The Effects of COVID-19 Pandemic on Spanish Protected Areas: the Case of Picos de Europa National Park

Protected areas are complex social-ecological systems;thus, they were unavoidably impacted by COVID-19. Spain is one of the most diverse countries in terms of biodiversity in the European Union and the second most visited country in 2019 and third touristic destination worldwide. Understanding the effects of the pandemic in Spanish protected areas is very important to discuss new possibilities on how to drive sustainable development on these conserved spaces and how to manage them in the event of external shocks and uncertain scenarios. Therefore, the aim of this study is to have a better understanding of the effects and opportunities of the pandemic on Spanish protected areas. To address this concern, a qualitative analysis is conducted based on an assessment of secondary literature and relevant interviews. Picos de Europa national park was chosen as case study because of its unique features. This study shows the drawbacks of the pandemic in Picos de Europa in terms of management operations, drastic fluctuation of visitors, loss of tourism revenues, vulnerability of neighboring communities, missed opportunities in conservation and education and pressure on nature. On the other hand, it poses opportunities in terms of technology, innovation, fundings, lessons learned, rise in educational and conservation activities and more awareness on the environment and rural surroundings. This study suggests that is difficult to find a win-win solution that includes the targets of nature conservation, viability of local economies and tourism activities in Picos de Europa. Ideas for management options that focus on dealing with the negative outcomes of the pandemic are suggested. © 2022, Pontificia Universidad Catolica del Peru. All rights reserved.

Quantitative Identification Study of Epidemic Risk in the Spatial Environment of Harbin City

Global pandemics pose a threat to the sustainable development of urban health. As urban spaces are important places for people to interact, overcrowding in these spaces can increase the risk of disease transmission, which is detrimental to the sustainable development of urban health. Therefore, it is crucial to identify potential epidemic risk areas and assess their risk levels for future epidemic prevention and the sustainable development of urban health. This article takes the main urban area of Harbin as the research object and conducts a cluster spatial analysis from multiple perspectives, including building density, functional density, functional mix, proximity, intermediacy, and thermal intensity, proposing a comprehensive identification method. The study found that (1) functional density is the most significant influencing factor in the formation of epidemic risks. Among various urban functions, commercial and public service functions have the strongest impact on the generation and spread of epidemic risks, and their distribution also has the widest impact range. (2) The spaces with higher levels of epidemic risk in Harbin are mainly distributed in the core urban areas, while the peripheral areas have relatively lower levels of risk, showing a decreasing trend from the center to the periphery. At the same time, the hierarchical distribution of urban space also has an impact on the spatial distribution of the epidemic. (3) The method proposed in this study played an important role in identifying the spatial aggregation of epidemic risks in Harbin and successfully identified the risk levels of epidemic distribution in the city. In spatial terms, it is consistent with high-risk locations of epidemic outbreaks, which proves the effectiveness and feasibility of the proposed method. These research findings are beneficial for measures to promote sustainable urban development, improve the city's epidemic prevention capabilities and public health levels, and make greater contributions to the sustainable development of global public health, promoting global health endeavors.

To What Extent do Social Determinants of Health Modulate Presentation, ITU Admission and Outcomes among Patients with SARS-COV-2 Infection? An Exploration of Household Overcrowding, Air Pollution, Housing Quality, Ethnicity, Comorbidities and Frailty.

