrorism involving weapons and explosives, it is critical that Public Health respond appropriately to this potential threat: prompt recognition of the event is the key step in ensuring that the number of casualties is contained.

Characterization of outbreak response strategies and potential vaccine stockpile needs for the polio endgame.

BackgroundFollowing successful eradication of wild polioviruses and planned globally-coordinated cessation of oral poliovirus vaccine (OPV), national and global health leaders may need to respond to outbreaks from reintroduced live polioviruses, particularly vaccine-derived polioviruses (VDPVs). Preparing outbreak response plans and assessing potential vaccine needs from an emergency stockpile require consideration of the different national risks and conditions as they change with time after OPV cessation.MethodsWe used an integrated global model to consider several key issues related to managing poliovirus risks and outbreak response, including the time interval during which monovalent OPV (mOPV) can be safely used following homotypic OPV cessation; the timing, quality, and quantity of rounds required to stop transmission; vaccine stockpile needs; and the impacts of vaccine choices and surveillance quality. We compare the base case scenario that assumes aggressive outbreak response and sufficient mOPV available from the stockpile for all outbreaks that occur in the model, with various scenarios that change the outbreak response strategies.ResultsOutbreak response after OPV cessation will require careful management, with some circumstances expected to require more and/or higher quality rounds to stop transmission than others. For outbreaks involving serotype 2, using trivalent OPV instead of mOPV2 following cessation of OPV serotype 2 but before cessation of OPV serotypes 1 and 3 would represent a good option if logistically feasible. Using mOPV for outbreak response can start new outbreaks if exported outside the outbreak population into populations with decreasing population immunity to transmission after OPV cessation, but failure to contain outbreaks resulting in exportation of the outbreak poliovirus may represent a greater risk. The possibility of mOPV use generating new long-term poliovirus excretors represents a real concern. Using the base case outbreak response assumptions, we expect over 25 % probability of a shortage of stockpiled filled mOPV vaccine, which could jeopardize the achievement of global polio eradication. For the long term, responding to any poliovirus reintroductions may require a global IPV stockpile. Despite the risks, our model suggests that good risk management and response strategies can successfully control most potential outbreaks after OPV cessation.ConclusionsHealth leaders should carefully consider the numerous outbreak response choices that affect the probability of successfully managing poliovirus risks after OPV cessation.

The First Use of the Global Oral Cholera Vaccine Emergency Stockpile: Lessons from South Sudan.

Andrew Azman and colleagues describe their experience of deploying >250,000 doses of oral cholera vaccine in South Sudan in 2014

Managing Cholera as a Preventable Global Threat

The significant annual burden of disease from cholera remains a preventable global tragedy. An oral cholera vaccine (OCV) emergency stockpile represents a good beginning for improved global cholera management, and modeling studies suggest that realizing the greatest impacts of using OCVs for outbreak response depends on national preparedness. Using the stockpile will create opportunities to gain valuable evidence and experience about the potential role and relative cost-effectiveness of OCVs. It is time to see cholera as a serious and preventable global threat worthy of coordinated attention and management, active global surveillance, and increased human and financial resource investments.

関原天然ガス地下貯蔵の現状とモニタリング計画

From a viewpoint of stable supply of gas resources, importance of natural gas underground storage has been widely recognized. Teikoku Oil (INPEX) established, for the first time in Japan in 1969, the underground gas storage (UGS) in Sekihara gas field, which was a depleted gas reservoir located a few kilometers north to Minami-Nagaoka. Since then, it has played a great role for peak shaving and/or emergency stockpile in Minami-Nagaoka gas production operation. At present, approximately 80 MMm3 of working gas is stored with the maximum deliverability of 2.4 MMm3/day.For the purposes of increasing both the working gas capacity and withdrawal rate, delta-pressuring, operation at a maximum pressure greater than the discovery pressure associated with that reservoir, is expected for Sekihara UGS. Unfortunately, there are no experience and no regulations for “delta-pressuring” in Japan. The special measurements and the monitoring systems installed in Sekihara UGS for the safe operation of delta-pressuring are introduced in this paper.

Critical evaluation of emergency stockpile ventilators in an in vitro model of pediatric lung injury

Modern health care systems may be inadequately prepared for mass casualty respiratory failure requiring mechanical ventilation. Current health policy has focused on the "stockpiling" of emergency ventilators, though little is known about the performance of these ventilators under conditions of respiratory failure in adults and children. In this study, we seek to compare emergency ventilator performance characteristics using a test lung simulating pediatric lung injury. Evaluation of ventilator performance using a test lung. Laboratory. None. Six transport/emergency ventilators capable of adult/child application were chosen on the basis of manufacturer specifications, Autovent 3000, Eagle Univent 754, EPV 100, LP-10, LTV 1200, and Parapac 200D. Manufacturer specifications for each ventilator were reviewed and compared with known standards for alarms and functionality for surge capacity ventilators. The delivered tidal volume, gas flow characteristics, and airway pressure waveforms were evaluated in vitro using a mechanical test lung to model pediatric lung injury and integrated software. Test lung and flow meter recordings were analyzed over a range of ventilator settings. Of the six ventilators assessed, only two had the minimum recommended alarm capability. Four of the six ventilators tested were capable of being set to deliver a tidal volume of less than 200 mL. The delivered tidal volume for all ventilators was within 8% of the nominal setting at a positive end expiratory pressure of zero but was reduced significantly with the addition of positive end expiratory pressure (range, ±10% to 30%; p < .01). All ventilators tested performed comparably at higher set tidal volumes; however, only three of the ventilators tested delivered a tidal volume across the range of ventilator settings that was comparable to that of a standard intensive care unit ventilator. Multiple ventilators are available for the provision of ventilation to children with respiratory failure in a mass casualty scenario. Few of these ventilators possess the minimum alarm functionality and consistently deliver the prescribed tidal volume that allows for safe and effective ventilation of critically ill pediatric patients. These findings will help clinicians understand the performance and limitations of available ventilators intended for use in children.

