Using innovative population-level data to understand the mental health impact of community-level events on young people: An example from the COVID-19 pandemic in Victoria

Aims: Since the onset of the COVID-19 pandemic, a significant rise in mental ill-health has been observed globally in young people, particularly amongst those in their final years of secondary school. The students' negative experiences coincide with a critical transitional period, which can subsequently disrupt milestones in social and educational development. This study aims to use innovative population-level data to map the impact of the pandemic on students entering higher education. Method(s): Tertiary education application data for Victorian students were obtained from the Victorian Tertiary Admissions Centre both pre-pandemic (2019/2020) and pandemic (2020/2021). Prevalence of mental health special considerations were compared between cohorts across geographical areas and applicant demographic subgroups. Relative risk regression models were used to understand the role of different risk factors. Result(s): The rate of mental health special considerations increased by 38% amongst all applications (pre-pandemic: 7.8%, n = 56 916;pandemic: 10.8%, n = 58 260). The highest increases were observed amongst students in areas with severe lockdown experiences and areas impacted by 2019/2020 black summer bushfires. The increases were higher amongst year 12 students and students with other preexisting risk factors (e.g., physical condition, learning disability). However, interestingly slightly higher increases were observed in areas with higher socioeconomic status, which is potentially related to inequality in mental health service access. Conclusion(s): As the consequences of mental health difficulties and academic disruption in youth can be long-lasting, it is critical to establish a mental health supportive framework both in and outside of higher education to facilitate young people's recovery from the pandemic.

Priming close social contact protective behaviors enhances protective social norms perceptions, protection views, and self-protective behaviors during disasters.

Many people do not make choices that minimize risk in the face of health and environmental threats. Using pre-registered analyses, we tested whether a risk communication that primed perceptions about health-protective preparation and behavior of close social contacts promoted protection views and protective behaviors. From December 10-24, 2020, we fielded a 2 (threat vignette: wildfire or COVID-19) x 3 (social contact prime: control, inaction, or action) experiment to a representative sample of 1,108 California residents facing increased COVID-19 cases/deaths, who had recently experienced the most destructive wildfire season in California history. Outcome variables were protection views and protective behavior (i.e., information seeking). Across threat conditions, stronger social norms, efficacy, and worry predicted greater protection views and some protective behaviors. Priming social-contact action resulted in greater COVID-19 information-seeking compared to the control. In the wildfire smoke condition, priming social contact action and inaction increased perceived protective behavior social norms compared to the control; social norms partially mediated the relationships of priming with protection views and protective behaviors; and having existing mask supplies enhanced the relationship between priming inaction and greater protection views compared to priming action or the control. Findings highlight the importance of social influence for health protection views and protective behaviors. Communications enhancing social norms that are sensitive to resource contexts may help promote protective behaviors.

COVID-19 and 5G conspiracy theories: long term observation of a digital wildfire.

The COVID-19 pandemic has severely affected the lives of people worldwide, and consequently, it has dominated world news since March 2020. Thus, it is no surprise that it has also been the topic of a massive amount of misinformation, which was most likely amplified by the fact that many details about the virus were not known at the start of the pandemic. While a large amount of this misinformation was harmless, some narratives spread quickly and had a dramatic real-world effect. Such events are called digital wildfires. In this paper we study a specific digital wildfire: the idea that the COVID-19 outbreak is somehow connected to the introduction of 5G wireless technology, which caused real-world harm in April 2020 and beyond. By analyzing early social media contents we investigate the origin of this digital wildfire and the developments that lead to its wide spread. We show how the initial idea was derived from existing opposition to wireless networks, how videos rather than tweets played a crucial role in its propagation, and how commercial interests can partially explain the wide distribution of this particular piece of misinformation. We then illustrate how the initial events in the UK were echoed several months later in different countries around the world.

