Managing blood supplies during natural disasters, humanitarian emergencies, and pandemics: lessons learned from COVID-19.

INTRODUCTION: The COVID-19 pandemic has resulted in a historic public health crisis with widespread social and economic ramifications. The pandemic has also affected the blood supply, resulting in unprecedented and sustained blood shortages. AREAS COVERED: This review describes the challenges of maintaining a safe and sufficient blood supply in the wake of natural disasters, humanitarian emergencies, and pandemics. The challenges, which are accentuated in low- and high-income countries, span the impact on human capacity (affecting blood donors and blood collections personnel alike), disruption to supply chains, and economic sustainability. COVID-19 imparted lessons on how to offset these challenges, which may be applied to future pandemics and public health crises. EXPERT OPINION: Pandemic emergency preparedness plans should be implemented or revised by blood centers and hospitals to lessen the impact to the blood supply. Comprehensive planning should address the timely assessment of risk to the blood supply, rapid donor recruitment, and communication of need, measures to preserve safety for donors and operational staff, careful blood management, and resource sharing.

Use of the HESPER Web to Assess Perceived Needs Immediately After Multiple Disaster Events in Fiji.

OBJECTIVE: In January 2022, Fiji was hit by multiple natural disasters, including a cyclone causing flooding, an underwater volcanic eruption, and a tsunami. This study aimed to investigate perceived needs among the disaster-affected people in Fiji and to evaluate the feasibility of the Humanitarian Emergency Settings Perceived Needs Scale (HESPER Web) during the early stage after multiple natural disasters. METHODS: A cross-sectional study using a self-selected, non-representative study sample was conducted. The HESPER Web was used to collect data. RESULTS: In all, 242 people participated. The number of perceived serious needs ranged between 2 and 14 (out of a possible 26), with a mean of 6 (SD = 3). The top 3 most reported needs were access to toilets (60%), care for people in the community who are on their own (55%), and distress (51%). Volunteers reported fewer needs than the general public. CONCLUSIONS: The top 3 needs reported were related to water and sanitation and psychosocial needs. Such needs should not be underestimated in the emergency phase after natural disasters and may require more attention from responding actors. The HESPER Web was considered a usable tool for needs assessment in a sudden onset disaster.

Characterizing household emergency preparedness levels for natural disasters during the COVID-19 pandemic: United States, 2020-2021.

INTRODUCTION: It is vital that households are prepared for a natural disaster to help mitigate potential negative impacts. Our goal was to characterize United States household preparedness on a national level to guide next steps to better prepare for and respond to disasters during the COVID-19 pandemic. METHODS: We added 10 questions to the existing Porter Novelli's ConsumerStyles surveys in fall 2020 (N = 4,548) and spring 2021 (N = 6,455) to examine factors that contribute to overall household preparedness levels. RESULTS: Being married (odds ratio (OR), 1.2), having children in the home (OR, 1.5), and having a household income of $150,000 or more (OR, 1.2) are all associated with increased preparedness levels. Those in the Northeast are least likely to be prepared (OR, 0.8). Persons living in mobile homes, Recreational Vehicles, boats, or vans are half as likely to have preparedness plans compared to those living in single family homes (OR, 0.6). CONCLUSIONS: As a nation, there is much work to be done in terms of preparedness to reach performance measure targets of 80 percent. These data can help inform response planning and the updating of communication resources such as websites, fact sheets, and other materials to reach a wide audience of disaster epidemiologists, emergency managers, and the public.

Learning from disaster: A natural experiment exploring disaster preparedness before and during the COVID-19 pandemic by houses of worship.