Determination of H5N1 vaccine potency using reference antisera from heterologous strains of influenza

Please cite this paper as: Vodeiko and Weir (2011). Determination of H5N1 vaccine potency using reference antisera from heterologous strains of influenza. Influenza and Other Respiratory Viruses 6(3), 176–187. Background Standardization of inactivated influenza vaccines by hemagglutinin (HA) content is performed by the single radial immunodiffusion (SRID) method. Regulatory agencies prepare, calibrate, and distribute SRID reagent standards necessary for testing of seasonal influenza vaccines, and a similar process is used to produce potency reagents for candidate pandemic influenza vaccines that are manufactured for emergency stockpiles. Objectives Because of the concerns in generating a timely strain‐specific potency antiserum for an emerging pandemic virus, we evaluated the feasibility of using heterologous potency reference antiserum as a replacement for a strain‐specific (homologous) antiserum in the SRID potency assay for stockpiled H5N1 vaccines. Results The results indicate that a heterologous H5N1 antiserum can be used to determine the accurate potency of inactivated H5N1 influenza vaccines. Additionally, when H5N1 vaccine was subjected to an accelerated stability protocol, both homologous and heterologous antisera provided similar measurements of vaccine potency decline. Limitations to the heterologous antiserum approach to potency determination were shown by the inability of antiserum to recent seasonal H1N1 viruses to work in an SRID assay with the 2009 pandemic H1N1 A/California/07/2009 antigen. Conclusions The data demonstrate the feasibility of using heterologous antiserum for potency determination of at least some candidate vaccines in case of a shortage or delay of homologous antiserum. Further, the results suggest the prudence of stockpiling a broad library of potency reagents including many strains of influenza viruses with pandemic potential to provide an added measure of assurance that reagent production would not be a bottleneck to vaccine production during a pandemic.

COMPANIES MEET VACCINE NEEDS

A SOUTH AMERICAN OUTBREAK of more than 100 suspected cases of yellow fever has mobilized global health groups and their drug industry partners to supply needed vaccines. There is no treatment for the viral disease, only prevention via immunization. Thus, vaccinations must be given quickly after an outbreak to keep yellow fever from spreading, particularly in populated areas. Early last week, the United Nations Children’s Fund (UNICEF) delivered to Paraguay 2 million doses of vaccine supplied by Sanofi Pasteur, the vaccines division of France’s Sanofi-Aventis. The drug company is a leading manufacturer of yellow fever vaccine and supplies an emergency stockpile managed by an international group that includes UNICEF. Previously, Brazil and other countries in the region provided some of the needed vaccine. Brazilian officials, however, suspended exports of yellow fever vaccine after an outbreak in their country, according to the World Health Organization. At the request of health authorities, Sanofi Pasteur ...

枯渇油・ガス田の有効利用

Teikoku Oil Co., Ltd. operates Minami-Nagaoka gas field, one of the biggest natural gas fields in Japan. Increasing demand of natural gas requires that Teikoku Oil should reinforce its production capability, including number of production wells, in Minami-Nagaoka. From a viewpoint of stable supply of gas resources, importance of natural gas underground storage has been widely recognized. Teikoku Oil established, for the first time in Japan in 1969, the underground storage system in Sekihara gas field, which was a depleted gas reservoir located a few kilometers north to Minami-Nagaoka. Since then, it has played a great role for peak shaving and/or emergency stockpile in Minami-Nagaoka gas production operation. At present, approximately 140 MMNm3 of natural gas is stored with the maximum deliverability of 1.6 MMNm3/day. Some technical issues encountered and solved during the storage operation for these 30 years are discussed in this lecture. In addition, Teikoku Oil notices that its experiences gained through the underground storage of natural gas in Sekihara could be directly applied to underground storage of carbon dioxide. Namely, injecting and storing man-made emissions of carbon dioxide, a greenhouse gas, in underground is considered as one of the possible measures against a global warming problem. Teikoku Oil is a member of a national research project on the underground storage of carbon dioxide led by RITE (Research Institute of Innovated Technology of Earth) and SEC (Safety and Environment Center for Petroleum Development). A pilot test to inject and store 15, 000 tons of carbon dioxide into a water zone is scheduled in and after 2003, for which one injection and two observation wells have already been drilled in Minami-Nagaoka. This noteworthy project is also introduced in this lecture. A key concept common to the both topics above is “utilization of depleted gas/oil reservoirs.”