National Emergency Preparedness Research Articles

Large scale system transformation: Ukraine

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

Research on electromagnetic pulse signal detection method based on intelligent compressed sensing technology

Abstract Electromagnetic pulse signal measurement is crucial for national security, scientific research, technological advancement, and emergency preparedness, playing a vital role in various aspects of modern society. In this work, an electromagnetic pulse signal detection approach utilizing compressed sensing technology is suggested. By unitizing three parallel low-frequency analog-to-digital converters, the high-frequency acquisition waveform of the measured electromagnetic pulse signal can be recovered. The compressed sensing effect of the proposed system on electromagnetic pulse signal is tested by simulation, which verifies the feasibility of this method.

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

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

Impact of COVID-19 Lockdown on Emergency Department Visits, Hospital Admissions, and Mortality in Northern Jordan: An Interrupted Time Series Analysis

Background: The Jordanian healthcare system was significantly affected by the COVID19 pandemic, as lockdowns and infections strained the healthcare system. The impact of the ensuing national lockdown on emergency department visits, hospital admissions, and mortality is unclear. Purpose: To assess the impact of COVID-19 lockdown on the pattern of emergency department visits, hospital admissions, and mortality at a major hospital in northern Jordan. Methods: An electronic database belonging to King Abdullah University Hospital was used for a retrospective analysis, and the data was accessed in 2022. All patients who visited the emergency department before, during, and after the lockdown in 2020 and 2019 were analyzed using an interrupted time-series analysis. Descriptive statistics were calculated for categorical variables, followed by the Wilcoxon Signed-Ranks Test to detect mean differences. Results: ED visits decreased by 53.5% during the lockdown period and by 22% after the lockdown period compared to the same periods a year before. During lockdown, hospital admissions rose significantly from 11.8% in 2019 to 17.1% in 2020, with 23.96% critical care unit admissions. Post-lockdown, ED admissions increased from 11.3% in 2019 to 16.3% in 2020, with critical care admissions rising to 30.10%, and the mortality rate increased by 50%. Conclusion: The study concluded a decrease in hospital admissions and emergency visits during lockdown, but an increase in mortality rates. Future planning should focus on optimizing care for lifethreatening emergencies, improving national emergency preparedness, and developing Hospital Readiness Checklists for effective response to emergencies like COVID-19. Implications for Nursing: Nursing has faced challenges and changes due to the COVID19 lockdown. Patient admissions decreased after the 2020 lockdown, impacting nursing practice, mental health, and patient care. Nurses should be adapted to telehealth services, maintain care remotely, and address nurses’ mental health issues. Virtual tools should be utilized to connect with patients. Keywords: Jordan, COVID-19, Lockdown, Emergency department, Hospital admissions, Interrupted time series analysis.

Conclusions from a needs analysis: The PIO training gap in the National Preparedness Goal.

At the national level, the field of emergency management has distinctive capabilities and responsibilities organized by the United States Department of Homeland Security and Federal Emergency Management Agency (FEMA) doctrine. Key to this doctrine is the goal: a secure and resilient nation. This goal is known as the National Preparedness Goal (NPG). The NPG is supported by five missions, and these five missions are supported by 32 core capabilities. One of the core capabilities is Public Information and Warning. This core capability is so important and spans all five missions. ". . . Public information is a vital function in disaster operations that contributes greatly to saving lives and protecting property." Public information officers (PIOs) are responsible for collecting, analyzing, verifying, and communicating risk, crisis, and recovery information to a wide variety of people across the "whole community." This needs analysis conducted as a component of this paper demonstrated a need for a strategic, coordinated, and unified approach to training PIOs in the NPG. A review of employee training literature, along with the conclusions from the needs analysis and the central role the NPG plays in FEMA doctrine, revealed the value of integrating the NPG into PIO training. The purpose of this paper was to determine to what extent the NPG identifies training procedures to empower PIOs to fulfill their communication responsibilities within the NPG and to determine if current PIO training is preparing PIOs to support their NPG responsibilities. Content analysis methodology was used to determine to what extent training was described within the NPG. Cross-tabulation (Crosstab) methodology was utilized to determine coincidence between existing PIO training course learning objectives (CLOs) and the NPG. This paper may serve as a framework for aligning PIO training with the NPG. Furthermore, once completed, this paper may serve as tool to evaluate PIO training, communication planning, and post-incident after-action reports. Content analysis of the NPG revealed no description of training recommendations or training regimen for PIOs and/or emergency managers to fulfill their NPG responsibilities. Crosstab methodological data analysis revealed a 53 percent coincidence between the NPG and the PIO CLOs. The NPG is FEMA's standard for national emergency preparedness. Communication, and thus PIOs, plays a significant part in fulfilling this standard. The more PIOs can be trained in achieving the NPG communication mission, the more resilient the whole community will be when there are crises.