Background: Internationally, researchers have called for evidence to support tackling health inequalities during the severe acute respiratory syndrome coronavirus 2 (COVID19) pandemic. Despite the 2020 Marmot review highlighting growing health gaps between wealthy and deprived areas, studies have not explored social determinants of health (ethnicity, frailty, comorbidities, household overcrowding, housing quality, air pollution) as modulators of presentation, intensive care unit (ITU) admissions and outcomes among COVID19 patients. There is an urgent need for studies examining social determinants of health including socioenvironmental risk factors in urban areas to inform the national and international landscape. Methods: An in-depth retrospective cohort study of 408 hospitalized COVID19 patients admitted to the Queen Elizabeth Hospital, Birmingham was conducted. Quantitative data analyses including a two-step cluster analysis were applied to explore the role of social determinants of health as modulators of presentation, ITU admission and outcomes. Results: Patients admitted from highest Living Environment deprivation indices were at increased risk of presenting with multi-lobar pneumonia and, in turn, ITU admission whilst patients admitted from highest Barriers to Housing and Services (BHS) deprivation Indies were at increased risk of ITU admission. Black, Asian and Minority Ethnic (BAME) patients were more likely, than Caucasians, to be admitted from regions of highest Living Environment and BHS deprivation, present with multi-lobar pneumonia and require ITU admission. Conclusion: Household overcrowding deprivation and presentation with multi-lobar pneumonia are potential modulators of ITU admission. Air pollution and housing quality deprivation are potential modulators of presentation with multi-lobar pneumonia. BAME patients are demographically at increased risk of exposure to household overcrowding, air pollution and housing quality deprivation, are more likely to present with multi-lobar pneumonia and require ITU admission. Irrespective of deprivation, consideration of the Charlson Comorbidity Score and the Clinical Frailty Score supports clinicians in stratifying high risk patients.

Five Level Triage vs. Four Level Triage in a Quaternary Emergency Department: National Analysis on Waiting Time, Validity, and Crowding-The CREONTE (Crowding and RE-Organization National TriagE) Study Group.

Background and Objectives: Triage systems help provide the right care at the right time for patients presenting to emergency departments (EDs). Triage systems are generally used to subdivide patients into three to five categories according to the system used, and their performance must be carefully monitored to ensure the best care for patients. Materials and Methods: We examined ED accesses in the context of 4-level (4LT) and 5-level triage systems (5LT), implemented from 1 January 2014 to 31 December 2020. This study assessed the effects of a 5LT on wait times and under-triage (UT) and over-triage (OT). We also examined how 5LT and 4LT systems reflected actual patient acuity by correlating triage codes with severity codes at discharge. Other outcomes included the impact of crowding indices and 5LT system function during the COVID-19 pandemic in the study populations. Results: We evaluated 423,257 ED presentations. Visits to the ED by more fragile and seriously ill individuals increased, with a progressive increase in crowding. The length of stay (LOS), exit block, boarding, and processing times increased, reflecting a net raise in throughput and output factors, with a consequent lengthening of wait times. The decreased UT trend was observed after implementing the 5LT system. Conversely, a slight rise in OT was reported, although this did not affect the medium-high-intensity care area. Conclusions: Introducing a 5LT improved ED performance and patient care.

Should I stay or should I board? Willingness to wait with real-time crowding information in urban public transport

Overcrowding is a major phenomenon affecting travel experience in urban public transport, whose negative impacts can be potentially mitigated with real-time crowding information (RTCI) on public transport vehicle departures. In this study, we investigate the willingness to wait (WTW) with instantaneous RTCI to avoid the in-vehicle (over)crowding the passenger faces, focusing specifically on urban crowding context (i.e. bus and tram systems). We conduct a stated-preference survey in Krakow (Poland), where we examine the choice probability between boarding now a more crowded vehicle vs. waiting at the stop for a less-crowded PT departure, and estimate a series of discrete choice models. Results show that 50–70% of respondents consider skipping a first departure which is excessively overcrowded and 10–30% would skip a vehicle with moderate standing crowding on-board. Acceptable waiting times typically range between 2 and 13 min, depending on crowding level and propensity to arrive on-time, but may even exceed 20 min in individual cases. These findings indicate that RTCI can induce a substantial WTW, affecting travel behaviour. We discuss its implications for mitigating service disruptions and demand management policies, including prospective support for public transport recovery in the aftermath of covid-19 crisis. © 2023

Impact of COVID-19 on vacation recreational walking: Evidence from an urban coastal destination

