Rethinking local resilience for extreme heat events.

OBJECTIVE: This study aims to provide insights into how local resilience structures in England can be leveraged to deliver a whole-of-society approach to managing a national response to extreme heat events during summer months. STUDY DESIGN: A communication based on the literature review of currently available research on health emergency response and extreme heat events in England. METHODS: This communication draws insights from the authors' research programmes, which examined national-level public health emergency response during the COVID-19 pandemic and literature review of the latest available English research on health and extreme heat events. RESULTS: Periods of extreme heat are on the rise in England. Local resilience forums (LRFs), due to their multiagency nature, offer a shared situational awareness and understanding of the need in their local communities. Such information is critical to ensure messaging about heat risks and available resources are tailored to reach specific targeted groups within their communities. Scenario planning and adaptation efforts require a more local articulation which LRFs are well placed to manage. CONCLUSIONS: LRFs are well suited as key structures in the English emergency response to extreme heat events. We suggest that English public health and hospital organisations, working with community partners via the LRFs, must develop their thinking about pressures from adverse weather in the summer months.

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.