Building on Success Serving the Nation: Codifying Key Pharmacy Practice Authorities Beyond COVID-19.

Building on Success Serving the Nation: Codifying Key Pharmacy Practice Authorities Beyond COVID-19.

Developing a HazMat Decontamination Training Program for a Hospital in Singapore for National Emergency Preparedness.

Introduction:Sengkang General Hospital (SKH) is a part of the national network of hospitals to respond to civil emergencies including hazardous material (Hazmat) incidents in Singapore. The HDS course aims to train our staff on basic knowledge of the effects of hazardous material exposure and the operations of the HDS.Method:HDS course was planned in three phases:Phase one aimed to train all DEM personnel so as to have a critical mass of personnel equipped to operate the HDS upon immediate notice. Phase two involves hospital staff from non-emergency departments. Material and simulations for phase two was simplified to focus on the skills and prompt decontamination. Phase three aims to test out capabilities of HDS and review processes through department simulations and hospital.Results:155 staff have completed HDS training since 2019, amongst them, 23 as instructors. 67.7% found the demonstrations, skills and practices exceeded expectations. 69% were able to apply skills taught during simulation and overall, 71.2% were able to understand topics covered in the modules.SKH was at the forefront of battling Covid-19 and resources were tight. We have resumed trainings to complete Phase two. We aim to train more than 35% of manpower in non-emergency departments to achieve higher recall.Conclusion:Training for national emergencies is challenging. HDS is located right outside the emergency department and has advantages of allowing smooth traffic to decontaminate patients and prompt treatment. However, training can get disrupted with incoming ambulances, patient influx and lack of resources.SKH aims to be well prepared in handling pandemics and still maintain its capabilities in assisting in national emergencies. There are plans for hospital simulation exercises for all relevant stakeholders and internal and external reviews are required to improve decontamination systems and processes. It is important to continue training hospital personnel to support HDS during crises.

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

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

Stress, anxiety, and depression among healthcare workers during the COVID-19 pandemic in Kosovo

Abstract Background The COVID-19 pandemic has created a very large workload burden on health systems worldwide, Kosovo is no exception to this trend. A pandemic may have a negative impact on health care workers’ (HCWs) mental health. In this cross-sectional study, we assessed the self-reported prevalence of stress, anxiety, and depression and identified their predictive factors among HCWs in Kosovo. Methods Data were collected on sociodemographics (sex, age, occupation, education, workplace) and the presence and severity of depression, anxiety, and stress through the 21-item Depression, Anxiety, and Stress Scale (DASS-21) online questionnaire. Descriptive statistics, t-tests, and linear logistic regression were used to analyze the data. Results Of the 545 respondents, the majority were male (53.0%), under 60 years of age (94.7%), and married (81.7%). Most of them were physicians (78.2%), while the remaining respondents were nurses, midwives, and other health professionals (22%). The prevalence rates for moderate to extremely high levels of stress, anxiety, and depressive symptoms were 21.9%, 13.0%, and 13.9%, respectively. Nurses reported significantly higher mean scores for depression and anxiety than physicians (P < 0.05). Being married, having poor health, not exercising, and reporting ‘burnout’ from work significantly predicted higher levels of depressive, anxiety, and stress symptoms among health workers (P < 0.05). Conclusions HCWs require specific national mental health intervention programs that will, among other effects, help raise awareness of the early recognition of symptoms related to stress, anxiety, depression, and burnout due to workload as well as the importance of regular physical exercise. These programs should be part of the national emergency preparedness, emergency response, and health sector strategy, aiming to build and sustain a resilient health system. Key messages • During COVID-19 pandemic, certain factors predicted higher levels of mental health burden among HCWs. • Addressing these factors require policy recommendations with concrete systemic interventions.

