Health Emergency Research Articles

Amended WHO International Health Regulations for better global pandemic governance?

Recent amendments to the International Health Regulations (IHR), adopted at the 77th World Health Assembly in May 2024, represent an important conceptual development in the field of global pandemic governance. The regulations now include the notion of a pandemic emergency, a heightened subcategory of the public health emergency of international concern, which necessitates rapid, equitable, and enhanced coordinated international action to counteract global pandemics. In addition, changes to the guiding principles expressly require that the implementation process ‘shall promote equity and solidarity’. This is further crystallised in concrete commitments to enable equitable access to health products and provide for the mobilisation of financial resources for developing countries. Taking lessons from the COVID-19 pandemic, these changes make the IHR a more effective tool against global pandemics and represent significant steps towards achieving global health justice.

Update on Mpox Management: Epidemiology, Vaccines and Therapeutics, and Regulatory Changes.

Mpox, caused by the monkeypox virus (MPXV), is categorized into two primary clades: Clade I and Clade II, with notable outbreaks linked to Clade IIb. Historically endemic in Africa, recent years have seen significant global spread. The World Health Organization (WHO) declared mpox a Public Health Emergency of International Concern in August 2024, highlighting the emergence of Clade Ib outside Africa and the broadening demographic impact of the outbreak. This review updates the current status of mpox vaccines and treatments, including their safety and effectiveness. There are two US Food and Drug Administration (FDA)-approved vaccines for the prevention of mpox disease, JynneosTM and ACAM2000®. The JynneosTM vaccine, recommended for high-risk individuals, has seen limited uptake despite its efficacy in preventing disease. Tecovirimat, while FDA-approved for smallpox and available in the European Union for mpox, has shown mixed results in recent trials, with new data suggesting limited effectiveness in Clade I infections and emergence of new mutations with resistance to this drug. Brincidofovir and Vaccinia Immune Globulin Intravenous offer additional treatment options, particularly for severe cases, although their use is constrained by regulatory and logistical challenges. Furthermore, the WHO recently approved the first commercial molecular assay, the Alinity m MPXV assay by Abbott Molecular Inc., for emergency use-an essential step in expanding testing capacity in regions experiencing mpox outbreaks. These updates underscore the critical need for continued research to enhance therapeutic outcomes and adapt public health strategies. Ensuring equitable access to vaccines, treatments, and diagnostics remains a significant challenge as the global community responds to the evolving mpox situation.

Investigation of the knowledge, attitude and behavior of medical personnel and related needs for emergency rescue in public health emergencies

BackgroundThe frequent occurrence of Public Health Emergencies (PHEs) presents a significant challenge to global health security. As the primary responders in PHE situations, the comprehensive capabilities of medical personnel to address these emergencies are of global concern. AimThis study aims to evaluate the knowledge, attitudes, and behaviors of medical personnel regarding emergency rescue in public health emergencies in Guizhou Province, China. Additionally, it seeks to explore their related needs to inform the development of intervention strategies, ultimately enhancing the ability of medical personnel to manage public health emergencies. MethodsA descriptive cross-sectional design was employed to assess the knowledge, attitudes, and behaviors of medical personnel concerning emergency rescue and the related needs of PHEs. Data collection involved a questionnaire evaluating the knowledge, attitudes, and behaviors of medical personnel regarding the emergency rescue of PHEs, along with a self-designed questionnaire assessing the needs of medical personnel in responding to PHEs. Univariate analysis and multiple linear regression were utilized to analyze the factors influencing medical personnel’s knowledge, attitudes, and behaviors in response to PHEs. ResultsA total of 4,074 medical personnel were surveyed. The results indicated that the knowledge, attitudes, and behaviors of medical personnel regarding PHEs were at a high level. Additionally, the related needs of medical personnel for PHEs included training, psychological support, and behavioral support. Differences were observed in the scores of emergency rescue knowledge among medical personnel based on age, years of experience, educational background, and positions (P < 0.05). Furthermore, variations in scores related to emergency rescue were noted across different age groups, years of experience, educational backgrounds, and professional titles (P < 0.05). Significant differences were also found in the scores of medical staff based on years of experience and hospital grades in their responses to PHEs (P < 0.05). Emergency rescue knowledge was influenced by factors such as anxiety and fear, years of experience, and professional titles when confronted with PHEs. Similarly, anxiety and fear, years of experience, and professional titles were identified as influencing factors for emergency rescue attitudes. Lastly, the grade of the hospital where the medical staff were employed emerged as a significant factor affecting emergency rescue behavior. ConclusionMedical personnel play a vital role in the emergency rescue of PHEs however, there are notable differences in their knowledge, attitudes, and behaviors. It is recommended that targeted training, psychological support, and behavioral incentives be strengthened to enhance their capacity for effective response.

