Perception of Hurricane and COVID-19 Risks for Household Evacuation and Shelter Intentions

The COVID-19 pandemic presented new challenges for scholars and government officials to predict people's evacuation decisions under a conflicting natural disaster. In this study, we examined households' evacuation and shelter intentions given the potential conflicts between the perceived risks from a hurricane and the coexisting public health crisis. We surveyed households living inside hurricane evacuation zones in Florida during the 2020 hurricane season. Data were first used to examine the evacuation and shelter intentions before and during the pandemic. We then measured respondents' hurricane and COVID-19 risk perception, respectively. The impacts of both risk perceptions on respondents' hurricane evacuation intentions were explored. We found that when people felt unsafe to stay home for a Category 2, 3, or 4 hurricane, their intended evacuation was about the same before and during the pandemic regardless of their COVID-19 risk perception. The COVID-19 risk perception, however, significantly lowered the evacuation intention for a Category 1 hurricane. It also significantly influenced evacuees' preference for nontraditional shelters such as government-contracted hotels. The results of our study have practical implications for emergency management and public health governance. Our study also provides insights into decision-making under the conflict between natural hazards and infectious diseases. (English) [ FROM AUTHOR] La pandemia del COVID-19 planteó nuevos retos a los eruditos y funcionarios gubernamentales para predecir las decisiones de evacuación de la gente sometida a un desastre natural conflictivo. En este estudio, examinamos la evacuación e intenciones de albergue de familias teniendo en cuenta potenciales conflictos entre los riesgos percibidos de un huracán y las crisis coexistentes en la salud pública. Encuestamos a las familias que residían en las zonas de evacuación por huracanes de la Florida durante la temporada de huracanes del 2020. Los datos se usaron primero para examinar las intenciones de evacuación y de refugio antes y durante la pandemia. Después, medimos la percepción del riesgo de afectaciones por huracanes y COVID-19 de los encuestados, respectivamente. Se exploraron los impactos de ambos tipos de percepciones de riesgo en las intenciones de evacuación, por encuestado. Hallamos que cuando la gente se siente insegura de permanecer en casa frente a huracanes de las categorías 2, 3 y 4, su evacuación intencionada era más o menos la misma de antes y durante la pandemia, sin importar la percepción del riesgo de COVID-19. No obstante, la percepción del riesgo de COVID-19 redujo de manera significativa la evaluación de la intención de evacuación para un huracán de categoría 1. Eso también influyó significativamente en la preferencia de los evacuados por refugios no tradicionales, como los hoteles contratados por el gobierno. Los resultados de nuestro estudio tienen implicaciones prácticas en el manejo de las emergencias y la gobernanza de la salud pública. También proporciona nuestro estudio nuevas visiones en lo que concierne a toma de decisiones bajo condiciones de conflicto entre las catástrofes naturales y la enfermedades contagiosas. (Spanish) [ FROM AUTHOR] 新冠肺炎流行病与其它自然灾害相互冲突, 给专家和政府预测人群的疏散决定提出了新的挑战。我们探讨了家庭疏散和避难的意愿, 考虑了飓风的感知风险与公共卫生危机之间的潜在冲突。我们调查了2020年飓风季节美国佛罗里达州飓风疏散区内的家庭。首先, 基于数据探讨了流行病之前和期间的疏散和避难意愿。然后, 我们分别度量了受访者对飓风和新冠肺炎的风险感知。探讨了这两种风险感知对受访者飓风疏散意愿的影响。我们发现, 在2、3或4级飓风中, 当人们认为居家危险时, 不管如何感知新冠肺炎风险, 人们在新冠肺炎流行之前和期间的疏散意愿大致相同。然而, 新冠肺炎风险感知显著降低了1级飓风的撤离意愿。它还显著影响了疏散者对非传统庇护所（如, 政府指定酒店）的偏好。我们的研究结果, 对应急管理和公共卫生治理具有实际意义。我们的研究, 还为自然灾害和传染病相互冲突情况下的决策提供了见解。 (Chinese) [ FROM AUTHOR] Copyright of Professional Geographer is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Introducing the Dilation and Evacuation Technique in Brazil: Lessons Learned From an International Partnership to Expand Options for Brazilian Women and Girls.