This study illuminates how congregations adapted to an unfolding crisis in real-time and reveals areas of organizational learning and vulnerability. The driving question of this study asks "how has congregational disaster readiness changed during COVID-19?" From this, three measurable corollary questions emerge. First, how has experience during the pandemic changed risk assessment and planning? Second, how has disaster networking changed due to pandemic experiences? Third, did pandemic experience lead to a change in collaboration activities and actions? A natural experiment research design is used to answer these questions. Data collected from survey responses from 50 congregational leaders in 2020 are compared to their baseline responses and interviews as part of a more extensive study from 2019 of over 300 leaders. Descriptive analysis is used to evaluate how congregational leaders changed their risk assessment, disaster planning, disaster networking, and collaboration activities from 2019 to 2020. Open-ended questions provide qualitative context for the survey responses. Initial results support two themes for scholars and emergency managers: learning is immediate, and network maintenance matters. First, while awareness of pandemics has grown, congregational leaders narrowly applied the lessons they learned to temporally and spatially immediate hazards. Second, congregational networking and collaboration became more insular and local during the pandemic response. These results could have substantial implications for community resilience, especially given the role congregations and similar organizations play in community disaster resiliency.

"I can't make all this work." End of life care provision in natural disasters: a qualitative study.

BACKGROUND: Natural disasters are becoming more frequent and severe and profoundly impact the end-of-life care experience, including service provision. There is a paucity of research examining healthcare workers' experiences in responding to care demands when disasters strike. This research aimed to fill this gap by exploring end-of-life care providers' perceptions of the impact of natural disasters on end-of-life care. METHODS: Between Feb 2021-June 2021 ten in-depth semi-structured interviews were conducted with healthcare professionals providing end-of-life care during recent natural disasters, COVID-19, and/or fires and floods. Interviews were audio-recorded, transcribed, and analysed using a hybrid inductive and deductive thematic approach. RESULTS: The overarching theme from the healthcare workers' accounts was of being unable to provide effective compassionate and quality care - "I can't make all this work." They spoke of the considerable burdens the system imposed on them, of being overextended and overwhelmed, having their roles overturned, and losing the human element of care for those at end-of-life. CONCLUSION: There is urgent need to pioneer effective solutions to minimise the distress of healthcare professionals in delivering end-of-life care in disaster contexts, and to improve the experience of those dying.

Disasters in Spain from 1950 - 2020: Impact on Public Health.

OBJECTIVE: The aim of this study was to establish the frequency and profile of disasters and to analyze trends in disasters and their impact on Spanish public health. METHODS: Retrospective observational study of disasters that occurred in Spain from 1950 through 2020 was conducted. The variables studied for each episode were number of people affected, number of injured/sick, and number of deaths. Absolute and relative frequencies, population rates, mean, median, standard error of the mean (SEM), and 95% confidence intervals (CI) were used, and trend analysis was performed using exponential smoothing and linear regression. RESULTS: A total of 491 disasters were identified in Spain. Of these, 255 (51.9%) were natural disasters, 224 (45.7%) technological disasters, and 12 (2.4%) man-made disasters. The average number of disasters per year was 7.01 (95% CI, 5.99-9.34). These disasters affected a total of 820,489 people, with an average of 3,491 people (SEM = 2.18) per episode. There was a significant increase (P <.001) in the total frequency of disasters in Spain during the period studied. CONCLUSIONS: Spain has a disaster profile of mixed type, combining natural with technological disasters. From 1950 through 2020, there was a significant increase in the number of disasters, with an overall profile similar to that of Europe, with climatological disasters being the most frequent type.

A spatiotemporal decay model of human mobility when facing large-scale crises.

A common feature of large-scale extreme events, such as pandemics, wildfires, and major storms is that, despite their differences in etiology and duration, they significantly change routine human movement patterns. Such changes, which can be major or minor in size and duration and which differ across contexts, affect both the consequences of the events and the ability of governments to mount effective responses. Based on naturally tracked, anonymized mobility behavior from over 90 million people in the United States, we document these mobility differences in space and over time in six large-scale crises, including wildfires, major tropical storms, winter freeze and pandemics. We introduce a model that effectively captures the high-dimensional heterogeneity in human mobility changes following large-scale extreme events. Across five different metrics and regardless of spatial resolution, the changes in human mobility behavior exhibit a consistent hyperbolic decline, a pattern we characterize as "spatiotemporal decay." When applied to the case of COVID-19, our model also uncovers significant disparities in mobility changes-individuals from wealthy areas not only reduce their mobility at higher rates at the start of the pandemic but also maintain the change longer. Residents from lower-income regions show a faster and greater hyperbolic decay, which we suggest may help account for different COVID-19 rates. Our model represents a powerful tool to understand and forecast mobility patterns post emergency, and thus to help produce more effective responses.