Prevalence and Predictors of Sleep and Trauma Symptoms in Wildfire Survivors

Objective: This study aimed to establish the prevalence and to identify predictors of insomnia, nightmares and post-traumatic stress disorder (PTSD) in wildfire survivors. Method(s): A total of 126 (23 males, 102 females, and 1 nonbinary individual, Mage = 52 years, SD = 14.4) wildfire survivors from Australia, Canada and the USA took part in an online survey. Participants completed a demographic questionnaire and self-report measures including: The Insomnia Severity Index (ISI), PTSD Checklist for DSM-5 (PCL-5), and Disturbing Dream and Nightmare Severity Index (DDNSI). Result(s): Results showed that 49.2% of the sample reported clinical insomnia on the ISI, 28.7% reported nightmares on the DDNSI, and 77.88% reported PTSD symptoms on the PCL-5. Fear for life of others (Pearson's r = .40, .21, .31), and the impact of smoke (Pearson's r, .47, .25,.41) significantly correlated with insomnia, nightmares and PTSD symptoms, respectively. Hierarchical regression showed that smoke was a significant predictor of insomnia (beta = .17, p <.05, 95% CI, 0.15 - 1.49), and insomnia predicted both of PTSD (beta = .27, p <.05, 95% CI, 0.26 - 1.05), and nightmares (beta = .19, p = .04, 95% CI, 1.01 - 1.45) scores. Conclusion(s): Insomnia, nightmares and PTSD are highly prevalent in wildfire survivors. Smoke, one of the trauma-related factors, was found to be as a significant predictor of insomnia;and insomnia was a significant predictor of both PTSD and nightmares. Future longitudinal studies are needed to establish which disorder emerges first as a result of smoke.Copyright © 2022

The COVID-19-wildfire smoke paradox: Reduced risk of all-cause mortality due to wildfire smoke in Colorado during the first year of the COVID-19 pandemic.

BACKGROUND: In 2020, the American West faced two competing challenges: the COVID-19 pandemic and the worst wildfire season on record. Several studies have investigated the impact of wildfire smoke (WFS) on COVID-19 morbidity and mortality, but little is known about how these two public health challenges impact mortality risk for other causes. OBJECTIVES: Using a time-series design, we evaluated how daily risk of mortality due to WFS exposure differed for periods before and during the COVID-19 pandemic. METHODS: Our study included daily data for 11 counties in the Front Range region of Colorado (2010-2020). We assessed WFS exposure using data from the National Oceanic and Atmospheric Administration and used mortality counts from the Colorado Department of Public Health and Environment. We estimated the interaction between WFS and the pandemic (an indicator variable) on mortality risk using generalized additive models adjusted for year, day of week, fine particulate matter, ozone, temperature, and a smoothed term for day of year. RESULTS: WFS impacted the study area on 10% of county-days. We observed a positive association between the presence of WFS and all-cause mortality risk (incidence rate ratio (IRR) = 1.03, 95%CI: 1.01-1.04 for same-day exposures) during the period before the pandemic; however, WFS exposure during the pandemic resulted in decreased risk of all-cause mortality (IRR = 0.90, 95%CI: 0.87-0.93 for same-day exposures). DISCUSSION: We hypothesize that mitigation efforts during the first year of the pandemic, e.g., mask mandates, along with high ambient WFS levels encouraged health behaviors that reduced exposure to WFS and reduced risk of all-cause mortality. Our results suggest a need to examine how associations between WFS and mortality are impacted by pandemic-related factors and that there may be lessons from the pandemic that could be translated into health-protective policies during future wildfire events.

Impacts of Wildfire Smoke and Air Pollution on a Pediatric Population with Asthma: A Population-Based Study.

Wildfires are increasing yearly in number and severity as a part of the evolving climate crisis. These fires are a significant source of air pollution, a common driver of flares in cardiorespiratory disease, including asthma, which is the most common chronic disease of childhood. Poorly controlled asthma leads to significant societal costs through morbidity, mortality, lost school and work time and healthcare utilization. This retrospective cohort study set in Calgary, Canada evaluates the relationship between asthma exacerbations during wildfire smoke events and equivalent low-pollution periods in a pediatric asthma population. Air pollution was based on daily average levels of PM2.5. Wildfire smoke events were determined by combining information from provincial databases and local monitors. Exposures were assumed using postal codes in the health record at the time of emergency department visits. Provincial claims data identified 27,501 asthma exacerbations in 57,375 children with asthma between 2010 to 2021. Wildfire smoke days demonstrated an increase in asthma exacerbations over the baseline (incidence rate ratio: 1.13; 95% CI: 1.02-1.24); this was not seen with air pollution in general. Increased rates of asthma exacerbations were also noted yearly in September. Asthma exacerbations were significantly decreased during periods of COVID-19 healthcare precautions.

