Health Emergency Management Research Articles

Societal Disruption as a Disaster

Introduction:This research aims to review the impact of drug addiction, domestic violence and suicide in Australia through the lens of disaster risk reduction. This study explores whether drug addiction, domestic violence and suicide can be considered as disasters according to established thresholds and definitions; and whether contemporary health emergency and disaster risk management (HEDRM) practice can be adapted to support action to reduce the impact of these events and inform disaster risk reduction.Method:A literature review was conducted to explore drug addiction, domestic violence and suicide as societal disruptions causing disasters. Key Australian government reports describing deaths associated with suicide, domestic violence and drug addiction were identified, following which a constrained snowball sampling was applied to the bibliography of each document to gather further key articles and inform the evolution of the impact of these themes in Australia over the period 2000-2018. The search strategy included both peer reviewed and grey literature. We used the search terms ‘social disruption’, 'non-traditional', ‘drug addiction’, ‘domestic violence, ‘suicide’ and 'societal disruption' as key words and included articles if they demonstrated an analysis of the theme related to health impact related to disaster settings.Results:Utilizing the Australian Disaster Resilience Knowledge Hub and the international CRED criteria for a disaster, the impact on human health of drug addiction, domestic violence, and suicide upon the Australian population each meet the criteria of a disaster.Conclusion:Public health practice through the lens of the determinants of social disruption combined with activities that consider hazards, vulnerability, and exposure, can institute prevention, preparedness, response, and recovery programs to reduce the impact of drug addiction, domestic violence, and suicide.

Reviewing the Implementation of the Emergency Medical Team Minimum Data Set

Introduction:The Emergency Medical Team (EMT) Strategic Advisory Group of the WHO has endorsed the EMT Minimum Data Set (MDS) Daily Reporting Form in 2017 and the revised EMT Minimum Standards of the WHO suggests EMTs report it regularly in case national reporting forms are not available.Method:This study searched and listed previous use cases of the MDS by reviewing published papers including gray literature and interviews with national authorities, organizations, and experts.Results:In 2019, the MDS had been activated for the first time in Mozambique during international scale response at the tropical cyclone Idai; also in Japan it was used at the typhoon Faxai/Hagibis response; further in the Independent State of Samoa during the measles outbreak. In 2020, the MDS was used during a COVID-19 mega-cluster incident on the Diamond Princess Cruise Ship in Japan, the tropical cyclone Harold in Vanuatu and the Kumamoto Heavy Rain in Japan. In 2021, the one was used during the Izuyama landslide response in Japan; and the typhoon Rai response in the Philippines. In 2022, it was used during the cyclone Batsirai response in Madagascar; and in Moldova, Poland, and Ukraine to respond to the armed conflict situation in Ukraine.Many countries are preparing to use the form; in 2022 the Association of SouthEast Asian Nations (ASEAN) has officially endorsed the form as a regional standard form for EMT daily reporting. Military partners also were testing the form, in 2019 forces from eight nations at the 39th Cobra Gold 20 in Thailand used the form for training purposes.Conclusion:The MDS was used in at least 14 emergencies in nine countries. Mozambique and Japan have published academic literature using the MDS. The use of MDS would strengthen Health Emergency and Disaster Risk Management (H-EDRM) in a data-based manner.

Advancing Knowledge Translations to Contribute to Resilience in Emergency Preparedness, Response and Recovery: The Role of Evidence Aid