Lessons Learned from Natural Disasters around Digital Health Technologies and Delivering Quality Healthcare.

As climate change drives increased intensity, duration and severity of weather-related events that can lead to natural disasters and mass casualties, innovative approaches are needed to develop climate-resilient healthcare systems that can deliver safe, quality healthcare under non-optimal conditions, especially in remote or underserved areas. Digital health technologies are touted as a potential contributor to healthcare climate change adaptation and mitigation, through improved access to healthcare, reduced inefficiencies, reduced costs, and increased portability of patient information. Under normal operating conditions, these systems are employed to deliver personalised healthcare and better patient and consumer involvement in their health and well-being. During the COVID-19 pandemic, digital health technologies were rapidly implemented on a mass scale in many settings to deliver healthcare in compliance with public health interventions, including lockdowns. However, the resilience and effectiveness of digital health technologies in the face of the increasing frequency and severity of natural disasters remain to be determined. In this review, using the mixed-methods review methodology, we seek to map what is known about digital health resilience in the context of natural disasters using case studies to demonstrate what works and what does not and to propose future directions to build climate-resilient digital health interventions.

"The Drug Sellers Were Better Organized than the Government": A Qualitative Study of Participants' Views of Drug Markets during COVID-19 and Other Big Events.

"Big events", such as wars, economic crises, pandemics, or natural disasters, affect the risk environment in which people use drugs. While the impact of big events on injection risk behaviors and access to drug-treatment services is well documented, less is known about the effects of big events on drug markets. Based on self-reporting data on drug availability among people who use drugs (PWUD) in the aftermath of Hurricane Maria in Puerto Rico and during the COVID-19 lockdown in a Midwestern US state, this study aims to document the effects of big events on drug markets. Qualitative data on the effects of Hurricane Maria on drug markets are based on participants' self-reporting (N = 31). Data collection started after the hurricane and ended in 2020. Data on changes to the drug supply during the COVID-19 lockdown were collected based on semi-structured interviews with PWUD (N = 40) in a Midwestern US state. Findings show that while the drug markets might have initially been affected by big events, most effects were temporary. Drug availability, pricing, and quality might have suffered some initial fluctuations but stabilized as the drug markets absorbed the initial shocks caused by the hurricane and the lockdown measures. In preparation for increasingly more frequent and virulent pandemics and natural disasters, health infrastructures should be strengthened to prevent not only overdose episodes and deaths but also drug-related harms.

Interruptions to HIV Care Delivery During Pandemics and Natural Disasters: A Qualitative Study of Challenges and Opportunities From Frontline Healthcare Providers in Western Kenya.

During public health crises, people living with HIV (PLWH) may become disengaged from care. The goal of this study was to understand the impact of the COVID-19 pandemic and recent flooding disasters on HIV care delivery in western Kenya. We conducted ten individual in-depth interviews with HIV providers across four health facilities. We used an iterative and integrated inductive and deductive data analysis approach to generate four themes. First, increased structural interruptions created exacerbating strain on health facilities. Second, there was increased physical and psychosocial burnout among providers. Third, patient uptake of services along the HIV continuum decreased, particularly among vulnerable patients. Finally, existing community-based programs and teleconsultations could be adapted to provide differentiated HIV care. Community-centric care programs, with an emphasis on overcoming the social, economic, and structural barriers will be crucial to ensure optimal care and limit the impact of public health disruptions on HIV care globally.

Business grants following natural disasters and their different impact on the performance of female and male-owned microenterprises: Evidence from Sri Lanka.