Exploring Antibacterial Usage and Pathogen Surveillance over Five Years in a Tertiary Referral Teaching Hospital Adult General Intensive Care Unit (ICU)

Antimicrobial resistance is a globally recognised health emergency. Intensive care is an area with significant antimicrobial consumption, particularly increased utilisation of broad-spectrum antibacterials, making stewardship programmes essential. We aimed to explore antibacterial consumption, partnered with pathogen surveillance, over a five-year period (2018 to 2023) in a tertiary referral adult general intensive care unit (ICU). The mean number of admissions was 1645 per annum. A comparison between the ICU populations admitted before and after the COVID-19 pandemic peak (2020/21) identified several notable differences with increased average daily unit bed occupancy (21.6 vs. 25.2, respectively) and a higher proportion of admissions with sepsis (28.4% vs. 32.5%, respectively) in the post-pandemic period. Over the entire five years, the overall proportion of antibacterial use by the WHO AWaRe classification was 42.6% access, 54.7% watch and 2.6% reserve. One hundred and forty-seven positive blood culture isolates were reported, with the most concerning antibacterial resistance identified in 7.5% (9 Escherichia coli and 2 Klebsiella pneumoniae isolates). The COVID-19 pandemic peak year was associated with increased ICU bed occupancy, as well as a greater number of positive blood cultures but lower antibacterial consumption. Despite an increasingly complex workload, a large proportion of overall antibacterial consumption remained within the access category. However, the mortality rate and the incidence of most concerning antimicrobial resistance with respect to pathogens remained satisfyingly consistent, suggesting the positive consequences of real-world antibiotic stewardship in an intensive care setting.

Monkeypox 2024 outbreak: Fifty essential questions and answers.

As the world still vividly recalls the previous monkeypox (mpox) outbreak that impacted over 120 countries worldwide with more than 99,000 cases in 2022, we are now facing a second wave of infections from the monkeypox virus (MPXV), characterized by an exponential increase in cases. The current 2024 outbreak has already recorded more than 20,000 cases in Africa, marking a dramatic escalation compared to previous outbreaks. The predominance of the newly identified clade Ib variant, first detected in the Democratic Republic of the Congo (DRC) and now identified across multiple African nations and beyond, underscores its enhanced transmissibility and potential for international spread, evidenced by cases in Sweden and Thailand. The World Health Organization (WHO) declared on August 14, 2024, the current mpox outbreak a Public Health Emergency of International Concern (PHEIC), calling for heightened global public health measures. The ongoing pattern of unusual, frequent, and extensive outbreaks of mpox with potential global implications poses significant questions. This review addresses, in the format of 50 questions and answers, the 2024 mpox outbreak, detailing its characteristics, epidemiological data, and impact compared to previous outbreaks. It comprehensively explores critical questions related to MPXV virological characteristics, immunological response, clinical manifestations, epidemiology, diagnostics, and available treatments. The review also documents the significant and evolving challenges posed by the current mpox outbreak, highlighting its scale, spread, and public health response.