예비전력(豫備戰力) 실효성 확보를 위한 국가비상대비체계 발전 방향 연구

The purpose of this study is to present the development direction of the national emergency preparedness system in Korea. Considering that the creation of reserve forces is based on the national emergency preparedness system, for Securing the Effectiveness of Reserve Forces should precede the development of the national emergency preparedness system. To summarize the study results, first, in terms of laws and regulations, the Fundamental Act on National Crisis Management should be enacted first to lay the foundation for adjusting and controlling various crisis management laws. The effectiveness of the wartime waiting law (draft) should be improved through the peaceful legalization. It was proposed that the Act on Partial Mobilization to Overcome Crisis, such as Local War, should be enacted in peacetime. Second, In terms of reinforcing of organization and manpower organization, the Emergency Preparedness Policy Bureau of the Disaster and Safety Management Headquarters of the Ministry of the Interior and Safety needs to be promoted to the Vice Minister-level Emergency Preparedness Headquarters, and the central and local emergency preparedness organization needs to be standardized and job education and training. If follow-up study on emergency preparedness plan, mobilization resource management and execution, including related laws and organizational development directions proposed in this study, it is expected that the current national emergency preparedness system will be resolved and the reserve forces will be established.

Challenges and Opportunities for Risk Management of Volcanic Hazards in Small-Island Developing States

The explosive volcanic eruptions of La Soufrière volcano, St Vincent and the Grenadines, in April 2021 caused the displacement of thousands of people, resulting in heavy disruption of livelihoods and economic activities, destruction of critical infrastructure, and volcanic ash deposits that affected the entire mountainous island of St Vincent and the neighboring island of Barbados. The resulting triple crisis in the region included volcanological risks, the prevailing COVID-19 pandemic, and hydrometeorological risks due to the approaching hurricane season. This article analyzes the scientific and operational activities that The University of the West Indies Seismic Research Centre undertook after effusive activity was detected in December 2020, as well as the actions taken during an official response mission of the United Nations, led by the Joint Environment Unit of the United Nations Environment Programme and the United Nations Office for the Coordination of Humanitarian Affairs in Geneva and upon request for international environmental assistance from the Government of St Vincent. It examines the interplay and collaboration between these 2 organizations and other disaster risk reduction agencies. The article also highlights how the interconnected, systemic nature of risks and disasters emphasizes the ultimate need for regional coordination and collaboration across sectors, including scientific monitoring networks; national, regional, and international emergency preparedness and response agencies; academia; and the private sector. The presented case study for elucidating the ongoing lahar hazard at La Soufrière volcano supports a long-term view for planning and mitigation in this challenging topography. This will help to ensure that the volcanic risks in the Caribbean region are appropriately considered a major component of the multihazard approach undertaken by national authorities and scientists to manage community safety and sustainable economic development through adequate means of disaster risk reduction and emergency preparedness.

Experience with open schools and preschools in periods of high community transmission of COVID-19 in Norway during the academic year of 2020/2021

BackgroundSchools and preschools have largely remained open in Norway throughout the pandemic, with flexible mitigation measures in place. This contrasts with many other high-income countries that closed schools for long periods of time. Here we describe cases and outbreaks of COVID-19 in schools and preschools during the academic year 2020/2021, to evaluate the strategy of keeping these open with infection prevention control measures in place.MethodsIn this descriptive study, the Norwegian Institute of Public Health initiated systematic surveillance for COVID-19 cases and outbreaks in schools and preschools in October 2020. Data was compiled from the national outbreak alert system VESUV, municipality websites, and media scanning combined with the national emergency preparedness register Beredt C-19. An outbreak was defined as ≥ 2 cases among pupils or staff within 14 days at the same educational setting. Settings were categorized as preschool (1–5-years), primary school (6–12-years), lower secondary school (13–15-years) and upper secondary school (16–18- years). We reported the incidence rate among preschool and school-aged pupils and gave a descriptive overview of outbreaks and included cases per educational setting.ResultsDuring the whole academic year, a total of 1203 outbreaks in preschools and school settings were identified, out of a total of 8311 preschools and schools nationwide. The incidence of COVID-19 in preschool- and school-aged children and the rates of outbreaks in these settings largely followed the community trend. Most of the outbreaks occurred in primary schools (40%) and preschools (25%). Outbreaks across all settings were mostly small (median 3 cases, range 2 to 72), however, 40 outbreaks (3% of total) included 20 or more cases. The larger outbreaks were predominantly seen in primary schools (43%).ConclusionsWe observed few large outbreaks in open schools and preschools in Norway during the academic year of 2020/2021, also when the Alpha variant was predominant. This illustrates that it is possible to keep schools and preschools open even during periods of high community transmission of COVID-19. Adherence to targeted IPC measures adaptable to the local situation has been essential to keep educational settings open, and thus reduce the total burden on children and adolescents.