Introduction:Policymakers, practitioners and the public all have a role in health emergency and disaster risk management (Health EDRM). They need to access, understand and use evidence from research to take actions to reduce health risks and harm. They need the best available evidence to maximize their ability to save lives and reduce suffering. Evidence Aid seeks to meet this need through collections of specially prepared plain-language summaries of systematic reviews, freely available online in multiple languages (www.EvidenceAid.org). The summaries and webpages can be linked to reference management software and embedded in other websites.Method:Evidence Aid has added a substantial number of summaries to its collections since 2020, for example, adding a collection for reviews of relevance to the COVID-19 pandemic and its associated measures. From 2021, Evidence Aid built on its partnership with the Pan American Health Organization (PAHO/WHO) to identify and summarize reviews relevant to building resilience into health systems. This included enhancements enriching the content of each summary with the authors’ implications for practice and research, equity considerations and funding sources.Results:In November 2022, the Resilient Health Systems collection contained more than 200 summaries relevant to ensuring that health systems are resilient to emergencies, disasters and related challenges. There were also 600 summaries relevant to the COVID-19 pandemic, 150 on the health of refugees and asylum seekers, more than 100 on physical and mental health impacts of disasters and 110 on preventing and treating acute malnutrition.Conclusion:Evidence Aid’s 1000+ summaries of systematic reviews relevant to Health EDRM provide a unique gateway into this evidence base for policymakers, practitioners and the public wishing to ensure that disaster preparedness, response, recovery and rehabilitation are effective and efficient. It should be a key component in helping people and organizations to care, cope and overcome in an increasingly challenging world.

Climate, Weather Extremes and Health: Latest WHO-WMO Resources and Tools for Health Emergency Managers

Introduction:As populations worldwide are experiencing more frequent and intense weather and climate extremes, many professionals of the WADEM community are at the frontline of managing compounding and cascading impacts on physical and mental health. Vulnerable, isolated, and marginalized people are the most affected by climate and weather threats. The elderly and children faced 3.7 billion more life-threatening heatwave days in 2021 than annually in 1986-2005 increasing the need for emergency care on a large scale.Method:The World Health Organization (WHO) and World Meteorological Organization (WMO), together with partners from health agencies, climate services, academia and other sectors are collaborating to accelerate the use of climate, weather and environmental science and services for better health protection. A selection of key resources and tools will be highlighted that can be used by the WADEM community to better understand, anticipate, and manage health risks from extreme weather and climate.Results:Participants will learn about the new WHO-WMO ClimaHealth Portal, a global knowledge and action hub with huge potential for facilitating learning and action to better protect health from climate risks. Tools and resources include the Global Heat Health Information Network (GHHIN) Checklist and Technical Brief for improved heatwave preparedness and response in the context of COVID-19, and a new WHO Guidance Document on Measuring the Climate Resilience of Health Systems providing a framework and indicators for assessing and protecting health systems from climate threats.Conclusion:As extreme weather intensifies, integrated climate-informed services for the health sector including multi-hazard early warning systems and action plans, as well as strengthened partnerships between the health community and hydrometeorological services are indispensable to further restrict adverse health impacts. Accelerating the uptake and upscale of existing tools and resources is urgently needed to meet the increasing health and societal challenges caused by climate change and weather extremes.

A scalable model to ensure sustainability of resources and quality in health emergency management in public administration

A scalable model to ensure sustainability of resources and quality in health emergency management in public administration

Improving access to primary health care for refugee women and children using Health Emergency and Disaster Risk Management Framework during pandemic: a mixed method study in three countries

Improving access to primary health care for refugee women and children using Health Emergency and Disaster Risk Management Framework during pandemic: a mixed method study in three countries

‘It was organized from the bottom’: the response from community-based institutions during the 2014 Ebola epidemic

AbstractWhat was the turning point in the world's largest and deadliest outbreak of the Ebola virus disease? Public health interventions tend to focus on supply-side provision of public health goods. These goods are clinical resources such as medicine or equipment. However, no nation has enough resources to ‘treat’ its way out of a widespread epidemic. Behavioural changes, such as social distancing, are needed too. Behaviours are the demand-side of public health goods and if unaddressed, perpetuate disease transmission. Community-based institutions addressed demand-side barriers during the 2014 Ebola epidemic in Liberia and Sierra Leone. Sixty-seven interviews were conducted in several provinces in Liberia and Sierra Leone. The findings show that information asymmetry and collective action challenges lowered the demand for clinical resources. Community-based institutions intervened via health sensitization and emergency regulations. Therefore, health seeking and public cooperation improved. This research study demonstrates a need to integrate community-led action into public health emergency management.