Dilation and evacuation (D&E) is the recommended surgical procedure for uterine evacuation in the second trimester. Despite its established safety record, it is not routinely available in most countries around the world. In this paper, we describe the multi-phase capacity-building project we undertook to introduce D&E in Brazil. First, we invited a highly motivated obstetrician-gynecologist and abortion provider to complete an observership at an established D&E site in the United States. We then organized a month-long clinical training for two experienced gynecologists in Brazil, followed by ongoing remote mentorship. Almost all patients we approached during the training opted for D&E, and all expressed satisfaction with their experience. Despite the restrictive legal setting and prevailing abortion stigma in Brazil, our training was well-received, and we did not experience any overt resistance from hospital staff. We learned that obtaining institutional support is essential; and that presenting scientific evidence during dedicated didactic times was an important strategy to obtain buy-in from other local healthcare providers. An important challenge we encountered was low case volume given the restrictive legal setting. We addressed this by partnering with nearby hospitals and non-profit organizations for patient referrals. We also rescheduled, adapted and optimized this project for implementation in the midst of the COVID-19 pandemic. Despite the challenges we faced, this project led to the successful introduction of D&E up to 16-18 weeks at two sites in Brazil. In the future, we plan additional training to increase capacity for D&E at more advanced gestational ages.

Impacts of household vulnerability on hurricane logistics evacuation under COVID-19: The case of U.S. Hampton Roads.

Historical data suggest that when a severe tropical storm or hurricane impacts a community, the vulnerable segment of the population suffers the most severe consequences. With an increased aging population, it is crucial to understand how vulnerability alters evacuation behavior. Emergent variables such as fear of COVID-19 require additional exploration. People afraid of COVID-19 exposure may refuse to evacuate, exposing themselves unnecessarily. Differentiation is critical to evacuation logistics since it is needed to determine what proportion would stay in a local shelter, public or other, rather than evacuating or staying in their home and guide the logistics resource allocation process. This research uses data from a web and phone survey conducted in the Hampton Roads area of U.S. Virginia, with 2,200 valid responses to analyze the influence of social and demographic vulnerability factors and risk perception on evacuation decisions. This research contributes to the existing literature by developing a multinomial order logit model based on vulnerability factors and intended evacuation decisions, including staying at home, looking for a shelter, or leaving the Hampton Roads area. Findings show that race and risk perception are the variables that influence the decision-making process the most. Fear of COVID-19 transmission is also associated with an increased likelihood of leaving homes during evacuation. The variations in findings from previous studies are discussed regarding their implications for logistics emergency managers.

Dual disasters: Seismic evacuation decision-making during COVID-19 lockdown: A case study of Luding earthquake, Sichuan Province.

Although there is a growing body of literature on the COVID-19 pandemic and the implemented strategies that have imposed additional risks in tackling emergencies by increasing socio-economic vulnerabilities, studies on human evacuation behavior during lockdowns are lacking. This paper contributes to evacuation and emergency research by examining seismic evacuation decision-making by surveying the areas affected by the Luding earthquake on 5 September 2022, when most parts of Sichuan province were experiencing strict pandemic restrictions. Using these data and per the emergency evacuation decision-making mechanism, we developed six hierarchical series of logistic regression models. Our major results suggest that 1) Socio-demographic parameters have shown different correlations with the study's dependent variables in each stage of those hierarchical models, 2) Respondents at home at the time of the earthquake were more likely to identify the earthquake risk than those who stayed outdoors; the former group showed less willingness to evacuate, 3) Rural residents have perceived higher earthquake risks than urban residents, and 4) Loss of job, change in income due to COVID-19 restrictions, and difficulty accessing daily supplies during the lockdown affected the residents' risk assessment and evacuation decision-making negatively. Insights into these aspects are expected to contribute to a better understanding of evacuation behavior during double disasters by modifying emergency response regulations and providing the residents with information about emergencies during pandemic restrictions.