The Impact of Coronavirus Disease of 2019 (COVID-19) Lockdown Restrictions on the Criteria Pollutants

Air pollution is accountable for various long-term and short-term respiratory diseases and even deaths. Air pollution is normally associated with a decreasing life expectancy. Governments have been implementing strategies to improve air quality. However, natural events have always played an important role in the concentration of air pollutants. In Australia, the lockdown period followed the Black Summer of 2019-2020 and coincided with the season of prescribed burns. This paper investigates the changes in the concentration of criteria pollutants such as particulate matter, nitrogen dioxide, ozone, and sulphur dioxide. The air quality data for the lockdown period in 2020 was compared with the pre-lockdown period in 2020 and with corresponding periods of previous years from 2016 to 2019. The results were also compared with the post-lockdown scenario of 2020 and 2021 to understand how the concentration levels changed due to behavioural changes and a lack of background events. The results revealed that the COVID-19 restrictions had some impact on the concentration of pollutants;however, the location of monitoring stations played an important role.

Long-term impacts of non-occupational wildfire exposure on human health: A systematic review.

The intensity and frequency of wildfires is increasing globally. The systematic review of the current evidence on long-term impacts of non-occupational wildfire exposure on human health has not been performed yet. To provide a systematic review and identify potential knowledge gaps in the current evidence of long-term impacts of non-occupational exposure to wildfire smoke and/or wildfire impacts on human health. We conducted a systematic search of the literature via MEDLINE, Embase and Scopus from the database inception to July 05, 2022. References from the included studies and relevant reviews were also considered. The Newcastle-Ottawa Scale (NOS) and a validated quality assessment framework were used to evaluate the quality of observational studies. Study results were synthesized descriptively. A total of 36 studies were included in our systematic review. Most studies were from developed countries (11 in Australia, 9 in Canada, 7 in the United States). Studies predominantly focused on mental health (21 studies, 58.33%), while evidence on long-term impacts of wildfire exposure on health outcomes other than mental health is limited. Current evidence indicated that long-term impacts of non-occupational wildfire exposure were associated with mortality (COVID-19 mortality, cardiovascular disease mortality and acute myocardial disease mortality), morbidity (mainly respiratory diseases), mental health disorders (mainly posttraumatic stress disorder), shorter height of children, reduced lung function and poorer general health status. However, no significant associations were observed for long-term impacts of wildfire exposure on child mortality and respiratory hospitalizations. The population-based high-quality evidence with quantitative analysis on this topic is still limited. Future well-designed studies considering extensive wildfire smoke air pollutants (e.g., particulate matter, ozone, nitrogen oxides) and estimating risk coefficient values for extensive health outcomes (e.g., mortality, morbidity) are warranted to fill current knowledge gaps.

Vast ecosystem disturbance in a warming climate may jeopardize our climate goal of reducing CO2: a case study for megafires in the Australian 'black summer'.

A warming climate is one of the most important driving forces of intensified wildfires globally. The unprecedented wildfires broke out in the Australian 'Black Summer' (November 2019-February 2020), which released massive heat, gases, and particles into the atmosphere. The total carbon dioxide (CO2) emissions from wildfires were estimated at ∼963 million tons by using a top-down approach based on direct satellite measurements of CO2 and fire radiative power. The fire emissions have led to an approximately 50-80 folds increase in total CO2 emission in Australia compared with the similar seasons of 2014-2019. The excess CO2 from wildfires has offset almost half of the global anthropogenic CO2 emission reductions due to the Corona Virus Disease 2019 in 2020. When the wildfires were intense in December 2019, they caused a 1.48 watts per square meter additional positive radiative forcing above the monthly average in Australia and the vicinity. Our findings demonstrate that vast ecosystem disturbance in a warming climate can strongly influence the global carbon cycle and hamper our climate goal of reducing CO2.