This study examined the impact of COVID-19 on recreational walking while on vacation, a relevant activity among tourists especially in urban destinations. We surveyed visitors to Costa Daurada, an urban coastal destination in Catalonia in August 2020. Only 5% of participants reported lower recreational walking levels compared to normal circumstances;75% reported similar levels;and 20% reported higher levels. Higher recreational walking levels were associated with visiting local amenities or strolling and with a higher level of perceived safety from COVID-19 when walking. Higher perceived overcrowding was associated with less recreational walking. The pandemic may have altered recreational behavior while on vacation in urban settings especially by increasing outdoor activities such as recreational walking. If persistent, such behavioral changes could have relevant implications for both the tourism and recreation sectors and for local policymakers who aim to promote walkability while managing tourist pedestrian flows.

OVERCROWDING IN INDIAN PRISONS: DURING PRE COVID-19 AND ONGOING PANDEMIC

The Prison administration in India usually faces several challenges in prison management even during the normal times. These challenges got aggravated during the ongoing pandemic COVID-19. One of the main challenges has been the overcrowding in prisons in India. The Supreme Court of India (SC) took suo-moto cognizance of the issue of overcrowding in prisons during the pandemic and considered the situation that the prison inmates were at a high risk of transmission of COVID-19 virus due to the high rate of ingress and egress, in prisons. Thus, the Supreme Court directed the state governments to constitute a High Power Committee (HPC) and identify the prisoners including undertrials who could be released on interim bail or parole. The authors of this research paper have undertaken a study of the issue of overcrowding in Indian prisons in pre COVID-19 times and finding out if the overcrowding actually reduced in the last one year during the ongoing pandemic in view of the SC order. The authors have also explored and an alysed the reasons behind such high overcrowding in India Prisons and have made some suggestions to overcome these in future. © 2022, Supporting Academic Initiatives Foundation. All rights reserved.

A qualitative analysis of the main factors in bed management in high complexity hospital emergencies

Overcrowding in the emergency department is a problem that generates several implications for bed management, which is deemed one of a hospital's most critical processes. Effective management of hospital production capacity includes bed management processes, which can be improved in order to leverage hospital performance. Thus, this study sought to understand how bed management works and identify the main factors that influence its management. The study was performed through a case study, with data collected from semi-structured interviews and bibliographic research, which were triangulated. Thematic content analysis of the interviews and cross-analysis were performed. As a result, the main factors that influence hospital Bed management were identified: communication between teams and units;definition of performance goals;decisions shared between units;occupation and discharge planning by the teams;length of stay;the role of the nurses;and COVID-19. The greatest difficulties in the management process are related to these factors. Additionally, suggestions are provided to mitigate such reported difficulties.Alternate :A superlotação no departamento de emergência é um problema que gera várias implicações para a gestão de camas, o que é considerado um dos processos mais críticos de um hospital. O gerenciamento efetivo da capacidade de produção do hospital inclui processos de gerenciamento de leitos, que podem ser melhorados a fim de alavancar o desempenho do hospital. Assim, este estudo procurou entender como funciona o gerenciamento de leitos e identificar os principais fatores que influenciam sua gestão. O estudo foi realizado através de um estudo de caso, com dados coletados a partir de entrevistas semi-estruturadas e pesquisas bibliográficas, que foram trianguladas. Foram realizadas análises de conteúdo temático das entrevistas e análises cruzadas. Como resultado, foram identificados os principais fatores que influenciam a administração do hospital: comunicação entre equipes e unidades;definição de metas de desempenho;decisões compartilhadas entre unidades;planejamento de ocupação e alta pelas equipes;tempo de permanência;o papel dos enfermeiros;e COVID-19. As maiores dificuldades no processo de gestão estão relacionadas a estes fatores. Além disso, são fornecidas sugestões para mitigar tais dificuldades relatadas.