Severe pneumonia due to legionella and SARS-CoV-2 co-infection necessitating medical evacuation from a cargo ship.

Cargo ships are at risk of disease outbreaks like Legionella and SARS-CoV-2 due to their cramped and shared conditions. A case of medical evacuation due to co-infection of Legionella pneumophila with SARS-CoV-2 highlights the need for international infection control guidelines, information networks, and molecular epidemiological approaches for identifying infection routes.

Lessons from Co-Occurring Disasters: Covid-19 and Eight Hurricanes

Changing climate dynamics have resulted in a confluence of disaster events to which Louisiana government leaders and emergency managers have never before had to respond simultaneously: a global pandemic and an "epidemic" of landfalling hurricanes during the 2020 season (eight cones over Louisiana) with challenging, unusual characteristics: (1) two hurricanes passing over the same location within 36 hours, a fujiwhara - Hurricanes Marco and Laura, (2) 150 mile-per-hour winds inadequately forecasted and of an almost unprecedented speed, (3) a difficult to forecast surge magnitude that led to incorrect immediate response, (4) delayed long-term recovery efforts from responders outside of the area because of initial reporting errors regarding surge heights and wind speed, and (5) a storm, Zeta, that passed directly over a densely populated area that would have been hard hit by rain if the storm had slowed. In addition, the number and closeness in dates of storm occurrences led to lengthy coastal highwater levels. To these co-occurring threats forecasters, state and local officials and residents responded with expertise and commitment, adhering to close collaboration, modifying evacuations and undertaking protective measures, all contributing to a low death rate from storms and a modest death rate from COVID. More just outcomes were supported by the general capacity of the responders, commitment to keep the residents informed about both risks and appropriate responses to them and the provision of special services, calculated for the new situation of the pandemic and the storm epidemic, for those without the means to respond adequately to both.

Evacuation of Refugees from Afghanistan: Health Control at the Spanish Border in the Context of the COVID-19 Pandemic.

Following the announcement of the retreat of troops from Afghanistan, the Spanish Government organised the so-called "Antigone Operation" for the evacuation of Afghan collaborators. The most relevant ministries were involved in the response. The Ministry of Health, through the Foreign Health Department, performed the health control on arrival. The whole operation was conducted at an air base. It included the health control of refugees composed of temperature measurement, a basic visual control and a coronavirus disease (COVID-19) rapid antigen test for those over 12 years of age; the assessment of their basic needs (food and hygiene); identification and security procedures; and the initial administrative processing. The refugees were accommodated in a temporary facility at the base, where they waited to be transferred to their final destinations. Between 19 and 27 August 2021, 2168 refugees arrived on 17 flights; 680 of them were children under 12 years of age. One thousand four hundred and ninety-nine rapid antigen tests were performed, with one positive result. "Antigone Operation" is unprecedented in Spain and is one of the most complex operations carried out in recent years. The COVID-19 pandemic required the establishment of a health control system on arrival, performed by Foreign Health, which contributed significantly to the overall success of the operation.

Assessing Thai Hospitals' Evacuation Preparedness Using the Flexible Surge Capacity Concept and Its Collaborative Tool

According to the concept of "flexible surge capacity,” hospitals may need to be evacuated on two occasions: (1) when they are exposed to danger, such as in war;and (2) when they are contaminated, such as during the Covid-19 pandemic. In the former, the entire hospital must be evacuated, while in the latter, the hospital becomes a pandemic center necessitating the transfer of its non-contaminated staff, patients, and routine activities to other facilities. Such occasions involve several degrees of evacuation—partial or total—yet all require deliberate surge planning and collaboration with diverse authorities. This study aimed to investigate the extent of hospital evacuation preparedness in Thailand, using the main elements of the flexible surge capacity concept. A mixed method cross-sectional study was conducted using a hospital evacuation questionnaire from a previously published multinational hospital evacuation study. The tool contained questions regarding evacuation preparedness encompassing surge capacity and collaborative elements and an open-ended inquiry to grasp potential perspectives. All 143 secondary care, tertiary care, and university hospitals received the questionnaire;43 hospitals provided responses. The findings indicate glitches in evacuation protocols, particularly triage systems, the inadequacies of surge planning and multiagency collaboration, and knowledge limitations in community capabilities. In conclusion, the applications of the essential components of flexible surge capacity allow the assessment of hospital preparedness and facilitate the evaluation of guidelines and instructions through scenario-based training exercises. © 2023, The Author(s).