OBJECTIVE: This paper investigates gender differences in the treatment effects of business grants on firm performance following natural disasters, and seeks to identify the mechanisms underlying the unequal effects. METHOD: A panel data-set from an experiment in Sri Lanka is used to measure the difference in the treatment effects of a business grant on the performance of female and male-owned firms following the 2004 Indian Ocean tsunami. The sample of 608 microenterprises includes 297 female-owned firms and 311 male-owned firms. There are 338 firms (Male = 176, Female = 162) in the treatment group that received the grant and 270 firms (Male = 135, Female = 135) in the control group that did not receive the grant. Data on firm performance, firm characteristics and owner characteristics were collected in 13 survey waves from April 2005 to December 2010. Firm performance, which is measured by firm profit, is assessed by employing linear regression with fixed effects in an intention-to-treat analysis. FINDINGS: The results suggest that the business grant has a positive impact on the performance of male-owned firms, but zero effect on that of female-owned firms. Several potential mechanisms drive the results, including gender differences in business investment, household expenditure and initial business closures. The results also show a positive treatment effect of the business grant on the psychological recovery of recipients, but there is no evidence supporting gender differences in this dimension. CONTRIBUTION: This paper provides new evidence on gender differences in the treatment effects of business grants on firm performance in the context of post-disasters, and has implications for business recovery programs aimed at supporting female microentrepreneurs in the aftermath of large-scale catastrophes.

Examining the Indirect Death Surveillance System of The Great East Japan Earthquake and Tsunami.

The long-term mortality risk of natural disasters is a key threat to disaster resilience improvement, yet an authoritative certification and a reliable surveillance system are, unfortunately, yet to be established in many countries. This study aimed to clarify the mechanism of post-disaster indirect deaths in Japan, to improve the existing disaster recovery evaluation system and support decision making in public policy. This study first investigated the definition of indirect deaths via a literature review before examining the observed number of indirect deaths via case study, census data from the Population Demographic and Household Surveys, other social surveys, and reports in the case of the Great East Japan Earthquake and Tsunami, which severely damaged northeastern Japan, especially the three prefectures, which are the target areas in this context (i.e., Fukushima, Iwate, and Miyagi). It was found that the reported number of indirect deaths was significantly underestimated. In total, 4657 indirect deaths were estimated to have occurred in the target prefectures. This was higher than the reported number, which was 3784. The overall statistics established via collaboration between local administrations and governments can be improved to provide better reference for researchers and policymakers to investigate the long-term effects of natural disaster.

Quantifying societal emotional resilience to natural disasters from geo-located social media content.

Natural disasters can have devastating and long-lasting effects on a community's emotional well-being. These effects may be distributed unequally, affecting some communities more profoundly and possibly over longer time periods than others. Here, we analyze the effects of four major US hurricanes, namely, Irma, Harvey, Florence, and Dorian on the emotional well-being of the affected communities and regions. We show that a community's emotional response to a hurricane event can be measured from the content of social media that its population posted before, during, and after the hurricane. For each hurricane making landfall in the US, we observe a significant decrease in sentiment in the affected areas before and during the hurricane followed by a rapid return to pre-hurricane baseline, often within 1-2 weeks. However, some communities exhibit markedly different rates of decline and return to previous equilibrium levels. This points towards the possibility of measuring the emotional resilience of communities from the dynamics of their online emotional response.

Increased generosity under COVID-19 threat.

In the face of crises-wars, pandemics, and natural disasters-both increased selfishness and increased generosity may emerge. In this paper, we study the relationship between the presence of COVID-19 threat and generosity using a four-year longitudinal dataset (N = 696,942) capturing real donations made before and during the pandemic, as well as allocations from a 6-month dictator game study (N = 1003 participants) during the early months of the pandemic. Consistent with the notion of "catastrophe compassion" and contrary to some prior research showing a tendency toward self-interested behavior under threat, individuals across both datasets exhibited greater financial generosity when their county experienced COVID-19 threat. While we find that the presence of threat impacted individual giving, behavior was not sensitive to threat level. Our findings have significant societal implications and advance our understanding of economic and psychological theories of social preferences under threat.

