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1.
Front Public Health ; 10: 835330, 2022.
Article in English | MEDLINE | ID: covidwho-2199441

ABSTRACT

Background: The Coronavirus disease 2019 (COVID-19) pandemic has exposed the public health preparedness and response system across the world. The current study was conducted to gauge the perception of public health professionals of Indian Technical and Economic Cooperation (ITEC) countries regarding the preparedness and responses of their countries in mitigating the COVID-19 pandemic. Methodology: Three capacity-building programs, namely "Managing COVID-19 Pandemic-Experience and Best practices of India" were conducted by PGIMER, Chandigarh, for public health professionals from ITEC countries from April to May 2021 in which 97 participants from 13 countries have participated. The tools used in the study were adapted from WHO's COVID-19 Strategic Preparedness and Response (SPRP), Monitoring and Evaluation Framework, interim guidelines for Critical preparedness, readiness and response actions for COVID-19, and a strategic framework for emergency preparedness, and finalized using Delphi technique. The overall preparedness of managing COVID-19 was rated using five-point Likert scale, whereas the overall score for the country in combating the COVID-19 pandemic was assessed using 10 point scale. Results: We found that the perception of public health professionals to government response regarding COVID-19 for fostering improvement on COVID-19 situation was "moderate" with respect to transmission and surveillance mechanism, uniform reporting mechanism, and availability of adequate personal protective equipment (PPE) for health workers. However, the participants rated government response as "poor" in the availability of multisectoral national operational plan, human resource capacity, availability of trained rapid response team (RRT), preparedness in prevention and clinical management, training of healthcare workers, communication and community engagement strategies, facilities to test samples of patients, and transparent governance and administration. Conclusion: A poor level of preparedness of countries in diverse domains of managing the COVID-19 pandemic was observed. As the global threat of COVID-19 is still looming, great efforts on building a robust preparedness and response system for COVID-19 and similar pandemics are urgently required.


Subject(s)
COVID-19 , Civil Defense , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Pandemics/prevention & control , Perception , Personal Protective Equipment
2.
BMJ Open ; 12(11): e062624, 2022 11 22.
Article in English | MEDLINE | ID: covidwho-2152991

ABSTRACT

OBJECTIVES: A systematic review was conducted with the aims of identifying sectors mentioned in the public health emergency preparedness and response (PHEPR) literature and mapping the involvement of those sectors in the seven PHEPR cycle domains. SETTING: A detailed search strategy was conducted in Embase and Scopus, covering the period between 1 January 2005 and 1 January 2020. METHODS: Published articles focusing on preparedness for and/or response to public health emergencies of multiple origins on the European continent were included. The frequency with which predetermined sectors were mentioned when describing collaboration during the preparedness and response cycle was determined. RESULTS: The results show that description of the involvement of sectors in PHEPR in general and collaboration during PHEPR is predominantly confined to a limited number of sectors, namely 'Governmental institutions', 'Human health industry', 'Experts' and 'Civil Society'. Description is also limited to only three domains of the PHEPR cycle, namely 'Risk and crisis management', 'Pre-event preparations and governance' and 'Surveillance'. CONCLUSIONS: Optimal preparedness and response require predefined collaboration with a broader scope of partners than currently seems to be the case based on this literature review. We recommend considering these outcomes when planning multisectoral collaboration during preparedness and response, as well as the need to further operationalise the term 'multisectoral collaboration' during PHEPRs. PROSPERO REGISTRATION NUMBER: PROSPERO with registration number 176 331.


Subject(s)
Civil Defense , Humans , Civil Defense/methods , Public Health/methods
4.
Health Secur ; 20(S1): S60-S70, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1838056

ABSTRACT

Research is foundational for evidence-based management of patients. Clinical research, however, takes time to plan, conduct, and disseminate-a luxury that is rarely available during a public health emergency. The University of Nebraska Medical Center (UNMC) developed a single institutional review board (IRB), with a vision to establish a rapid review resource for a network focused on clinical research of emerging pathogens in the United States. A core aspect of successful initiation of research during a pandemic or epidemic is the ability to operationalize an approach for rapid ethical review of human subject research and conduct those reviews at multiple sites-without losing any of the substantive aspects of ethics review. This process must be cultivated in anticipation of a public health emergency. US guidance for operationalizing IRB review for multisite research in a public health emergency is not well studied and processes are not well established. UNMC sought to address operational gaps and identify the unique procedural needs of rapid response single IRB (RR-sIRB) review of multisite research by conducting a series of preparedness exercises to develop and test the RR-sIRB model. For decades, emergency responder, healthcare, and public health organizations have conducted emergency preparedness exercises to test requirements for emergency response. In this article, we describe 2 types of simulation exercises conducted by UNMC: workshops and tabletops. This effort represents a unique use of emergency preparedness exercises to develop, refine, and test rapid review functions for an sIRB and to validate readiness of regulatory research processes. Such processes are crucial for conducting rapid, ethical, and sound clinical research in public health emergencies.