Retour d'expérience sur le centre médical de coordination et d'évacuation aérien Covid — Paris-Orly

Après la décision de réaliser des évacuations aériennes de patients Covid vers les régions françaises ouest et sud avec des vecteurs civils et des vecteurs militaires, le Samu 94, en collaboration avec les services de l'aéroport Paris-Orly, a ouvert un centre médical d'évacuation (CME) au niveau du service médical de l'aéroport (SMU). Le CME établi sous tente, équipé des ressources en matériel médical et en médicaments, permettait d'accueillir temporairement 16 patients. Le Samu 94 a établi un centre de coordination des opérations au niveau du SMU. Ce centre de coordination était constitué de l'ensemble des ressources nécessaires à l'accomplissement de la mission. Le centre de coordination recevait du Samu zonal l'information des patients à transférer. Le rôle du centre de coordination était d'assurer l'enchaînement logistique depuis la prise en charge du patient dans l'hôpital d'origine, vers l'établissement de destination en région. Le centre de coordination s'assurait de la mobilisation des équipes médicales pour la prise en charge des patients soit directe par moyen héliporté posé sur la dropping zone de l'hôpital, soit par la mise en œuvre d'un préacheminement terrestre et d'un embarquement dans un moyen aérien civil ou militaire au niveau du hub de Paris-Orly.Alternate : After the decision to transport by medical air evacuation COVID patients to the western and southern French regions with civilian air vectors and military air vectors, the Samu 94, in collaboration with the services of Paris-Orly airport, opened a medical center of evacuation (CME) at the airport medical service (SMU). The CME under tent, equipped with medical equipment and drug resources, was able to temporarily accommodate 16 patients. The Samu 94 has also established an operational medial coordination center at the level of the SMU. The coordination center was composed of all human resources necessary for the accomplishment of the mission. The coordination center received information from the zonal SAMU about patients to be transferred. The role of the coordination center was to ensure all the logistical chain from the pic-up of the patient at the hospital of origin, to the destination hospital. The coordination center ensures the mobilization of the medical team who take care of the patient either directly by helicopter placed on the DZ of the hospital, or by implementation a land transportation before boarding in a civilian, military plane or helicopter at the Paris-Orly hub.

Military Involvement in the Evacuation of Nursing Home Patients in the COVID-19 Pandemic

The subject of the article concerns the involvement of the armed forces in the processes of evacuating patients from nursing homes in the event of contracting coronavirus. The analysis concerned the evacuation of patients from social welfare homes, a Covid-19 carried out in the first stage of the study as part of the "Resistant Spring” action coordinated by the Polish Army. These activities required external resource support. The aim of the article is to develop a model procedure for evacuating patients from care centres in a pandemic situation involving many entities, including military units. The research methods employed included qualitative methods, such as analysis of literature and documents, expert interviews a case study, observation and process mapping. It was found that it is necessary to develop a model evacuation procedure, its implementation among all participants, as well as regular practical exercises increasing the efficiency of the process and communication. In addition, planning and organisational conditions for the efficiency of processes under civil-military cooperation for the purposes of preventing the spread of the Covid-19 were identified. The article concerns civil-military cooperation in special circumstances by considering Conid-19 conditions. The results suggest that it is necessary to consciously shape civil-military relations in terms of readiness to cooperate in crisis situations. The article presents the socio-organisational changes caused by Covid-19, in particular in terms of practical implications at the operational level, as well as the directions of further theoretical considerations regarding decision-making and cooperation between the civil and military spheres. Article classification Case study. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Transformation d'un restaurant hospitalier en unité de soins critiques de courte durée