Recruitment and retention of participants in longitudinal studies after a natural disaster.

Climate change and population growth will increase vulnerability to natural and human-made disasters or pandemics. Longitudinal research studies may be adversely impacted by a lack of access to study resources, inability to travel around the urban environment, reluctance of sample members to attend appointments, sample members moving residence and potentially also the destruction of research facilities. One of the key advantages of longitudinal research is the ability to assess associations between exposures and outcomes by limiting the influence of sample selection bias. However, ensuring the validity and reliability of findings in longitudinal research requires the recruitment and retention of respondents who are willing and able to be repeatedly assessed over an extended period of time. This study examined recruitment and retention strategies of 11 longitudinal cohort studies operating during the Christchurch, New Zealand earthquake sequence which began in September 2010, including staff perceptions of the major impediments to study operations during/after the earthquakes and respondents' barriers to participation. Successful strategies to assist recruitment and retention after a natural disaster are discussed. With the current COVID-19 pandemic, longitudinal studies are potentially encountering some of the issues highlighted in this paper including: closure of facilities, restricted movement of research staff and sample members, and reluctance of sample members to attend appointments. It is possible that suggestions in this paper may be implemented so that longitudinal studies can protect the operation of their research programmes.

Impact of Natural Disasters on Mental Health: A Cross-Sectional Study Based on the 2014 China Family Panel Survey.

Mental health problems are a leading cause of disability in both developed and developing countries, and the consequences of mental health disorders for individuals, families, and society as a whole could be severe and costly. To supplement relevant research and provide insightful policy suggestions to families, government and societies, this study investigates the nexus between natural disasters and mental health for middle-aged and older adults in rural China. Based on data of 8721 observations from the 2014 China Family Panel Studies, we estimate the effects of natural disasters on mental health using ordinary least squares and propensity score matching. Our findings suggest that natural disasters have a significant negative effect on middle-aged and older adults' mental health in the case of rural China. This effect is heterogeneous depending on individuals' education level and their agricultural production status. Finally, individuals' happiness and life satisfaction are shown to be the potential mechanism through which the effect of natural disasters on mental health operates.

Infant and young child feeding during natural disasters: A systematic integrative literature review.

BACKGROUND: As climate change worsens, the frequency and intensity of natural disasters continues to increase. These extreme weather events particularly affect the physical and mental health of vulnerable groups such as mothers and infants. From low-income to high income countries, poorly organised disaster response can negatively impact infant and young child feeding practices. AIM: To examine challenges and supportive strategies for infant and young child feeding during natural disasters to inform further research and guide disaster recommendations and practice. METHODS: A comprehensive search strategy explored the electronic databases PubMed, CINAHL and Cochrane Library. Screening, data extraction and analysis were conducted using Covidence. Quality assessment was conducted using the Mixed Methods Appraisal Tool (MMAT). Studies were analysed using thematic analysis. FINDINGS: This review included 13 studies (4 mixed methods, 1 critical ethnography, 2 quasi-experimental studies, 4 descriptive studies, 1 qualitative study, 1 evidence gap map analysis). Breastfeeding facilitators during natural disaster contexts are privacy for breastfeeding, community and family support, adaptation of professional breastfeeding support to the local context and pre-existing breastfeeding practice. Breastfeeding challenges during natural disasters include decreased breastfeeding self-efficacy, lack of knowledge and resources and over-reliance on formula baby milks. Formula baby milk feeding challenges during natural disasters are the lack of access to resources required for hygienic formula baby milk preparation as well as the lack of availability of formula baby milk in some contexts. CONCLUSION: This systematic integrative review demonstrates that interventions which facilitate optimal infant and young child feeding in natural disaster contexts must be culturally and socially appropriate; increasing women's knowledge of optimal breastfeeding and safe formula baby milk feeding practices as well as breastfeeding self-efficacy.