Construction and application of the emergency resilience capability evaluation scale and model for grassroots medical workers: a cross-sectional study in Guangzhou, China

ObjectivePublic health emergencies pose a serious challenge to the ability of medical personnel to respond. We aimed to establish a scientific and effective resilience capability assessment scale for grassroots medical workers and explore the way to improve resilience.Research designDeveloped a resilience ability assessment scale and applied it on the medical personnel who worked in community health service centers for more than 1 year. Related indicators were identified through literature review and the Delphi method. The established scale was given weight using the attribute analytic hierarchy process, and the evaluation model was built through the grey correlation analysis.Principal findingsA three-level indicator scale was established, which included three first-level indicators [professional quality (weight 0.346), psychological capital (weight 0.614), and emergency attitude (weight 0.040)]. The second-level indicators had 13 contents and were further subdivided into 46 three-level indicators. The overall resilience ability assessment score of 347 medical workers in Guangzhou was only 0.787. However, steady scientific-exercise habits and relative training can help improve their public health emergency resilience ability (p &amp;lt; 0.05).ConclusionThe establishment of the scale can provide a strategic basis for improving the resilience strength of grass-roots medical personnel. We should encourage this group to form a good habit of exercise, strengthen their crisis awareness by actively organizing theoretical training and practical exercises on public health emergencies, and improve their psychological capital level.Patient or public contributionIn this study, 347 medical workers from 6 basic medical institutions in Guangzhou participated in the questionnaire.

The association between perceive social support and post-traumatic stress disorder symptoms among medical staff in Hubei, China: a chain mediating effect of resilience and positive coping

BackgroundEvidence suggests that PTSD symptoms following public health emergencies are influenced by many factors. The aim of this study was to investigate the relationship between perceived social support and Post-traumatic stress disorder symptoms and to explore the chain-mediated role of resilience and positive coping style, among medical staff in Hubei Province, China, during a public health emergency.MethodsConvenience sampling was used to select medical staff from two general hospitals in Hubei Province in July 2022 for this study. A total of 2,751 medical staff were included in the study. Multidimensional Scale of Perceived Social Support, 10- itemConnor- Davidson resilience scale, Simplified Coping Style Questionnaire and The Post-traumatic stress disorder Checklist for DSM-5 were used to assess the levels of perceived social support, resilience, coping style and Post-traumatic stress disorder symptoms of medical staff two years after the public health emergency. Statistical descriptions were conducted using SPSS, and a structural equation model was established using AMOS to analyze the chain-mediated roles of resilience and positive coping style between perceived social support and Post-traumatic stress disorder symptoms.ResultsStructural equation modeling results showed a standardized total effect of perceived social support on Post-traumatic stress disorder symptoms of -0.416 (95%CI [-0.456, -0.374], P < 0.001). Resilience mediated the effect of perceived social support and Post-traumatic stress disorder, with an indirect effect of -0.016 ( 95%CI [0.031, 0.001], P = 0.038). Positive coping mediated the effect of perceived social support and Post-traumatic stress disorder, with an indirect effect of -0.024 (95%CI [-0.035, -0.014], P < 0.001). Resilience and positive coping style chain-mediated between perceived social support and Post-traumatic stress disorder symptoms, mediating 17.1% of the total effect.ConclusionPerceived social support has significant direct and indirect effects on Post-traumatic stress disorder symptoms and resilience. In addition, positive coping style act as chain mediators between perceived social support and Post-traumatic stress disorder symptoms. We suggest that strengthening perceived social support for medical staff can enhance their resilience, encouraging them to adopt positive coping, which in turn reduces the level of post-traumatic stress symptoms among medical staff following public health emergencies.