Managed Wildfire: A Strategy Facilitated by Civil Society Partnerships and Interagency Cooperation

Federal land managers in the United States are permitted to manage wildfires with strategies other than full suppression under appropriate conditions to achieve natural resource objectives. However, policy and scientific support for “managed wildfire” appear insufficient to support its broad use. We conducted case studies in northern New Mexico and southwestern Utah to examine how managers and stakeholders navigated shifting barriers and opportunities to use managed wildfire from 2018 to 2021. The use of managed wildfire was fostered through an active network of civil society partnerships in one case, and strong interagency cooperation and existing policies and plans in the other. In both, the COVID-19 pandemic, drought, and agency direction curtailed recent use. Local context shapes wildfire response strategies, yet centralized decision-making and policy also can enable or constrain them. Future research could refine the understanding of social factors in incident decision-making, and evaluation of risks and tradeoffs in wildfire response. Implications Managers and stakeholders seeking to restore fire’s ecological roles in their own landscapes through the use of managed wildfires could use these findings to cultivate supportive local environments for their objectives. Both case studies offer examples of how managed wildfires may be facilitated through civil society partnerships and interagency cooperation. Networks of civil society and agency partners can encourage policy change at multiple levels through concerted efforts over time, particularly by building a larger case through localized examples of collaborative projects and a body of regionally relevant scientific evidence. Strong interagency cooperation on both mitigation and response can also foster an environment of mutual understanding, even given differing missions and mandates for managed wildfire. Management implications Federal wildfire response must consider multiple objectives that may compete across scales, social-ecological contexts, and timeframes. These include minimizing negative impacts on human values, responding to immediate risks of fire exposure, managing land sustainably under longer timeframes;and meeting accomplishment targets, such as acres of hazardous fuels reduction, ecological restoration, and other resource objectives. Federal wildfires and land managers are permitted to manage wildfires for natural resource objectives but face challenges of ambiguous terminology, conflicting policies, drought, increasing numbers of homes in wildlands, and unanticipated events, such as the COVID-19 pandemic. Conditions, opportunities, and barriers to manage wildfire vary substantially by locality and are dependent on local actors, yet also subject to higher-level changes in policy direction. Beyond improved risk analytics and decision support tools, enabling social and internal institutional conditions may also facilitate opportunities for use of managed wildfire. Social science can provide evidence and frameworks including concrete lessons learned, expanded use of after-action reviews, process monitoring, briefings with leadership, and science application through boundary-spanning organizations. © 2022 Taylor & Francis Group, LLC.

CONSULTATION-LIAISON PSYCHIATRY RESPONSE TO THE IMPACT OF BUSHFIRES, VOLCANOS AND COVID-19 ON A STATE-WIDE BURN CENTRE

Background: The Statewide Burns Unit (SWBU) at Royal North Shore Hospital, one of two burns units in NSW, is a 12-bed unit run under the plastics/burns surgical team, nurse unit manager and multidisciplinary allied health team. Consultation-liaison (CL) psychiatry provides a part-time CL psychiatry registrar supervised by a parttime CL psychiatrist, who see and assess all admissions for pre-morbid and/or new and emerging acute mental health (MH) issues. Over 2019-2021 the SWBU saw significant numbers of burn injury patients because of several natural disasters and a spike in self-immolation during Sydney's COVID-19 lockdowns. The traumatic nature of the injuries was challenging for staff to manage over such a prolonged period. Senior team members were aware of the urgent need to (1) increase support for staff to minimise burnout risk and (2) improve access to longer-term psychological treatments for patients after discharge. Objectives: To report on the MH issues managed during this time, the management challenges and the process of significant service development, aiming to address unmet patient need as well as staffing, burnout and vicarious trauma. Methods: Naturalistic file review and NSW Statewide Burns registrar review supplemented by data from interviews with SWBU multidisciplinary team staff members. Conclusion: Trauma-informed and relational care is at the heart of the SWBU multidisciplinary team approach to care, requiring high-level service support and funding. CL psychiatry services can have a significant role in promoting service development, which sits under CanMEDS hats of clinical expert, advocate and leader.