Solving the housing crisis in Nunavut, Canada.

In Canada, there are vast differences between the state of accommodation/housing, health, social inequalities, education and economic conditions for people in the northern and southern regions of the country. Overcrowding in Inuit Nunangat is a direct result of the promises made by past government policy that led to Inuit people settling in sedentary communities in the North on the understanding that they would be provided with social welfare. However, these welfare programmes proved to be either insufficient or non-existent for Inuit people. Therefore, Inuit are living in overcrowded homes in Canada, resulting in a severe housing shortage, poor-quality housing and homelessness. This has led to the spread of contagious diseases, mould, mental-health issues, gaps in education for children, sexual and physical violence, food insecurity and adverse challenges for the youth of Inuit Nunangat. This paper proposes several actions to ease the crisis. First, funding should be stable and predictable. Next, there should be ample construction of transitional homes which could be used to accommodate people before moving them into proper public housing. Policies regarding staff housing should be amended, and if possible, these vacant staff houses could provide shelter to eligible Inuit people, which could help lessen the housing crisis. The advent of COVID-19 has made the issue of affordable and safe housing more serious because without safe housing, the health, education and well-being of the Inuit people in Inuit Nunangat are in peril. This study focuses on how the governments of Canada and Nunavut are dealing with this issue.

Smart Visual Sensing for Overcrowding in COVID-19 Infected Cities Using Modified Deep Transfer Learning

Currently, COVID-19 is circulating in crowded places as an infectious disease. COVID-19 can be prevented from spreading rapidly in crowded areas by implementing multiple strategies. The use of unmanned aerial vehicles (UAVs) as sensing devices can be useful in detecting overcrowding events. Accordingly, in this article, we introduce a real-time system for identifying overcrowding due to events such as congestion and abnormal behavior. For the first time, a monitoring approach is proposed to detect overcrowding through the UAV and social monitoring system (SMS). We have significantly improved identification by selecting the best features from the water cycle algorithm (WCA) and making decisions based on deep transfer learning. According to the analysis of the UAV videos, the average accuracy is estimated at 96.55%. Experimental results demonstrate that the proposed approach is capable of detecting overcrowding based on UAV videos' frames and SMS's communication even in challenging conditions. © 2005-2012 IEEE.

Striving for a new normal after the Covid-19 pandemic: taking small businesses at Bangsaen Beach as an example

The Covid-19 pandemic interrupted Bangsaen Beach activities and disturbed livelihoods of small business operators. Before the pandemic, Bangsaen tourism experienced issues of beach quality degradation due to overcrowding, competitive vending, and lack of diversification. After the pandemic, the municipality imposed new regulations, reset zones to safeguard the public health, and jump-started the economy. The changing regulations created conflicts with vendors on zoning rearrangements and reduced sales. The author conducted a survey to investigate the beach activities, the local small business operations, and the local authority's regulation changes. The survey results indicated that Bangsaen needs alternative attractions to complement its beach activities and to help cope with traffic congestion. The results also find out the social disparity in the demography of the vendors, which calls for attention to gender aspects and inclusive facets in the social infrastructure development strategy. This study suggests that vendors collaborate collectively with the local government to challenge the appropriation of beach spaces and to create innovative tactics. In addition, destination management organizations need to strive for better collaboration with small business operators to help them adapt to the change and enter the formal economy.

Predicting Hospital Admissions to Reduce Crowding in the Emergency Departments

Having an increasing number of patients in the emergency department constitutes an obstacle to the admissions process and hinders the emergency department (ED)'s ability to deal with the continuously arriving demand for new admissions. In addition, forecasting is an important aid in many areas of hospital management, including elective surgery scheduling, bed management, and staff resourcing. Therefore, this paper aims to develop a precise prediction model for admissions in the Integral Healthcare System for Public Use in Catalonia. These models assist in reducing overcrowding in emergency rooms and improve the quality of care offered to patients. Data from 60 EDs were analyzed to determine the likelihood of hospital admission based on information readily available at the time of arrival in the ED. The first part of the study targeted the obtention of models with high accuracy and area under the curve (AUC), while the second part targeted the obtention of models with a sensitivity higher than 0.975 and analyzed the possible benefits that could come from the application of such models. From the 3,189,204 ED visits included in the study, 11.02% ended in admission to the hospital. The gradient boosting machine method was used to predict a binary outcome of either admission or discharge.