Research on the evaluation of emergency management capability for urban public health emergencies under the perspective of resilience—a case study of Henan Province, China

With the rapid development of the economy and society, the likelihood of sudden public health emergencies in urban areas continues to rise. In particular, major infectious diseases that have gained global attention, such as the SARS virus, H1N1 influenza, Ebola outbreak, and COVID-19 pandemic, have presented significant challenges to urban emergency management systems. Evaluating emergency management capability is a fundamental requirement for developing emergency response capacity. To this end, this study combines the theory of resilience with the theory of full-process equilibrium emergency management, selects 31 evaluation indicators from six key aspects: preparedness, forewarning, mitigation, disposal, recovery, and learning. The indicator weights are determined using the AHP-Entropy Weight Method, and a TOPSIS model is constructed to assess the emergency management capability of urban public health emergencies. The model’s applicability is validated by examining 18 cities in Henan Province. The findings suggest that Jiaozuo, Hebi, Zhengzhou, and Luohe possess relatively robust emergency management capabilities for sudden public health incidents, whereas Kaifeng, Pingdingshan, and Shangqiu exhibit weaker capabilities.

Sentiment analysis in infodemic management: leveraging the eppm Risk communication model

Infodemics are the rapid spread of false or misleading information related to public health emergencies, often through digital platforms. They can cause confusion, fear, and even harm to public health. This study investigates the application of sentiment analysis for infodemic management during disease outbreaks. Leveraging the Extended Parallel Process Model (EPPM) of risk communication, the research aims to categorize rumors based on their perceived threat level (high, medium, or low). Machine learning is employed to analyze infodemic text data collected from two Nigerian states (Oyo and Bauchi) to assess threat appraisal according to the EPPM model. The findings can inform targeted interventions for effective infodemic management before, during, and after outbreak of diseases.

2024 Mpox outbreak: A rapidly evolving public health emergency of international concern

The declaration of a second Public Health Emergency of International Concern (PHEIC) for mpox in August 2024 underscores the urgent need for a comprehensive understanding of the evolving epidemiology [1] clinical manifestations, and zoonotic potential of this emerging threat [2]. This work delves into the intricate interplay between human and animal mpox infections, with a specific focus on the unique characteristics of various viral clades and their implications for individual and public health.There is a critical need to elucidate the factors driving multiple spillover events and the subsequent emergence of new clades better adapted to human-to-human transmission. We hypothesize that anthropogenic changes, including deforestation, urbanization, and climate change are facilitating increased human-to-animal contact, leading to more frequent zoonotic transmissions and viral adaptations. Our conceptual framework integrates One Health principles, evolutionary virology, and epidemiological modeling to investigate the demographic, clinical, and treatment differences among mpox clades in both humans and animals. We employ a mixed-methods approach, combining genomic analysis, clinical data review, and ecological surveys to construct a comprehensive picture of mpox's changing dynamics. The research questions explore the differences in epidemiological and clinical profiles among mpox clades and the factors that likely contribute to successful cross-species transmission and human adaptation.This manuscript introduces an updated Identify, Isolate, Inform (3I) Tool meticulously redesigned to significantly improve the early detection, containment, and reporting of mpox cases across diverse settings. By integrating clinical, virological, and ecological data, this work aims to lay the groundwork for enhanced risk assessment, targeted interventions, and global preparedness strategies in the face of this evolving zoonotic threat.

Scoping review of countries’ practices missed by health emergency preparedness and response quantitative tools: COVID-19 and Ebola response experiences

IntroductionAfter the COVID-19 pandemic and previous disease outbreaks, it is critical to continuously examine the preparedness measurement tools and level of country preparedness for future health emergencies. Existing preparedness quantitative...