Embedded Social Science and the British Government COVID-19 Response

The complex and evolving nature of the SARS-CoV-2 pandemic poses significant challenges to national and international emergency preparedness and response. Governments must navigate streams of emerging data in real time, synthesising knowledge from diverse sources to inform policy. The UK government drew on experiences from earlier pandemics to bridge perceived gaps between social science research and policy through the secondment of early-career academics as embedded scientists. In this article, we present comparative ethnographic data describing embedded social scientists’ contributions to UK COVID-19 preparedness and response. We find that the liminal position, loose identities, and high degree of autonomy of embedded scientists allowed these individuals to navigate multiple networks to strengthen and legitimise the role of social science within policy debates.

SARS-CoV-2 infections and hospitalisations among immigrants in Norway-significance of occupation, household crowding, education, household income and medical risk: a nationwide register study.

Background:As in other countries, the COVID-19 pandemic has affected Norway’s immigrant population disproportionately, with significantly higher infection rates and hospitalisations. The reasons for this are uncertain.Methods:Through the national emergency preparedness register, BeredtC19, we have studied laboratory-confirmed infections with SARS-CoV-2 and related hospitalisations in the entire Norwegian population, by birth-country background for the period 15 June 2020 to 31 March 2021, excluding the first wave due to limited test capacity and restrictive test criteria. Straightforward linkage of individual-level data allowed adjustment for demographics, socioeconomic factors (occupation, household crowding, education and household income), and underlying medical risk for severe COVID-19 in regression models.Results:The sample comprised 5.49 million persons, of which 0.91 million were born outside of Norway, there were 82,532 confirmed cases and 3088 hospitalisations. Confirmed infections in this period (per 100,000): foreign-born 3140, Norwegian-born with foreign-born parents 4799 and Norwegian-born with Norwegian-born parent(s) 1011. Hospitalisations (per 100,000): foreign-born 147, Norwegian-born with foreign-born parents 47 and Norwegian-born with Norwegian-born parent(s) 37. The addition of socioeconomic and medical factors to the base model (age, sex, municipality of residence) attenuated excess infection rates by 12.0% and hospitalisations by 3.8% among foreign-born, and 10.9% and 46.2%, respectively, among Norwegian-born with foreign parents, compared to Norwegian-born with Norwegian-born parent(s).Conclusions: There were large differences in infection rates and hospitalisations by country background, and these do not appear to be fully explained by socioeconomic and medical factors. Our results may have implications for health policy, including the targeting of mitigation strategies.

AWR: Anticipate, Withstand, and Recover Resilience Metric for Operational and Planning Decision Support in Electric Distribution System

With the increasing number of catastrophic weather events and resulting disruption in the energy supply to essential loads, the distribution grid operators’ focus has shifted from reliability to resiliency against high impact, low-frequency events. Given the enhanced automation to enable the smarter grid, there are several assets/resources at the disposal of electric utilities to enhances resiliency. However, with a lack of comprehensive resilience tools for informed operational decisions and planning, utilities face a challenge in investing and prioritizing operational control actions for resiliency. The distribution system resilience is also highly dependent on system attributes, including network, control, generating resources, location of loads and resources, as well as the progression of an extreme event. In this work, we present a novel multi-stage resilience measure called the Anticipate-Withstand-Recover (AWR) metrics. The AWR metrics are based on integrating relevant ‘system characteristics based factors’, before, during, and after the extreme event. The developed methodology utilizes a pragmatic and flexible approach by adopting concepts from the national emergency preparedness paradigm, proactive and reactive controls of grid assets, graph theory with system and component constraints, and multi-criteria decision-making process. The proposed metrics are applied to provide decision support for a) the operational resilience and b) planning investments, and validated for a real system in Alaska during the entirety of the event progression.