DOUBLE JEOPARDY - PREGNANCY DURING A CATASTROPHIC BUSHFIRE EVENT FOLLOWED BY A PANDEMIC

Background: Over the summer of 2019/2020, NSW experienced the worst bushfires in recorded history shortly followed by the COVID-19 pandemic with mandated restrictions to movement from home and maternity care. A number of pregnancies spanned these events. Objective: To assess the impact of exposure to bushfires and pandemic restrictions on perinatal outcomes. Methods: The study included 60 054 pregnant women who gave birth November 2017-December 2020 in Sydney. Exposure cohorts were based on conception dates in relation to bushfire and pandemic restrictions: (1) bushfire exposure only;(2) bushfires in early pregnancy, born during lockdown;(3) conceived during bushfires, born during ongoing restrictions;(4) pandemic exposure only. Exposure cohorts were compared with pregnancies in the same periods in the two years prior. Generalised estimating equations assessed associations between the exposure cohorts with pregnancy and birth outcomes adjusting for covariates. Results: Pregnancies exposed to both bushfires and pandemic restrictions (2 and 3) had an increased risk of adverse perinatal outcomes compared to previous years and more than cohorts 1 and 4. For cohorts 2 and 3 unplanned caesarean sections were increased (aOR 1.16, 95% CI 1.04, 1.30);for cohort 2 low birthweight increased (aOR 1.21, 95% CI 1.03, 1.41);for cohort 3 gestational diabetes mellitus decreased (aOR 0.90, 95% CI 0.81, 1.00), while prelabour rupture of membranes and macrosomia increased (aOR 1.25, 95% CI 1.07, 1.4, aOR 1.17, 95% CI 1.03, 1.33 respectively). Conclusion: Exposure to both severe climate events and pandemic disruptions increases the risk of adverse perinatal outcomes. Given their increasing prevalence, additional research and vigilance is warranted.

Double jeopardy-pregnancy and birth during a catastrophic bushfire event followed by a pandemic lockdown, a natural experiment.

BACKGROUND: From November 2019 to January 2020, eastern Australia experienced the worst bushfires in recorded history. Two months later, Sydney and surrounds were placed into lockdown for six weeks due to the COVID-19 pandemic, followed by ongoing restrictions. Many pregnant women at this time were exposed to both the bushfires and COVID-19 restrictions. OBJECTIVE: To assess the impact of exposure to bushfires and pandemic restrictions on perinatal outcomes. METHODS: The study included 60 054 pregnant women who gave birth between November 2017 and December 2020 in South Sydney. Exposure cohorts were based on conception and birthing dates: 1) bushfire late pregnancy, born before lockdown; 2) bushfires in early-mid pregnancy, born during lockdown or soon after; 3) conceived during bushfires, lockdown in second trimester; 4) conceived after bushfires, pregnancy during restrictions. Exposure cohorts were compared with pregnancies in the matching periods in the two years prior. Associations between exposure cohorts and gestational diabetes, preeclampsia, hypertension, stillbirth, mode of birth, birthweight, preterm birth and small for gestational age were assessed using generalised estimating equations, adjusting for covariates. RESULTS: A decrease in low birth weight was observed for cohort 1 (aOR 0.81, 95%CI 0.69, 0.95). Conversely, cohort 2 showed an increase in low birth weight, and increases in prelabour rupture of membranes, and caesarean sections (aOR 1.18, 95%CI 1.03, 1.37; aOR 1.21, 95%CI 1.07, 1.37; aOR 1.10 (1.02, 1.18) respectively). Cohort 3 showed an increase in unplanned caesarean sections and high birth weight babies (aOR 1.15, 95%CI 1.04, 1.27 and aOR 1.16, 95%CI 1.02, 1.31 respectively), and a decrease in gestational diabetes mellitus was observed for both cohorts 3 and 4. CONCLUSION: Pregnancies exposed to both severe climate events and pandemic disruptions appear to have increased risk of adverse perinatal outcomes beyond only experiencing one event, but further research is needed.