Mandatory COVID-19 Vaccination and Free Self-Determination in the Health Field in Italy

Abstract The COVID-19 pandemic and the issues related to health emergency management have raised concerns about fundamental rights protection. One of the most complex and contentious issues in doctrine and jurisprudence is the introduction of mandatory COVID-19 vaccination for specified categories of subjects, such as healthcare workers and individuals of a specific age range, as occurred in Italy. The debate in Italy over the mandatory COVID-19 vaccination requirement focuses on whether this obligation interferes with the individual’s fundamental right to free self-determination as guaranteed by Article 32 of the Italian Constitution. In jurisprudence and doctrine, conflicting opinions are noted concerning this topic. Part of the doctrine argue that mandatory COVID-19 vaccination compromises some fundamental rights guaranteed by the Italian Constitution, such as the right to free self-determination and respect for human dignity. Other opinions find the basis of the vaccination in the community’s best interests, citing Article 32 of the Italian Constitution, which allows for the imposition of compulsory health treatment to safeguard citizens’ health. In this regard, the issue of mandatory COVID-19 vaccination requires a reflection on the balance of two fundamental rights: the individual right to free self-determination and the community’s interest in terms of protecting public health.

Research on the Development of China-Indonesia Tourism Cooperation Under the Background of the Belt and Road--Based on the Perspective of Normalization of Public Health Emergency Management 一带一路背景下中印尼旅游合作发展研究——以公共卫生应急管理常态化为视角

In 2022, China and Indonesia will enter the 72nd year of diplomatic relations, and since China's Belt and Road Initiative in 2013, the relationship between China and Indonesia in the fields of humanities, economy, trade and tourism has reached a new level. Tourism cooperation between the two countries is not only an important part of the initiative, but also an important way to meet the needs of tourism development in both countries, deepen trade and economic cooperation, and promote the construction of the Belt and Road. However, the development of tourism cooperation between the two countries has outstanding problems such as security issues, insufficient depth of cooperation and single approach, while the sudden outbreak of the epidemic at the end of 2019 has dealt a heavy blow to the tourism industry of the two countries and has affected the economy and trade of them. Based on the background of the Belt and Road, this article reorganizes the background, dynamics and obstacles of China-Indonesian tourism cooperation from the perspective of the normalization of public health emergency management, and builds a new path model to promote the deepening development of tourism cooperation between the two countries based on this, with a view to becoming an important path choice to promote the optimization and upgrading of bilateral tourism cooperation between China and Indonesia.

Assessing the effectiveness of training programme on the competency of medical staffs in public health emergency.

The competencies of medical staff in the public health emergency system and evaluated the effects of system-based professional training were investigated. A competency model for individuals in a public health emergency management system was developed, which contained 33 items with 5 domains. A competency-based intervention was performed. A total of 68 participants from 4 health emergency teams in Xinjiang, China were recruited and randomly divided into 2 groups: the intervention (N = 38) and control groups (N = 30). Participants in the intervention group received competency-based training, while those in the control group received no training. All participants responded to the COVID-19 activities. The competencies of medical staff in the 5 domains were then analyzed in the pre-intervention, post-first training, and post-COVID-19 intervention using a self-designed questionnaire. Participants' competencies were at the middle level at baseline. After the first training, competencies in the 5 domains significantly improved in the intervention group; in the control group, there was a significant increase in professional quality compared in the pre-training. After the response to COVID-19, the mean scores of competencies in the 5 domains significantly increased in both the intervention and control groups compared with those in the post-first training. Psychological resilience scores were higher in the intervention group than in the control group, whereas no significant differences in competencies were found in other domains. Competency-based interventions provided practice and showed a positive effect on improving the competencies of medical staff in public health teams. Med Pr. 2023;74(1):19-26.

Discussion on the establishment of regional peacetime and wartime combined emergency hospital from the collaborative governance theory

In the context of the prevention and control for coronavirus disease (COVID), public health emergency governance has been incorporated into an important part of the national governance system, and the "combination of peacetime and wartime" has become an important principle of public health emergency governance. Based on the experience of public health emergency management in large cities and the theory of collaborative governance, this study analyzed the problems and obstacles of general hospitals in coping with emerging respiratory infectious diseases. It is proposed to select general hospitals above tertiary level in the region to build peacetime and wartime combined emergency hospital, establish standardized conversion procedures and strengthen the construction of key elements of integrated emergency hospitals, so as to provide new ideas for the construction of emergency medical system "combination of peacetime and wartime" mechanism and improve the "combination of civilian and combat" public health emergency governance system.