En mars 2021, l'Île-de-France a connu une nouvelle vague de Covid-19. Face à une projection épidémique faisant craindre un dépassement des capacités, la cellule de crise de l'Assistance publique-Hôpitaux de Paris a validé la mise en oeuvre du projet Météor. Météor est la transformation d'un restaurant du personnel du CHU Pitié-Salpêtrière en réanimation d'accueil et d'orientation de patients Covid-19 avant qu'ils ne soient adressés à des réanimations plus pérennes sur site ou en dehors. Cette démarche n'ayant jamais été pensée auparavant, tout était à construire. Une équipe projet composée d'un cadre de santé, d'un médecin, d'un ingénieur et d'un directeur a piloté sa mise en oeuvre. Le projet s'est voulu modulable, démontable et intégré comme une ressource zonale. En à peine 15 jours, l'unité était opérationnelle. L'organisation des soins a été simplifiée et standardisée au maximum pour que chaque personnel puisse assurer sa mission en sérénité malgré un contexte et des lieux inhabituels. L'efficacité de la mise en oeuvre du projet est liée à l'expertise des équipes en place et au caractère multiprofessionnel de l'équipe projet. Le point de fragilité s'est avéré être les ressources humaines. La constitution d'un corps de réserve sanitaire de personnels de soins critiques est nécessaire pour anticiper la prochaine crise.Alternate : In March 2021, the Île-de-France area was experiencing a new wave of Covid-19. Faced with an epidemic projection that could exceed capacity, the Assistance publique-Hôpitaux de Paris (AP-HP) crisis unit validated the implementation of the Meteor project. The Meteor is the transformation of a restaurant within the Pitié-Salpêtrière University Hospital into a Covid-19 patient orientation intensive care unit before they are sent to more permanent ICUs on or off site. As this approach had never been thought of before, everything had to be constructed. A project team composed of a chief nurse, a physician, an engineer and a director piloted its implementation. The project was designed to be modular, dismantleable and integrated as a zonal resource. In barely 15 days, the unit was operational. The organization of care was simplified and standardized to the maximum so that each staff member could carry out his or her mission with serenity despite the unusual context and locations. The effectiveness of project implementation is linked to the expertise of the teams in place and the multiprofessional nature of the project team. The weakest point was human resources. The constitution of a health reserve body of critical care personnel is necessary to anticipate the next crisis.

Retour d'expérience des six évacuations sanitaires aériennes collectives MoRPHEE durant la pandémie de Covid-19

Après son apparition en Chine à la fin de 2019, l'épidémie de coronavirus 2019 (Covid-19) a rapidement provoqué le risque d'une saturation des ressources en soins intensifs dans chaque pays touché. La répartition de la maladie entre les différents territoires est hétérogène. Le transport interhospitalier sur longue distance de patients atteints de Covid-19 dans le but de limiter la pression sur les unités de soins intensifs au niveau national ou international n'a pas encore été décrit. L'objectif de cet article était de fournir des données descriptives des six missions d'évacuation aéromédicale collective (Evasan) de patients atteints de Covid-19 réalisées en Europe et sur le territoire national français les 18, 21, 24, 27, 31 mars et 3 avril 2020 grâce au dispositif MoRPHEE. Trente-six patients souffrant de syndrome de détresse respiratoire aiguë (SDRA) ont été évacués durant six missions d'évacuations sanitaires collectives. Le SDRA était modéré (rapport PaO2/FiO2 > 100 et ≤ 200) chez 24 patients et léger (rapport PaO2/FiO2 > 200 et ≤ 300) chez 12 patients. La durée médiane de la ventilation mécanique en soins intensifs avant le transport était de quatre jours (interquartile [IQ] : 3‒5). Le rapport médian PaO2/FiO2 était de 180 mmHg (IQ : 156‒202). Le débit médian de perfusion de noradrénaline était de 0,08 μg/kg par min. Aucune complication mettant en jeu le pronostic vital n'a été signalée. En conclusion, l'évacuation sanitaire aérienne collective de patients gravement malades de Covid-19 est une solution contribuant à contrôler le niveau de saturation du système de soins au niveau national ou international.Alternate : Since its emergence in China in late 2019, the coronavirus disease 2019 (COVID-19) outbreak has rapidly posed the risk of critical care resources overload in every affected country. The distribution of the disease among the territories is heterogeneous. Long-range inter-hospital transport of critically ill COVID-19 patients as a way to mitigate the localised pressure from overloaded intensive care units at a national or international level has not been reported yet. The aim of this article was to provide descriptive data about the six collective aeromedical evacuation of COVID- 19 patients performed within Europe and French national territory on March 18, 21, 24, 27, 31 and April 3, 2020. Thirty-six patients with acute respiratory distress syndrome (ARDS) were transported aboard six aeromedical evacuation missions. ARDS was moderate (PaO2/FiO2 ratio > 100 and ≤ 200) in 24 patients and mild (PaO2/FiO2 ratio > 200 and ≤ 300) in 12 patients. The median duration of mechanical ventilation in ICU before transportation was 4 days [Interquartile (IQ): 3–5]. The median PaO2/FiO2 ratio was 180 mmHg (IQ: 156–202). The median norepinephrine infusion rate was 0.08 μg/kg/min. No life-threatening event was reported. Collective aeromedical evacuation of COVID-19 critically ill patients could provide a reliable solution to help control the burden of the disease at a national or international level. Future works may evaluate the global safety and effectiveness of aeromedical evacuations in this context.