Investigation of COVID-19 Outbreak among Wildland Firefighters during Wildfire Response, Colorado, USA, 2020.

A COVID-19 outbreak occurred among Cameron Peak Fire responders in Colorado, USA, during August 2020-January 2021. The Cameron Peak Fire was the largest recorded wildfire in Colorado history, lasting August-December 2020. At least 6,123 responders were involved, including 1,260 firefighters in 63 crews who mobilized to the fire camps. A total of 79 COVID-19 cases were identified among responders, and 273 close contacts were quarantined. State and local public health investigated the outbreak and coordinated with wildfire management teams to prevent disease spread. We performed whole-genome sequencing and applied social network analysis to visualize clusters and transmission dynamics. Phylogenetic analysis identified 8 lineages among sequenced specimens, implying multiple introductions. Social network analysis identified spread between and within crews. Strategies such as implementing symptom screening and testing of arriving responders, educating responders about overlapping symptoms of smoke inhalation and COVID-19, improving physical distancing of crews, and encouraging vaccinations are recommended.

Ecological consequences of Australia's "Black Summer" bushfires: Managing for recovery.

Fire has long been a part of the Australian environment and remains a potent force in shaping the adaptations of species, the dynamics of populations, and the structure of ecological communities. However, the fire regime is changing. Fire seasons are longer, wet vegetation types that do not usually burn are now at risk, and fire intensity and severity are greater than in the recent past. A particularly widespread event occurred in the forest and woodland regions of Australia over the summer of 2019-2020. Termed the "Black Summer" bushfires, remotely sensed data indicate that over 30 million hectares of vegetation were burned, including an unprecedented large area of forest. The extraordinary geographical scale of the Black Summer fires, including the intensity and speed of fire spread, has led to widespread concern about the ecological damage that occurred. Recent estimates suggest that almost three billion vertebrates and up to 240 trillion invertebrates were affected by the fires. Fires were experienced in part of the geographical ranges of 832 vertebrate species and 37 threatened ecological communities, with some of these entities feared to be at risk of extinction. Field assessments of ecological recovery have been slowed by COVID-19 restrictions and by a diminution in ecological monitoring capacity that occurred before the last fire season. This paper assesses the dire ecological consequences of the Black Summer bushfires and proposes a series of steps to help achieve recovery of biodiversity and mitigate the effects of future mega-fires. Integr Environ Assess Manag 2021;17:1162-1167. © 2021 SETAC.

Cumulative trauma from multiple natural disasters increases mental health burden on residents of Fort McMurray.

Background: Fort McMurray, a city in northern Alberta, Canada, has experienced multiple traumatic events in the last five years, including the 2016 wildfire, the 2020 floods, and the COVID-19 pandemic. Traumatic events often lead to increased mental health burdens in affected communities. Objective: To assess if the number of traumatic events experienced by residents of Fort McMurray correlates with the prevalence and severity of mental health issues experienced. Methodology: A cross-sectional study using an online survey questionnaire was used to gather demographic, trauma (wildfire, flooding, and COVID-19), and clinical information from the resident of Fort McMurray between April 24 to June 2 2021. Likely Generalized Anxiety Disorder (GAD), Major Depressive Disorder (MDD), Post-Traumatic Stress Disorder (PTSD) and low resilience were measured using standardised rating scales. Data were analyzed with SPSS version 26 using Chi-Square tests and multivariate regression analysis. Results: Respondents who experienced COVID-19 and either flood or wildfire traumas (N = 101) were eleven times more likely to have GAD symptoms (OR: 11.39; 95% CI: 1.43-91.04), four times more likely to have likely MDD, (OR: 3.85; 95% CI: .995-14.90), ten times more likely to have likely PTSD (OR: 10.47; 95% CI: 1.28-85.67), and low resilience (OR: 10.56; 95% CI: 1.21-92.17). Respondents who experienced COVID-19, flooding, and wildfire traumas (N = 47) were eighteen times more likely to express GAD symptoms (OR: 18.30; 95% CI: 2.20-152.45) and more than eleven times likely to have likely PTSD (OR: 11.41; 95% CI: 1.34-97.37) in comparison to the respondents who experienced COVID-19 only trauma (N = 19). Conclusion: Measures to reduce climate change and associated natural disasters could reduce the impact of cumulative trauma and associated mental health burden in vulnerable populations. It is essential that more mental health resources are mobilised to support communities impacted by multiple natural disasters. HIGHLIGHTS: The number of traumatic disasters experienced in residents of Fort McMurray five years after the 2016 wildfires, a year after the 2020 flooding, and during the COVID-19 pandemic correlates with the prevalence and severity of the mental health conditions reported in this study.