The new map of injuries in the aftermath of the COVID-19 pandemic: examples from north with south Europe

The aim of this paper is to describe the impact of the pandemic on injuries. Data from National Injury Surveillance System of Norway and Portugal during Covid-19 period were analyzed. In Norway hospital data on injury diagnoses were collected from a national emergency preparedness register established during the pandemic. The number of injured patients per day in the period 1 January-30 June 2020 were identified. The change in patient volumes over two three-week periods before and during the lockdown by sex, age, level of care, level of urgency, type of contact and type of injury were analysed. In Portugal we described the temporal trend in 2020 of the Home and Leisure Accidents(HLA) among vulnerable groups(0-19years, 65years+), who needed attendance in Emergency Department(ED) of the National Health Service Hospitals. In 2019 and 2020, 240 538 HLA episodes were recorded in the age groups of interest. In Norway, there was an overall reduction of 43% in injured patients during the first three weeks of lockdown. The decrease in patient contacts did not differ by sex, but was most pronounced among young people. Substantial reductions were observed for both acute and elective treatment and across all levels of care and types of contact, with the exception of indirect patient contacts. The change in patient contacts varied considerably by injury type, with the largest reduction observed for dislocations/sprains/strains and a lower decrease for burns/corrosions/poisoning. Similar trend was observed in Portugal on home and leisure accidents episodes rate registered in children and young people up to 19 years decreased by 24,0% during the 2020 year. In groups of 10-14 years the greatest significant decrease of 35,2% was observed, followed by groups of 5-9 years with a decrease of 24,1%. In 65-74 years an increase of 13,2% was recorded, with the highest increase(19,1%) among people aged 75+. Implications for the health systems and health policy planning will be discussed.

국가위기관리체계 발전 방향

Recently, as the U.S. and China's hegemony competition has intensified, a new Cold War is being formed in East Asia where the world's military power is concentrated, and the security crisis is increasing, such as the continuous increase of North Korea's nuclear threat. This study examined the national crisis management system of the previous regimes in Korea and analyzed the laws and regulations related to the national crisis management, the organizational system, the control tower, and the consultative body to suggest the direction of the development of the national crisis management system that can cope with the future crisis situation. As a result, in the legal system field, the enactment of the “National Crisis Management Basic Act” which is the most basic of the national crisis management system is essential, and the grading of the national crisis alarm and the supplementation of the national crisis management stage were required. The organizational system and control tower suggested a plan to strengthen the function of the national emergency preparedness while controlling the crisis management in the disaster field by organizing the national crisis management execution control tower in the prime minister's office while the national security office serves as the control tower for the national crisis management. In addition, the councils operated according to individual laws and regulations were proposed to unify into the National Crisis Management Council so that they could cope efficiently if a large-scale crisis occurs simultaneously. Like the “Umbrella on a Clear Day,” the crisis is not predictable, and what is expected, prepared, and not known is the difference between heaven and earth. The crisis situation that will come in the future should be recognized as a scale and form beyond the imagination of mankind, and should be supplemented and developed by law, system and organizational system.

Canadian health emergency management professionals’ perspectives on the prevalence and effectiveness of disaster preparedness activities in response to COVID-19