-Editorial-SPECIAL ISSUE ON THE JULY 2020 HEAVY RAINFALL EVENT IN JAPAN

In July 2020, the Kyushu region experienced record-breaking heavy rains from July 4 to7, causing extreme floods in the Kuma and Chikugo Rivers. This was followed by atmospheric instability over a wide area from western Japan to the Tohoku region, resulting in heavy rainfall on July 13-14 in the Chugoku region, and on July 27-28 in the Tohoku region. There was also flooding of large rivers including the Go River and the Mogami River. In recent years, record-breaking torrential rainfall disasters have been occurring every year. The heavy precipitation scale has been increasing in space and time as well as in rainfall intensity, resulting in spatio-temporal expansion of the damage. Furthermore, in 2020, the disaster occurred amidst the restriction of social activities due to the COVID-19 pandemic. The compilation and dissemination of disaster survey data and lessons are essential for the sustainable development of society. Therefore, JSCE has planned a special issue on the July 2020 torrential rain disaster to share and disseminate disaster information and to contribute to the advancement of technology and science related to disaster prevention and mitigation. © 2022 Japan Society of Civil Engineers. All rights reserved.

ALL-RUSSIAN CENTER FOR DISASTER MEDICINE "ZASHCHITA" OF FEDERAL MEDICAL AND BIOPHYSICAL CENTER NAMED AFTER A.I. BURNAZYAN OF THE FEDERAL MEDICAL AND BIOLOGICAL AGENCY OF THE RUSSIAN FEDERATION: RESULTS OF WORK IN 2021 AND OBJECTIVES FOR 2022