Antecedentes: Fort McMurray es una ciudad en el norte de Alberta, Canadá, que ha experimentado múltiples eventos traumáticos en los últimos cinco años, incluyendo el incendio forestal del 2016, las inundaciones del 2020 y la pandemia por la COVID-19. Los eventos traumáticos con frecuencia conducen a una mayor carga de salud mental en las comunidades afectadas. Objetivo: Evaluar si el número de eventos traumáticos experimentados por los residentes de Fort McMurray se correlacionan con la prevalencia y la severidad de los problemas de salud mental experimentados. Métodos: Se realizó un estudio transversal utilizando un cuestionario en línea para recolectar información demográfica relacionada con el trauma (incendio forestal, inundación y COVID-19) y con la información clínica de los residentes de Fort McMurray entre el 24 de abril y el 2 de junio del 2021. Se midió la probabilidad del trastorno de ansiedad generalizada (TAG), del trastorno depresivo mayor (TDM), del trastorno de estrés postraumático (TEPT) y de una baja resiliencia utilizando escalas de medición estandarizadas. Los datos fueron analizados con el programa SPSS versión 26 utilizando las pruebas de Chi cuadrado y el análisis multivariado de regresión. Resultados: Los encuestados que experimentaron la COVID-19 y los traumas por las inundaciones o los incendios forestales (N=101) tenían once veces más probabilidad de tener síntomas de TAG (OR: 11.39; 95% CI: 1.43­91.04), cuatro veces más probabilidad de tener un TDM (OR: 3.85; 95% CI:.995­14.90), diez veces más probabilidad de tener TEPT (OR: 10.47; 95% CI: 1.28­85.67) y una baja resiliencia. Los encuestados que experimentaron traumas tanto por la COVID 19, por las inundaciones y por los incendios forestales (N=47) tenían dieciocho veces más probabilidad de expresar síntomas de TAG (OR: 18.30; 95% CI: 2.20­152.45) y más de once veces la probabilidad de tener TEPT (OR: 11.41; 95% CI: 1.34­97.37) en comparación con los encuestados que experimentaron a la COVID-19 como su única experiencia traumática (N=19). Conclusiones: Las medidas para reducir el cambio climático y los desastres naturales asociados podrían reducir el impacto acumulativo de las experiencias traumáticas y la carga de salud mental asociada en poblaciones vulnerables. Es esencial que se movilicen más recursos de salud mental para brindar apoyo a las comunidades afectadas por múltiples desastres naturales.

A Historical Perspective to Inform Strategic Planning for 2020 End-of-Year Wildland Fire Response Efforts

A severe outbreak of wildfire across the US Pacific Coast during August 2020 led to persistent fire activity through the end of summer. In late September, Fire Weather Outlooks predicted higher than usual fire activity into the winter in parts of California, with concomitant elevated fire danger in the Southeastern US. To help inform the regional and national allocation of firefighting personnel and equipment, we developed visualizations of resource use during recent late season, high-demand analogs. Our visualizations provided an overview of the crew, engine, dozer, aerial resource, and incident management team usage by geographic area. While these visualizations afforded information that managers needed to support their decisions regarding resource allocation, they also revealed a potentially significant gap between resource demand and late-season availability that is only likely to increase over time due to lengthening fire seasons. This gap highlights the need for the increased assessment of suppression resource acquisition and allocation systems that, to date, have been poorly studied.

Health Systems Responsiveness in Addressing Indigenous Residents' Health and Mental Health Needs Following the 2016 Horse River Wildfire in Northern Alberta, Canada: Perspectives From Health Service Providers.