Emergency powers and the pandemic: Reflecting on state legislative reforms and the future of public health response.

The first 2 years of combatting the COVID-19 pandemic necessitated an unprecedented use of emergency powers. States responded with an equally unprecedented flurry of legislative changes to the legal underpinnings of emergency response and public health authorities. In this article, we provide a brief background on the framework and use of governors and state health officials' emergency powers. We then analyze several key themes, including both the enhancement and restriction of powers, emerging from emergency management and public health legislation introduced in state and territorial legislatures. During the 2020 and 2021 state and territorial legislative sessions, we tracked legislation related to the emergency powers of governors and state health officials. Legislators introduced hundreds of bills impacting these powers, some enhancing and others restricting emergency powers. Enhancements included increasing vaccine access and expanding the pool of eligible medical professions that could administer vaccinations, strengthening public health investigation and enforcement authority for state agencies, and preclusion of local orders by orders at the state level. Restrictions included establishing oversight mechanisms for executive actions, limits on the duration of the emergency, limiting the scope of emergency powers allowed during a declared emergency, and other restraints. By -describing these legislative trends, we hope to inform governors, state health officials, -policymakers, and emergency managers about how changes in the law may impact future public health and emergency response capabilities. Understanding this new legal landscape is critical to effectively preparing for future threats.

Risk communication and community engagement as an emerging pillar of health emergency management in Iran: Achievements and the way forward.

This article is part of the Research Topic Health Systems Recovery in the Context of COVID-19 and Protracted Conflict. Risk communication and community engagement (RCCE) is an essential component of emergency preparedness and response. In Iran, RCCE is a relatively new area of public health. During the COVID-19 pandemic in Iran, the national task force relied on conventional methods, which is to utilize existing primary health care (PHC) structure to implement RCCE activities around the country. The PHC network and the community health volunteers embedded in it enabled the country to bridge the health system and communities from the very beginning of the COVID-19 pandemic. The RCCE strategy to respond to COVID-19 was adapted over time with the development of a national program, commonly known as the "Shahid Qassem Soleimani" project. This project consisted of six steps including case detection, laboratory testing through the establishment of sampling centers, scale up of clinical care to vulnerable groups, contact tracing, home care for vulnerable population, and COVID-19 vaccination roll out. Nearly 3 years into the pandemic, the importance of designing RCCE for all types of emergencies, allocating a dedicated team to RCCE, coordinating with different stakeholders, improving the capacity of RCCE focal points, practicing more efficient social listening, and using social insight for better planning were identified as some lessons learned. Further, Iran's RCCE experience during the COVID-19 pandemic underscores the importance of continuing to invest in the health system, particularly PHC.

The COVID-19 Pandemic Response and Its Impact on Post-Corona Health Emergency and Disaster Risk Management in Republic of Korea

The COVID-19 pandemic significantly impacted the Republic of Korea’s Health Emergency and Disaster Risk Management (Health-EDRM). This study aims to examine the Republic of Korea’s response to the COVID-19 pandemic, focusing on Health-EDRM, especially human resources, health services, and logistics. Challenges in the Republic of Korea, including lack of medical workforce, confused risk communication, shortage of hospital beds, and inefficient distribution of medical resources, have been highlighted in this paper in terms of human resources, health service delivery, and logistics, which are components of Health-EDRM. It is essential to address the cooperation between the government and private sectors, the protection of occupational health and safety of medical staff during the pandemic, and strategies and technologies to scale up the health facilities, to respond to a future crisis like the COVID-19 pandemic.

Predicting the combined effects of case isolation, safe funeral practices, and contact tracing during Ebola virus disease outbreaks.