Subject(s)
Civil Defense , Emergency Responders , Ethics Committees, Research , Humans , Pandemics , Public Health , United States
5.
Psychiatr Danub ; 32(1): 15-21, 2020.
Article in English | MEDLINE | ID: covidwho-2100746

ABSTRACT

The coronavirus (COVID-19) outbreak was labeled a global pandemic by the WHO in March of 2020. Understanding how crisis influence an individual's reactions to stressful events (and vice versa) is important in order to create meaningful and effective interventions. Our literature search have revealed lack of the papers related to psychodynamic approach to recent crisis. Psychodynamic places a large emphasis on defense mechanisms and unconscious mind, where upsetting feelings, urges, and thoughts that are too painful for us to directly look at are housed. Even though these painful feelings and thoughts are outside of our awareness, they still influence our behavior in many ways. Optimal application of psychodynamic approach offers the frame for acceptance of psychological stress in a more positive way and benefits psychological growth. We believe that including psychodynamic approach in the national public and mental health emergency system will empower Croatia and the world during (and after) COVID-19 pandemic crisis.


Subject(s)
Coronavirus Infections/psychology , Mental Health , Pneumonia, Viral/psychology , Psychoanalysis , Stress, Psychological , Betacoronavirus , COVID-19 , Civil Defense , Croatia , Humans , Pandemics , SARS-CoV-2
6.
Lancet ; 395(10227): 871-877, 2020 03 14.
Article in English | MEDLINE | ID: covidwho-2076860

ABSTRACT

BACKGROUND: The novel coronavirus disease 2019 (COVID-19) epidemic has spread from China to 25 countries. Local cycles of transmission have already occurred in 12 countries after case importation. In Africa, Egypt has so far confirmed one case. The management and control of COVID-19 importations heavily rely on a country's health capacity. Here we evaluate the preparedness and vulnerability of African countries against their risk of importation of COVID-19. METHODS: We used data on the volume of air travel departing from airports in the infected provinces in China and directed to Africa to estimate the risk of importation per country. We determined the country's capacity to detect and respond to cases with two indicators: preparedness, using the WHO International Health Regulations Monitoring and Evaluation Framework; and vulnerability, using the Infectious Disease Vulnerability Index. Countries were clustered according to the Chinese regions contributing most to their risk. FINDINGS: Countries with the highest importation risk (ie, Egypt, Algeria, and South Africa) have moderate to high capacity to respond to outbreaks. Countries at moderate risk (ie, Nigeria, Ethiopia, Sudan, Angola, Tanzania, Ghana, and Kenya) have variable capacity and high vulnerability. We identified three clusters of countries that share the same exposure to the risk originating from the provinces of Guangdong, Fujian, and the city of Beijing, respectively. INTERPRETATION: Many countries in Africa are stepping up their preparedness to detect and cope with COVID-19 importations. Resources, intensified surveillance, and capacity building should be urgently prioritised in countries with moderate risk that might be ill-prepared to detect imported cases and to limit onward transmission. FUNDING: EU Framework Programme for Research and Innovation Horizon 2020, Agence Nationale de la Recherche.


Subject(s)
Civil Defense , Coronavirus Infections , Epidemics/prevention & control , Health Resources , Models, Theoretical , Pneumonia, Viral , Population Surveillance , Vulnerable Populations , Africa/epidemiology , COVID-19 , China/epidemiology , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Health Planning , Humans , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Risk Assessment , Travel
8.
Prehosp Disaster Med ; 37(5): 674-686, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2028611