Decision-making optimization for post-disaster restoration of multimodal transport networks in terms of resilience

IntroductionPublic health emergencies can have a ripple effect on the resilience of multimodal transport network, which will lead to problems such as route disruptions or blockages, route selection change and information transmission delay spreading to the whole network, further hindering the transportation planning and operational efficiency of the network. MethodsThis study constructs a multimodal transport route optimization model under uncertainty with the objective of the sum of transportation cost, transshipment cost, penalty cost and carbon emission cost. To enhance the computational efficiency of the model, a novel invasive weed optimization with memory and encoding value clustering capabilities is proposed. In addition, by fusing the Q-learning algorithm in reinforcement learning with the novel invasive weed algorithm, the action-value function table obtained from the training facilitates the selection of optimal routes. Based on empirical data, explore the sensitivity analysis of node disruptions, time windows, and fuzzy demand on route decision-making under public health emergencies. ResultsThe transport network is affected by public health emergencies, which makes the optimal route deviate from the expected goal, resulting in an increase in the total cost. The proportion of total cost is determined by the position of nodes in the network, with critical nodes suffering more losses than ordinary nodes. Reasonable setting of time windows and fuzzy demand intervals is an effective way to improve the resilience and transportation efficiency of multimodal transport network. ConclusionsThis study provides more applicable decision-making references for enterprises to prevent the risk of supply chain disruptions caused by public health emergencies.

Mass gathering events and COVID-19; lessons learnt from the 2020 European football championship.

Evidence about the impact of mass gatherings during the coronavirus disease 2019 (COVID-19) pandemic on the number of disease cases and on the health-care systems of host countries is limited. Additionally, there have been few publications on the lessons identified from the adaptation of mass gatherings held during the pandemic, including the implementation of comprehensive public health and social measures aimed at reducing viral transmission. This article describes preparations made for the 2020 Union of European Football Associations (UEFA) European Football Championship (UEFA Euro 2020) by the World Health Organization's (WHO) Regional Office for Europe, UEFA and other stakeholders after the championship had been rescheduled because of the COVID-19 pandemic. Technical guidance on preparations for the football tournament and risk assessment tools were provided by WHO. A task force established by the WHO Regional Office for Europe conducted traditional and event-based disease surveillance before and during UEFA Euro 2020, monitored public health and social measures in the 11 host countries, and developed a risk communication and community engagement strategy that involved multimedia campaigns targeting news and social media, fans, athletes, event organizers and other stakeholders. The lessons and good practices identified during UEFA Euro 2020 are described to help guide preparations for future mass gatherings in health emergencies. Sharing data and recommendations on best practice from previous mass gatherings with the organizers and countries involved in planning for a major event is particularly important.

INtelligent toolkit for reconnaissance, assessments and prehospital support in Perilous InciDents: a realistic experiment in prehospital environment

BackgroundFirst responders, when arriving at a disaster, need a rapid analysis of the environment in which they are going to operate, as they have to assess the conditions surrounding potential victims and neutralize any risks that may exist.The EU-funded INTREPID develops a new technology platform to assist first responders when arriving on the scene of a disaster. The project INTREPID aims to support safer operations in the form of more efficient, fast, and safe disaster site assessments. The objective of the study is to implement new technologies into rescue operations to facilitate and improve situational awareness and operation management capabilities to save lives.The focus of the study is relevant to the field of mass casualty incident management and disaster, as proper communication is extremely relevant in the management of catastrophes.MethodThe first phase of the project started with a qualitative methodology SCRUM, for catching the end user’s feedback and requirements to design the interface platform. It was developed a platform to support first responders in disasters areas improving the 3D scanning and analysis of disaster areas. This platform is based on the concepts of intelligence amplification and eXtended Reality, with hololens, drones and robots. The project continued with a β phase in which the platform with all tools integrated were tested in simulated mass casualty disasters.ResultsThese technologies are tested in different disaster scenarios: A flooded subway stop in Stockholm, an accident in the chemical industry in Marseille, and a man-made explosion in a hospital in Madrid. Through this platform, first responders can immediately initiate operations without exposing personnel to potential harmful risks without specialized equipment, with all important information shared and coordinated, among all responders, whether they are security, firefighters, or emergency health professionals.ConclusionsThe performance pilots and the questionnaire results validated the effectiveness and usability of the final version of the INTREPID platform and tools.