The recent outbreaks of Ebola virus disease (EVD) in Uganda and the Marburg virus disease (MVD) in Ghana reflect a persisting threat of Filoviridae to the global health community. Characteristic of Filoviridae are not just their high case fatality rates, but also that corpses are highly contagious and prone to cause infections in the absence of appropriate precautions. Vaccines against the most virulent Ebolavirus species, the Zaire ebolavirus (ZEBOV) are approved. However, there exists no approved vaccine or treatment against the Sudan ebolavirus (SUDV) which causes the current outbreak of EVD. Hence, the control of the outbreak relies on case isolation, safe funeral practices, and contact tracing. So far, the effectiveness of these control measures was studied only separately by epidemiological models, while the impact of their interaction is unclear. To sustain decision making in public health-emergency management, we introduce a predictive model to study the interaction of case isolation, safe funeral practices, and contact tracing. The model is a complex extension of an SEIR-type model, and serves as an epidemic preparedness tool. The model considers different phases of the EVD infections, the possibility of infections being treated in isolation (if appropriately diagnosed), in hospital (if not properly diagnosed), or at home (if the infected do not present to hospital for whatever reason). It is assumed that the corpses of those who died in isolation are buried with proper safety measures, while those who die outside isolation might be buried unsafely, such that transmission can occur during the funeral. Furthermore, the contacts of individuals in isolation will be traced. Based on parameter estimates from the scientific literature, the model suggests that proper diagnosis and hence isolation of cases has the highest impact in reducing the size of the outbreak. However, the combination of case isolation and safe funeral practices alone are insufficient to fully contain the epidemic under plausible parameters. This changes if these measures are combined with contact tracing. In addition, shortening the time to successfully trace back contacts contribute substantially to contain the outbreak. In the absence of an approved vaccine and treatment, EVD management by proper and fast diagnostics in combination with epidemic awareness are fundamental. Awareness will particularly facilitate contact tracing and safe funeral practices. Moreover, proper and fast diagnostics are a major determinant of case isolation. The model introduced here is not just applicable to EVD, but also to other viral hemorrhagic fevers such as the MVD or the Lassa fever.

Study of COVID-19 Epidemic Control Capability and Emergency Management Strategy Based on Optimized SEIR Model

Due to insufficient epidemic detection and control, untimely government interventions, and high epidemic prevention costs in the early stages of the epidemic outbreak, the spread of the epidemic may become out of control and pose a great threat to human society. This paper optimized and improved the traditional Susceptible-Exposed-Infectious-Removed (SEIR) model for investigating epidemic control and public health emergency management. Using the Corona Virus Disease 2019 (COVID-19) outbreak as an example, this paper simulates and analyzes the development of an epidemic outbreak during various periods with the optimized SEIR model, to explore the emergency control capacity of conventional medical control measures, such as large-scale outbreak testing capacity, hospital admission capacity, or daily protection of key personnel, and analyze the government’s emergency management strategies to achieve low-cost epidemic control. The model developed in this study and the results of its analysis demonstrate the differences in outbreak emergency control capacity under different conditions and different implementation strategies. A low-cost local outbreak emergency management strategy and the timing of the government’s resumption of work and school are discussed on this basis.

Pandemia de Covid-19 e Relações Verbais em Redes Sociais

The relationships between verbal behavior on social media during the Covid-19 pandemic are data sources to be investigated, and that can potentially contribute to further research by identifying gaps or points to be adjusted in health emergency management and disasters risk reduction management. Study 1 analyzed the at the Federal District Governor’s Facebook profi le, collecting all the posts between 02/26/2020 and 08/26/2021. Videos, photos, and links posted were recorded, and the publications were categorized for analysis. The results revealed inconsistencies between the governor’s statements, the epidemiological scenarios, and the health recommendations from international and national sources. Study 2 investigated verbal statements aimed at the mental health fi eld in interaction between university students through their interactions with the unbsincera page on Instagram. Data collection took place in nine blocks, with a focus on the academic semesters of 2020 and 2021. The analysis showed that most majority of the students’ posts addressed issues related to physical and mental health, including workload, stress, assessments, and professors. The pandemic management in its diff erent epidemiological settings has the social networks as a complementary instrument. These networks can lead to eff ective behavioral changes included in public policies. The scientifi c approach to human behavior, in multidisciplinary teams, may enhance the adoption and maintenance of protective patterns by the population.Keywords: Risk communication, mental health, metacontingency, verbal behavior

Tonga national emergency medical team response to the 2022 Hunga Tonga-Hunga Ha'apai volcanic eruption and tsunami: the first deployment of the Tonga Emergency Medical Assistance Team (TEMAT).