Following the 2016 Horse River Wildfire in northern Alberta, the provincial health authority, the ministry of health, non-profit and charitable organizations, and regional community-based service agencies mobilized to address the growing health and mental health concerns among Indigenous residents and communities through the provision of services and supports. Among the communities and residents that experienced significant devastation and loss were First Nation and Métis residents in the region. Provincial and local funding was allocated to new recovery positions and to support pre-existing health and social programs. The objective of this research was to qualitatively describe the health systems response to the health impacts following the wildfire from the perspective of service providers who were directly responsible for delivering or organizing health and mental wellness services and supports to Indigenous residents. Semi-structured qualitative interviews were conducted with 15 Indigenous and 10 non-Indigenous service providers from the Regional Municipality of Wood Buffalo (RMWB). Interviews were transcribed verbatim and a constant comparative analysis method was used to identify themes. Following service provider interviews, a supplemental document review was completed to provide background and context for the qualitative findings from interviews. The document review allowed for a better understanding of the health systems response at a systems level following the wildfire. Triangulation of semi-structured interviews and organization report documents confirmed our findings. The conceptual framework by Mirzoev and Kane for understanding health systems responsiveness guided our data interpretation. Our findings were divided into three themes (1) service provision in response to Indigenous mental health concerns (2) gaps in Indigenous health-related services post-wildfire and (3) adopting a health equity lens in post-disaster recovery. The knowledge gained from this research can help inform future emergency management and assist policy and decision makers with culturally safe and responsive recovery planning. Future recovery and response efforts should consider identifying and addressing underlying health, mental health, and emotional concerns in order to be more effective in assisting with healing for Indigenous communities following a public health emergency such as a wildfire disaster.

The Experience and Perceived Consequences of the 2016 Fort McMurray Fires and Evacuation.

Few studies have examined the scope of the subjective experience during and after a natural disaster. This qualitative study explored the perceptions of persons affected by the wildfires and evacuation of Fort McMurray in 2016. The objectives were to document (1) the experience of the evacuation, and (2) the biopsychosocial consequences of the wildfires as perceived by evacuees from Fort McMurray 3 months and 3 years after evacuation. This study included two data collections, one from 393 evacuees 3 months after evacuation using an online questionnaire, and the other from 31 participants (among those who participated in the 3-month evaluation) interviewed by telephone 3 years after evacuation. Eight themes describing the evacuation experience emerged from the qualitative analysis: the preparation for evacuation, the perceived traumatic nature of the evacuation, problems encountered while on the move, assistance received and provided, vulnerability conditions, presence of physical discomfort, relocation and no problem/no response. Seven categories of negative consequences emerged: material and financial loss, emotional/mental health disorders, cognitive impairments, behavioral changes, spiritual/existential reflections, social alterations, and physical conditions. Four categories of positive consequences emerged: posttraumatic growth, resilience/absence of consequences, altruism and community cohesion. This study showed a wide range of perceived consequences of fires and evacuations by Fort McMurray residents. The results highlight the importance of tailoring responses to the needs of evacuees and providing assistance to victims over a long period of time.

Association of COVID-19 and Endocrine Disorders

Coronavirus Disease 2019 (COVID-19), caused by the coronavirus, since its start in Wuhan a city in China has spread like a wild fire and created havoc all over the globe. Initially, the disease was thought to be causing only respiratory complication, but gradually it was found to be causing multiorgan complication. Due to the hypercoagulable property of coronavirus, it has shown neurological, cardiological and endocrine complication. Recently, the effect of the virus on endocrine system has also been noted. Evidence has shown that COVID-19 can hamper the hypothalamo-pituitary axis resulting in altered adrenal response to stress. The immune-mediated damage to the endocrine glands results in subacute thyroiditis. The presence of Angiotensin Converting Enzyme 2 (ACE 2) receptors on various tissues could be the cause of this immune mediated damage. COVID-19 has also precipitated hyperglycaemia and in few cases, uncovered the insulin resistance in previously undiagnosed cases. It is crucial to have knowledge about the impact of endocrine system, as it is the powerhouse of the body.