The dermatological manifestations and differential diagnosis of monkeypox: A narrative review.

Monkeypox (MPX) is a zoonotic viral disease caused by the monkeypox virus (MPXV), which belongs to the Orthopoxvirus genus. The main clinical features of MPX are fever, rash, and lymphadenopathy. It is usually a self-limited disease and can resolve within a few weeks in most cases. MPXV is now becoming a global concern. The world health organization declared the outbreak of MPX in 2022 a global health emergency. In this article, we focus on the mucocutaneous manifestations and differential diagnosis of MPX.

Effects of fine particulate matter from wildfire and non-wildfire sources on emergency-department visits in people who were housed and unhoused in San Diego County (CA, USA) during 2012–20: a time-stratified case–crossover study

Being unhoused can increase vulnerability to adverse health effects due to air pollution. We aimed to quantify changes in emergency-department visits during and after exposure to wildfire-specific and non-wildfire particulate matter 2·5 μm or less in diameter (PM2·5) in San Diego County (CA, USA) in people who were both unhoused and housed. For this time-stratified case-crossover study, we used data on exposure to wildfire-specific PM2·5 in California and individual-level data for people admitted to the emergency departments of two hospitals (UC San Diego Health emergency departments at La Jolla and Hillcrest, San Diego) in San Diego County between July 1, 2012, and Dec 31, 2020. People with a postcode outside of San Diego County were excluded. Demographic information was age group, race or ethnicity, and transport to the emergency department. Wildfire-specific PM2·5 concentration at the postcode level was previously estimated using an ensemble model that combined multiple machine-learning algorithms and explanatory variables obtained via data on 24-h mean PM2·5 concentrations from the US Environmental Protection Agency Air Quality System. Conditional logistic regression models were applied, adjusting for specific humidity, wind velocity, and maximum temperature extracted from the US Gridded Surface Meteorological Dataset. Housing status was established by registration staff or triage nurses on arrival at the emergency department. For people who were unhoused, exposure was defined based on the weighted mean PM2·5 concentration at the city level proportional to the number of people who were unhoused in each specific city across urban centres in San Diego County. For people who were housed, we used residence postcode to measure exposure. We assessed the association between PM2·5 from wildfire and non-wildfire sources and emergency-department visits in people who were housed and unhoused. There were 587 562 emergency-department visits at the two hospitals, 76 407 (13·0%) of which were by people who were unhoused. People who were housed had a higher exposure to overall PM2·5 (24-h mean over the study period of 9·904 mg/m3, SD 3·445) and non-wildfire PM2·5 (9·663, 2·977) than people who were unhoused (9·863, 3·221; 9·557, 2·599). However, people who were unhoused had a higher exposure to wildfire-specific PM2·5 (0·305, 1·797) than people who were housed (0·240, 1·690). Overall PM2·5 exposure was associated with increased odds of emergency-department visits for both people who were housed (odds ratio 1·003, 95% CI 1·001-1·004 per 1 μg/m3 PM2·5 for 0-3 days after exposure) and people who were unhoused (1·004, 1·000-1·008 for 0-3 days after exposure). We found that non-wildfire PM2·5 was associated with emergency-department visits among people who were housed (1·003, 1·002-1·005 for 0-3 days after exposure) and wildfire-specific PM2·5 was associated with emergency-department visits in people who were unhoused (1·006, 1·001-1·011 for 0-3 days after exposure). People who were unhoused in San Diego County were more likely to visit emergency departments after exposure to increased wildfire-specific PM2·5. As the intensity and frequency of wildfires increase, understanding risk factors for vulnerable populations, such as people who are unhoused, is crucial to develop effective adaptation strategies. US National Institutes of Health, National Institute on Aging.