An international, stepped wedge, cluster-randomized trial investigating the 0/1-h algorithm in suspected acute coronary syndrome in Asia: the rational of the DROP-Asian ACS study.

BACKGROUND: More than half of the world's population lives in Asia. With current life expectancies in Asian countries, the burden of cardiovascular disease is increasing exponentially. Overcrowding in the emergency departments (ED) has become a public health problem. Since 2015, the European Society of Cardiology recommends the use of a 0/1-h algorithm based on high-sensitivity cardiac troponin (hs-cTn) for rapid triage of patients with suspected non-ST elevation acute coronary syndrome (NSTE-ACS). However, these algorithms are currently not recommended by Asian guidelines due to the lack of suitable data. METHODS: The DROP-Asian ACS is a prospective, stepped wedge, cluster-randomized trial enrolling 4260 participants presenting with chest pain to the ED of 12 acute care hospitals in five Asian countries (UMIN; 000042461). Consecutive patients presenting with suspected acute coronary syndrome between July 2022 and Apr 2024 were included. Initially, all clusters will apply "usual care" according to local standard operating procedures including hs-cTnT but not the 0/1-h algorithm. The primary outcome is the incidence of major adverse cardiac events (MACE), the composite of all-cause death, myocardial infarction, unstable angina, or unplanned revascularization within 30 days. The difference in MACE (with one-sided 95% CI) was estimated to evaluate non-inferiority. The non-inferiority margin was prespecified at 1.5%. Secondary efficacy outcomes include costs for healthcare resources and duration of stay in ED. CONCLUSIONS: This study provides important evidence concerning the safety and efficacy of the 0/1-h algorithm in Asian countries and may help to reduce congestion of the ED as well as medical costs.

A study of the health status of the Slum Dwellers and the present healthcare facilities in the Slum areas

The spread of COVID- 19 pandemic is a wake-up call for cities, towns and areas for proper planning and sanitation. The overcrowding and exodus of people from rural to urban areas in search of employment has created a shortage of basic civic amenities and healthcare facilities. This affects their health status and their health seeking behaviour. The present descriptive research study was conducted in selected slum areas with stratified proportionate random sampling method. A survey questionnaire was used, and data was collected in two phases. Data was analyzed with the help of SPSS version25. Significance was tested with Chi-Square test and Logistic Regression. Low annual income is the barrier in maintaining good health of the slum households and it influences their health status. Healthcare expenditure of the slum households was very less. The district hospitals need up gradation to include all the consultation services. Disease incidence was found between age group 1 to 4 years and 45-65 years. The slum community's participation in health care services was needed to create a slum-free society. Proper housing, sanitation, safe drinking water, affordable healthcare and maternal and childcare services were very essential in these slum areas for their improvement.

Covid-19 e istituti penitenziari italiani: una riflessione relativa alle misure adottate e al loro impatto sui diritti dei detenuti

As covid-19 rips through the European countries, the fragile Italian penitentiary system reveals its deepest weaknesses. In this precarious scenario, severe precautionary measures have been promptly undertaken by the legislator to guarantee prisoners’ fundamental right to health care. Taking the cue from this emergency response framework, it will be examined the effectiveness of these normative solutions and their impact on constitutional rights of prisoners. Also, the long-term impact of this exceptional approach will be highlighted, by comparing it to significant jurisprudential guidelines of the Constitutional Court concerning this matter. © 2022, Societa Editoriale Federalismi s.r.l.. All rights reserved.