Emergency management (EM) professionals play an integral role in preparing healthcare organizations for disasters but evidence of their pervasiveness in Canadian healthcare is limited. Through an exploratory Canada-wide survey of EM in healthcare organizations, we aim to develop understanding of the prevalence and effectiveness of the disaster preparedness activities enacted in preparation for COVID-19. The online survey generated 161 responses; 150 (93%) had EM responsibility. EM reported that reviewing infectious disease (pandemic) plans and protocols was the most widespread activity (82%), while simulation-based exercises was the least (26%). Organizational incident management response to COVID-19 was led by a sole ‘incident commander’ 61% of the time, while 39% of ‘incident commands’ were led by multiple individuals. Of all those assigned to lead IM, only 68% received training in that role. Overall, the prevalence of disaster preparedness activities in healthcare organizations was positively associated with leaders who received training in incident response and having a dedicated EM resource. Meanwhile, the overall effectiveness of activities was positively correlated with having a sole ‘incident commander’ and was found to improve as the overall prevalence of activities rose. The study provides strong evidence for regional, organizational, and EM resource variation in the delivery of disaster preparedness activities and training for leaders in Canadian healthcare. Hence, we recommend the creation of a national health emergency preparedness system which includes legislated standards and a national training centre to ensure Canadian healthcare is bolstered against future disasters including pandemics.

PANDEMIC COVID-19: COMPARATIVE STUDY OF SOCIAL AND SCIENTIFIC DEVELOPMENTS BY PUNJAB AND SINDH GOVERNMENTS IN PAKISTAN

Purpose: The study analyzes the growing situation of Covid-19 in Pakistan and highlights the recent scientific and social developments made during this pandemic. The paper highlights the exertions of the government of Pakistan in general and especially the preventing measures taken by the Punjab and Sindh government to fight this pandemic. The paper discusses the emergency preparedness and response to the Covid-19 in Pakistan. Method: This research uses publicly available data to inspect the current situation of epidemic Covid-19 and its preventive measures in Pakistan, especially in Punjab and Sindh province. Besides, documents on the website of the daily situation report of NIH (National Institute of Health), WHO covid-19 dashboard (services and coordination) Ministry of National Health Regulation, different scholarly articles, and already existing world reports have been reviewed and analyzed Main Findings: The outbreak of Covid-19 was experienced first time in December 2019 at Wuhan city of China which spread promptly in China and then all-inclusive in 213 other countries including Australia, Asia, Europe, America, and Pakistan as well. Experts believed that in a developing country like Pakistan, its effects would be devastating. It has caused approximately 2, 862, 664 deaths and affected more than 131, 837, 512 people worldwide, while its statistics are growing fast. However, several steps have been adopted to overcome Covid-19 worldwide. Even, drastic measures were taken with limited resources in Pakistan to curb the growing situation of Covid-19 such as lockdown, awareness campaign, quarantine facilities, special hospitals, and laboratories for testing the virus. Application of the Study: The results of this research help the Pakistani government to make their policies more target-ordinated and systematic to cure this pandemic to restore its vigilance with available resources against Covid-19 and trained human capacities, laboratory networks, policy formulation, and national emergency preparedness. The originality of the Study: This research contributes that confusion and uncertainty between the policies of the federal government and provinces on lockdown measures could lead the thousands of untimely deaths. Experts believed that in a developing country like Pakistan, its effects would be devastating. Despite its limited resources, Pakistan took a stand against an epidemic coronavirus and made it a single-point agenda by all the provinces of Pakistan.

Impact of the COVID-19 pandemic on the treatment of injuries during lockdown in Norway.

In order to prevent a major outbreak of COVID-19 disease in Norway, a series of lockdown measures was announced on 12 March 2020. The aim of the present paper was to describe the impact of this lockdown on the treatment of injuries. We collected hospital data on injury diagnoses from a national emergency preparedness register established during the pandemic. We identified the number of injured patients per day in the period 1 January-30 June 2020, and analysed the change in patient volumes over two three-week periods before and during the lockdown by sex, age, level of care, level of urgency, type of contact and type of injury. Compared to pre-lockdown levels, there was an overall reduction of 43% in injured patients during the first three weeks of lockdown. The decrease in patient contacts did not differ by sex, but was most pronounced among young people. Substantial reductions were observed for both acute and elective treatment and across all levels of care and types of contact, with the exception of indirect patient contacts. The change in patient contacts varied considerably by injury type, with the largest reduction observed for dislocations/sprains/strains. The decrease was much lower for burns/corrosions and poisoning. A substantial reduction in the treatment of injuries was observed during lockdown in Norway. Possible explanations for this finding include an overall decrease in injury risk, a redistribution of hospital resources and a higher threshold for seeking medical attention as a result of the pandemic.