Challenges and prospects of clinical trials in Nigeria - Lessons from the WHO COVID-19 solidarity plus trial

Conducting randomized clinical trials (RCTs) during a pandemic is essential for obtaining timely evidence on safe and effective treatments, but it presents numerous obstacles. During the COVID-19 pandemic, the World Health Organization (WHO) sponsored multinational RCTs investigating repurposed drugs among hospitalized COVID-19 patients across countries with varying clinical research capacities. In Nigeria, several challenges hindered our progress, including inadequate infrastructure, initial insufficient investigator certification and expertise, and delays in securing regulatory approvals due to bureaucratic hurdles. Despite these challenges, the WHO-sponsored Solidarity Plus Trial (SPT) offered valuable opportunities to enhance research capacity, streamline participant enrolment through electronic randomization, and bolster infection prevention and control measures for healthcare workers. Moreover, the trial enabled us to upgrade infrastructure at multiple sites, facilitating improved case detection through more testing and data collection. A crucial lesson learned was the importance of expediting trial initiation to capitalize on the limited window for data collection during an outbreak. To optimize RCTs during pandemics, we advocate for enhanced community engagement, collaborative efforts across sectors, strengthened research capacity, flexible regulatory frameworks, and the establishment of adaptive clinical trial units. By addressing these challenges and leveraging opportunities, we can significantly enhance the efficiency and impact of RCTs during public health emergencies.

An Analysis of Psychological Capital and Influencing Factors Among Disaster Care Reservists

IntroductionIn recent years, with the frequent occurrence of public health emergencies, various infectious diseases and natural disasters (earthquakes, tsunamis, and fires have placed a burden on global public health and health care systems, especially on health care workers. This study aimed to investigate the current state of psychological capital among disaster care reservists and the factors influencing it. MethodsBetween January and February 2024, a total of 330 members of the disaster nursing reserve team from 4 tertiary general hospitals in Mianyang, China, were surveyed using an online platform named Wenjuanxing to obtain information on general demographics, psychological capital, and job burnout. ResultsThe total score of psychological capital was 91.10 ± 16.15. Psychological capital was negatively correlated with emotional depletion dimension and depersonalization dimension scores (P < .01) and positively correlated with personal achievement dimension scores (P < .01). The results of multiple regression analysis revealed that the psychological capital of members in disaster nursing reserve teams was influenced by various factors such as their marital status, having children, work experience in the department, level of public recognition and respect, number of disaster relief trainings, participation in disaster relief activities, types of disaster relief activities, and level of job burnout (P < .05). This accounted for 48.9% of the total variation. DiscussionThe psychological capital of disaster nursing reserve team members is affected by several aspects, which warrant great attention. Relevant management departments should adopt appropriate strategies to effectively mobilize their self-efficacy, improve their professional identity and sense of achievement, and enhance their psychological capital level.

Ethical Healthcare During Public Health Emergencies: A Focus on Non-COVID-19 Patients

Ethical Healthcare During Public Health Emergencies: A Focus on Non-COVID-19 Patients

Loss Of Public Health Emergency Funds Challenges The Financial Viability Of Nursing Homes, Especially Not-For-Profit Facilities.

Before the COVID-19 pandemic, for-profit nursing homes' revenue generally covered their costs, whereas not-for-profit nursing homes often needed donations and other nonpatient revenue to cover expenses. The unprecedented challenges presented by the pandemic caused the industry to report operating losses that were larger among not-for-profits and facilities relying on agency staff. COVID-19 public health emergency funding allowed nursing homes to remain profitable through 2021. By 2022, as these public health emergency funds were cut back, for-profit nursing homes had overall net incomes of $1.68 per resident day, whereas not-for-profit nursing homes lost $31.18 per resident day. Without public health emergency funds, for-profit and not-for-profit nursing homes would have had losses of $7.47 and $42.35 per resident day, respectively, in 2022. These results indicate that as public health emergency funds are entirely withdrawn, the long-term financial viability of nursing homes, especially not-for-profits, will be seriously challenged.