Overcrowding analysis in emergency department through indexes: a single center study.

INTRODUCTION: Overcrowding in the Emergency Department (ED) is one of the major issues that must be addressed in order to improve the services provided in emergency circumstances and to optimize their quality. As a result, in order to help the patients and professionals engaged, hospital organizations must implement remedial and preventative measures. Overcrowding has a number of consequences, including inadequate treatment and longer hospital stays; as a result, mortality and the average duration of stay in critical care units both rise. In the literature, a number of indicators have been used to measure ED congestion. EDWIN, NEDOCS and READI scales are considered the most efficient ones, each of which is based on different parameters regarding the patient management in the ED. METHODS: In this work, EDWIN Index and NEDOCS Index have been calculated every hour for a month period from February 9th to March 9th, 2020 and for a month period from March 10th to April 9th, 2020. The choice of the period is related to the date of the establishment of the lockdown in Italy due to the spread of Coronavirus; in fact on 9 March 2020 the Italian government issued the first decree regarding the urgent provisions in relation to the COVID-19 emergency. Besides, the Pearson correlation coefficient has been used to evaluate how much the EDWIN and NEDOCS indexes are linearly dependent. RESULTS: EDWIN index follows a trend consistent with the situation of the first lockdown period in Italy, defined by extreme limitations imposed by Covid-19 pandemic. The 8:00-20:00 time frame was the most congested, with peak values between 8:00 and 12:00. on the contrary, in NEDOCS index doesn't show a trend similar to the EDWIN one, resulting less reliable. The Pearson correlation coefficient between the two scales is 0,317. CONCLUSION: In this study, the EDWIN Index and the NEDOCS Index were compared and correlated in order to assess their efficacy, applying them to the case study of the Emergency Department of "San Giovanni di Dio e Ruggi d'Aragona" University Hospital during the Covid-19 pandemic. The EDWIN scale turned out to be the most realistic model in relation to the actual crowding of the ED subject of our study. Besides, the two scales didn't show a significant correlation value.

Nosocomial COVID-19 outbreaks in inpatient care facilities: causes and requirements

This article identified the source and reason for spread of COVID-19 infection and devise recommendations to halt the progress of infection in a non-COVID area. Results showed that 34 persons were impacted by the outbreak, which lasted from December 19, 2020, to January 12, 2021. Attack frequency was 9.2%. This study determined that inadequacies in infection control procedures, a high bed-to-patient ratio, anomalies in the ventilation system, overcrowding by patient attendants, and a communication gap between nursing officers and doctors were the root causes of the present outbreak. After the last confirmed case, the necessary controls for the outbreak were put in place, and no new instances were recorded for two weeks. SARS-CoV 2 nosocomial outbreaks are a concern in non-COVID hospital settings as well, so it is important to adhere to the same tight infection control procedures there as in COVID areas to stop these outbreaks.