The need to protect the population of the territories and personnel of the facilities serviced by the Federal Medical and Biological Agency in emergency situations by medical treatment organizations and mobile medical formations sets them an important task — to provide timely emergency and urgent medical care to victims in an emergency in accordance with modern principles of medical evacuation routing. The aim of the study is to analyze and to evaluate the main results of the activities of the All-Russian Center for Disaster Medicine "Zaschita" as a part of Federal Medical and Biophysical Center named after A.I. Burnazyan of the Federal Medical and Biological Agency of the Russian Federation, to develop proposals and to define objectives for further development and improvement of the system to organize medical care and medical evacuation in emergencies at facilities and territories served by FMBA of Russia. Materials and research methods. Materials: regulatory, legal and methodological documents governing the procedure for provid-ing medical aid to the victims of emergencies;reports of the structural units of the All-Russian Center for Disaster Medicine "Zaschita", including special exercises held in 2021;scientific papers on topical issues of medical support to the population in emergencies. Research methods: analytical, statistical, method of direct observation. Results of the study and their analysis. The results of the first year of operation of the the All-Russian Center for Disaster Medicine "Zaschita" as a part of Federal Medical and Biophysical Center named after A.I. Burnazyan of the Federal Medical and Biological Agency of the Russian Federation in 2021 are presented. The following results are considered and analyzed: special trainings of the Field Multidisciplinary Hospital and Consolidated medical detachment;work on medical support of mass events — "Tavrida" Forum of Young Culture and Arts Workers and "Silk Road" international rally. The work of the laboratory of scientific and methodical problems of medical support in emergency situations established in the All-Russian Center for Disaster Medicine "Zaschita" within the past year was characterized. Decrease of the Center of sanitary avia-tion and ambulance services abroad activities due to borders closing, caused by COVID-19 pandemic, is highlighted. The activities of the All-Russian Center for Disaster Medicine "Zaschita" in the field of civil defense in the interests of FMBA of Russia, are listed. The main tasks for the All-Russian Center for Disaster Medicine "Zaschita" for 2022 are formulated. © Burnasyan FMBC FMBA.

Exploring the links between flood events and the COVID-19 infection cases in Romania in the new multi-hazard-prone era.

The occurrence of flood events amid the COVID-19 pandemic represents a prominent part of the emerging multi-hazard landscape, as floods are one of the most frequent and destructive natural hazards. This spatial and temporal overlap of hydrological and epidemiological hazards translates into compounded negative effects, causing a shift in the hazard management paradigm, in which hazard interaction takes centre stage. This paper calls into question whether the river flood events that occurred during the COVID-19 pandemic in Romania and the way that they were managed had an impact on the infection with the SARS-CoV-2 virus at county scale. To this end, hazard management data concerning the flood events that were severe enough to impose the evacuation of the population were corroborated with COVID-19 confirmed cases data. A definite link between the flood events and the dynamics of COVID-19 cases registered in the selected counties is difficult to identify, but the analysis shows that all flood events were followed by various size increases in the COVID-19 confirmed cases at the end of the incubation time range. The findings are critically interpreted by providing viral load and social-related contexts, allowing a proper understanding of the interactions between concurrent hazards.

Disaster Evacuation for Home-Based Patients with Special Healthcare Needs: A Cross-Sectional Study.

Recent super-typhoons and torrential rains triggered by global warming have had disproportionately large effects on medically vulnerable people in Japan. This study aimed to identify factors associated with intention to evacuate to the nearest public shelter among family caregivers of pediatric patients receiving home medical care. The study included family caregivers of these patients from the Department of Pediatrics, Fukuoka University Hospital, Japan, including family caregivers of young adults with special healthcare needs. An original questionnaire was prepared drawing on previous studies and used for an interview survey. Overall, 57 individuals provided valid data and were included in the analysis. Factors associated with evacuation intention were non-use of a home ventilator (odds ratio [OR] 3.99, 95% confidence interval [CI]: 1.13-14.03) and not having made arrangements to use a non-public shelter (OR 7.29 95% CI: 1.62-32.88). This means that those who use mechanical ventilation or have secured alternative places to go if they need to evacuate their homes may not use the nearest public shelter in a disaster. We recommend that policy makers consider the use of mechanical ventilation and the availability of non-public shelters as predictors of evacuation behavior when considering disaster preparedness for these patients.

COVID-19 Vaccination in a Former Fukushima Nuclear Accident Evacuation Area: COVID-19 Vaccination for Former Evacuees.

After the Fukushima accident in 2011, approximately 160000 residents were forced to evacuate the site. The evacuation order has since been lifted and the Japanese government is now advancing a return strategy. As the return proceeds, deterioration of health indicators and measures in the municipalities around the nuclear power plant remains unchanged. This affected the local governments' coronavirus disease (COVID-19) vaccination drive during the COVID-19 pandemic. In Japan, municipalities keep track of residents' information and implement health-related measures. However, many residents evacuated the town, thus leaving their registered residence. With long-term evacuation and few returnees, it was difficult for government officials to constantly monitor the residents' health. Therefore, there is an urgent need to maintain residents' records and ensure that they receive health services without any gap. This report aimed to provide implications for post-disaster community health services and support as observed during the COVID-19 vaccination program at a disaster site.