The undersea Hunga Tonga-Hunga Ha'apai volcano erupted on 15 January 2022, causing a tsunami that affected Tonga as well as other countries around the Pacific rim. Tonga's international borders were closed at the time due to the coronavirus disease pandemic, but clinical surge support was needed to respond to this disaster. Tonga's Ministry of Health formed the Tonga Emergency Medical Assistance Team (TEMAT) in 2018 to provide clinical care and public health assistance during disasters, outbreaks and other health emergencies. TEMAT was activated for the first time in January 2022 to respond to medical and public health needs following the eruption and tsunami. On 16 January 2022, a five-person TEMAT advance team was deployed to conduct initial damage assessments and provide casualty care. Subsequently, TEMAT rotations were deployed to provide clinical care and public health support across the Ha'apai island group for over 2months. TEMAT deployed to the islands most affected by the volcanic eruption and tsunami within 24 hours of the event, providing emergency clinical, psychosocial and public health services across four islands. TEMAT reported daily to the Ministry of Health and National Emergency Management Office, providing critical information for response decision-making. All TEMAT actions were documented, and an after-action review was conducted following the deployment. TEMAT's deployment in response to the 2022 volcanic eruption and tsunami highlighted the importance of national emergency medical teams that are prepared to respond to a range of emergency events.

CrisisReady's novel framework for transdisciplinary translation: Case-studies in wildfire and hurricane response

Extreme weather events including wildfires and hurricanes are becoming increasingly hazardous due to climate change, and often result in transient or permanent population displacements. Disaster-related disruptions in infrastructure, workforce, wages, and social networks can combine with population displacements to result in interruptions in health care access and prolonged impacts on morbidity and mortality. The data needed to make health systems and emergency management approaches more resilient to these hazards, and more responsive to the needs of affected populations, are sequestered in silos across private corporations and public agencies. In two case studies, we describe how our research team at CrisisReady negotiated access to privately held and novel data sources like anonymized geolocation data from cell-phones, while striking a balance between data security and public health utility. We describe how our analytic tools are embedded into disaster response workflows by co-developing our research questions and outputs with responders and policy-makers. ReadyMapper, an interactive data visualization tool to track population mobility, infrastructure damage, and health system capacity, in near real-time, was deployed during wildfires in California and during the Hurricane Ida response in Louisiana. The Data-Methods-Translational framework we have developed is scalable and relies on sharing science and co-creating products with policy makers and response agencies to ensure real-world applicability. These attributes make the framework particularly useful for formulating evidence-based approaches to protect human health through climate change adaptation.

Barriers and Enablers to Using an Emergency Operations Center in Public Health Emergency Management: A Scoping Review.

The aim of this study was to review the role of public health emergency operations centers in recent public health emergencies and to identify the barriers and enablers influencing the effective use of a public health emergency operations center (PHEOC) in public health emergency management. A systematic search was conducted in 5 databases and selected grey literature websites. Forty-two articles, consisting of 28 peer-reviewed studies and 14 grey literature sources matched the inclusion criteria. Results suggest that PHEOCs are used to prepare and respond to a range of public health emergencies, including coronavirus disease (COVID-19). Factors found to influence the use of a PHEOC include the adoption of an incident management system, internal and external communications, data management, workforce capacity, and physical infrastructure. PHEOCs play an important role in public health emergency management. This review identified several barriers and enablers to using a PHEOC in public health emergency management. Future research should focus on addressing the barriers to using a PHEOC and looking at ways to evaluate the impact of using a PHEOC on public health emergency outcomes.