Privatized Justice: Ankle Monitors Are the New Private Prison

"17 The exploding prison population was undeniable-the DOJ reported 240,000 state and federal prisoners nationwide in 1975.18 In 2008, the U.S. prison and jail population peaked at 2.3 million.19 The upward trend has slowed, with just over 2 million at the end of 2019,20 but a March 2020 report estimates 2.3 million people are incarcerated across the United States.21 Unfortunately, even the releases triggered by COVID-19 are already proving to be short-lived-state prison and jail populations are "ticking back up" to prepandemic levels.22 B. Private Prisons Problems of prison overcrowding were widely known in the 1980s, with two-thirds of states under court order to improve conditions that violated the Constitution.23 But as the prison population grew,24 states struggled to balance the need for more facilities and the political pressure to be "tough on crime. The Corporate Duopoly Filling that need in the market, CoreCivic28 and GEO Group29 became the two largest players in the private prison industry. Since its founding in 1983, CoreCivic has become "the nation's largest owner of partnership correctional, detention, and residential reentry facilities and one of the largest private prison operators in the United States. "30 CoreCivic reported an annual revenue of $1.9 billion in 2020 and $1.86 billion in 2021,31 operating 113 facilities across 22 states.32 The corporation is also a major contractor in the temporary detention facility business (specifically immigration detention) and holds the longestrunning federal contract in the industry.33 In 2016, CoreCivic was awarded a $1 billion nounparalleled contest bill by the U.S. Administration to build and operate a detention facility for immigrants from Central America.34 In 2019, it was awarded a five-year contract worth $2.1 billion to provide guard services at a private San Diego immigrant detention center.35 GEO Group, considered the second-largest private prison corporation in the United States, was given the first federal government contract for a privately operated prison in 1997.36 Although traditionally showing a smaller profit margin than CoreCivic,37 GEO Group had an annual revenue of $2.35 billion for 2020 and $2.25 billion for 2021-an over $1 billion revenue increase since 2010.38 Worldwide, GEO operates and/or manages "approximately 86,000 beds at 106 secure and community-based facilities . . . and electronic monitoring and supervision services for more than 250,000 individuals. A 2017 study by the Prison Policy Initiative followed the money of mass incarceration-a $182 billion industry.43 While private prisons account for $3.9 billion of that industry, that does not even touch on the number of for-profit interests involved in everything from bail fees to commissary, telephone calls, and video visitation.44 A 2020 report lists over 4,100 corporations that profit from mass incarceration in the United States.45 Central to the success of the private prison industry has been its ability to offer diverse product offerings while maintaining ongoing profit margins.

WASH responses to COVID-19 in Ethiopia, Somalia and South Sudan

In the face of COVID-19, innovation, adaptation, and learning from experience have all been crucial to meeting the needs of those who have been displaced. In order to respond to this new disease, the humanitarian community had to get familiar with COVID-19. It was understood from the beginning that basic hygiene precautions, such adequate handwashing, could aid in preventing its transmission. However, a lot of displacement settings lack the infrastructure needed to put household and community-level infection prevention and control (IPC) measures into place. They might also have inadequate governance structures for overseeing and maintaining WASH services. Some of the hardest-to-reach populations are found in displacement contexts like Ethiopia, Somalia, and South Sudan, where people lack the resources to defend themselves and deal with health threats. Disease vulnerability may be exacerbated by overcrowding and restricted access to proper WASH facilities. In the meantime, xenophobia and stigma can develop due to the fear surrounding COVID-19 as well as the dissemination of false information. As new information became available and lessons were discovered, IOM teams operating in these environments had to modify their Risk Communication and Community Engagement (RCCE) and IPC efforts. Any disaster response has traditionally included funding for capacity building for hygiene promotion to strengthen local responses, but COVID-19 demanded more localisation because of the absence of international travel. It demonstrated how supporting local structures can help solidify hygiene promotion capacities while obviating the requirement for a high degree of international assistance in the event of future outbreaks by highlighting considerable local capacity and willingness in some communities.

Overcrowding in Emergency Department: Causes, Consequences, and Solutions-A Narrative Review.

Overcrowding in Emergency Departments (EDs) is a phenomenon that is now widespread globally and causes a significant negative impact that goes on to affect the entire hospital. This contributes to a number of consequences that can affect both the number of resources available and the quality of care. Overcrowding is due to a number of factors that in most cases lead to an increase in the number of people within the ED, an increase in mortality and morbidity, and a decrease in the ability to provide critical services in a timely manner to patients suffering from medical emergencies. This phenomenon results in the Emergency Department reaching, and in some cases exceeding, its optimal capacity. In this review, the main causes and consequences involving this phenomenon were collected, including the effect caused by the SARS-CoV-2 virus in recent years. Finally, special attention was paid to the main operational strategies that have been developed over the years, strategies that can be applied both at the ED level (microlevel strategies) and at the hospital level (macrolevel strategies).