Survey on the dissemination of Web-based information on "evacuation and sheltering” in the context of COVID-19 by the Japanese Government

Purpose: This study examines the websites of central government ministries, prefectures and municipalities to obtain a comprehensive bird's-eye view of how they are preparing for natural disasters in the context of the novel coronavirus (COVID-19) outbreak. Design/methodology/approach: This study examines the websites of central government ministries, prefectures and municipalities in Japan to survey the actual status of information dissemination on "evacuation and sheltering” in the context of COVID-19. Findings: This study found that the central government issued many notices, notifications and administrative communications to prefectures, cities with public health centers and special wards, which were mainly related to opening, securing and operating evacuation centers and improving the environment. It was found that most prefectures disseminated information on both survival and living evacuation and did so from June onward, when the flood season was approaching. Among the municipalities, there were differences in information dissemination tendencies by prefecture, and it became clear that smaller municipalities were especially incapable of fully disseminating information via the Web. Research limitations/implications: The data from the prefectures and municipalities surveyed in this study were collected from websites and do not necessarily represent the actual response to disaster-related evacuation in the context of COVID-19 in those areas. To clarify this evacuation, more detailed surveys are needed. Originality/value: This study is unique because no research has been conducted on the response of Japanese administrative agencies to disaster-related evacuation in the context of COVID-19;the actual situation was analyzed in this study by examining central government ministries, prefectures and municipalities as administrative agencies and comparing their responses. © 2021, Emerald Publishing Limited.

Aero-Medical Evacuation during SARS-CoV-2 Pandemic: Extraordinary Measure or Emerging Treatment Option?

Aero-medical evacuation has been considered as a feasible and safe treatment option during COVID pandemic, particularly when the needs of affected patients exceed what local clinics and hospitals are supposed to provide. In this article, we analyzed the clinical course of 17 patients medically evacuated to the "L. Spallanzani" Institute in Rome, Italy from foreign countries, mainly Africa and Eastern Europe, who had COVID-19 pneumonia with, or without, coinfections such as malaria, HIV, tuberculosis and microbiologically confirmed sepsis syndrome. The aero-medical evacuation of patients with infectious diseases has become one of the greatest medical achievements we have reached during this pandemic; in fact, only two patients with life threatening coinfections have died. Although logistically difficult and cost consuming, medical evacuation should be considered as a treatment option more than a single extraordinary measure, especially among complex cases that require specific technical and human resources.

Evacuation dilemmas of coastal households during cyclone Amphan and amidst the COVID-19 pandemic: a study of the Southwestern region of Bangladesh.

Cyclone Amphan battered the coastal communities in the southwestern part of Bangladesh in 2020 during the COVID-19 pandemic. These coastal communities were experiencing such a situation for the first time and faced the dilemma of whether to stay at home and embrace the cyclone or be exposed to the COVID-19 virus in the cyclone shelters by evacuating. This article intends to explore individuals' decisions regarding whether to evacuate in response to cyclone Amphan and in light of the risks of the COVID-19 pandemic. Consequently, this study investigated evacuation behaviors among the households and explored the impacts of COVID-19 during the evacuation procedures. We conducted household surveys to collect primary information and undertook 378 samples for interviews at a precision level of 0.05 in fourteen villages. Despite the utmost effort of the government, the results demonstrated that 96.6% of people in the coastal area received a cyclone evacuation order before the cyclone's landfall, and only 42% of people followed the evacuation order. The majority of households chose to stay at home because of fear of COVID-19 exposure in the crowded shelters. Although half of the evacuees were housed in cyclone shelters, COVID-19 preventive measures were apparently not set in place. Thus, this study will assist in crafting future government policies to enhance disaster evacuation plans by providing insights from the pandemic that can inform disaster management plans in the Global South.