ABSTRACT

INTRODUCTION: Recent disasters emphasize the need for disaster risk mitigation in the health sector. A lack of standardized tools to assess hospital disaster preparedness hinders the improvement of emergency/disaster preparedness in hospitals. There is very limited research on evaluation of hospital disaster preparedness tools. OBJECTIVE: This study aimed to determine the presence and availability of hospital preparedness tools across the world, and to identify the important components of those study instruments. METHOD: A systematic review was performed using three databases, namely Ovid Medline, Embase, and CINAHL, as well as available grey literature sourced by Google, relevant websites, and also from the reference lists of selected articles. The studies published on hospital disaster preparedness across the world from 2011-2020, written in English language, were selected by two independent reviewers. The global distribution of studies was analyzed according to the World Health Organization's (WHO) six geographical regions, and also according to the four categories of the United Nations Human Development Index (UNHDI). The preparedness themes were identified and categorized according to the 4S conceptual framework: space, stuff, staff, and systems. RESULT: From a total of 1,568 articles, 53 met inclusion criteria and were selected for data extraction and synthesis. Few published studies had used a study instrument to assess hospital disaster preparedness. The Eastern Mediterranean region recorded the highest number of such publications. The countries with a low UNHDI were found to have a smaller number of publications. Developing countries had more focus on preparedness for natural disasters and less focus on chemical, biological, radiological, and nuclear (CBRN) preparedness. Infrastructure, logistics, capacity building, and communication were the priority themes under the space, stuff, staff, and system domains of the 4S framework, respectively. The majority of studies had neglected some crucial aspects of hospital disaster preparedness, such as transport, back-up power, morgue facilities and dead body handling, vaccination, rewards/incentive, and volunteers. CONCLUSION: Important preparedness themes were identified under each domain of the 4S framework. The neglected aspects should be properly addressed in order to ensure adequate preparedness of hospitals. The results of this review can be used for planning a comprehensive disaster preparedness tool.


Subject(s)
Civil Defense , Disaster Planning , Disasters , Communication , Hospitals , Humans
9.
Am J Public Health ; 112(S6): S574-S575, 2022 08.
Article in English | MEDLINE | ID: covidwho-2002388
10.
Health Secur ; 19(4): 413-423, 2021.
Article in English | MEDLINE | ID: covidwho-1338084

ABSTRACT

Field simulation exercises (FSXs) require substantial time, resources, and organizational experience to plan and implement and are less commonly undertaken than drills or tabletop exercises. Despite this, FSXs provide an opportunity to test the full scope of operational capacities, including coordination across sectors. From June 11 to 14, 2019, the East African Community Secretariat conducted a cross-border FSX at the Namanga One Stop Border Post between the Republic of Kenya and the United Republic of Tanzania. The World Health Organization Department of Health Security Preparedness was the technical lead responsible for developing and coordinating the exercise. The purpose of the FSX was to assess and further enhance multisectoral outbreak preparedness and response in the East Africa Region, using a One Health approach. Participants included staff from the transport, police and customs, public health, animal health, and food inspection sectors. This was the first FSX of this scale, magnitude, and complexity to be conducted in East Africa for the purpose of strengthening emergency preparedness capacities. The FSX provided an opportunity for individual learning and national capacity strengthening in emergency management and response coordination. In this article, we describe lessons learned and propose recommendations relevant to FSX design, management, and organization to inform future field exercises.


Subject(s)
Civil Defense , Disaster Planning , Africa, Eastern , Disease Outbreaks , Humans , Public Health , World Health Organization
11.
Int J Environ Res Public Health ; 19(14)2022 07 19.
Article in English | MEDLINE | ID: covidwho-1938817

ABSTRACT

BACKGROUND: Pandemic preparedness of healthcare providers helps to mitigate future threats such as spread and fatality rates, as well as the management of the disease. Pharmacists are key partners with public health agencies, and the role of community pharmacists is becoming increasingly recognised in this COVID-19 pandemic. The study aimed to explore the emergency preparedness of community pharmacists (CPs) for COVID-19. METHODS: A cross-sectional study was performed among community pharmacists using cluster sampling followed by convenient sampling. A self-administered questionnaire was formulated using references from the previous literature and the WHO preparedness checklist. Descriptive analysis was undertaken for the participants' socio-demographic characteristics. All the data collected were entered into the Statistical Package for Social Sciences version 24 (SPSS V.24), (IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp.) for analysis. RESULTS: Most of the CPs had five or fewer years of practice experience, and they had all the mandatory information relating to the needs of their communities regarding the disease. The participants knew where to acquire these resources whenever needed. They were able to recognise the signs and symptoms of the disease. Most participants felt that they were confident to provide patient education and carry out their duties during these challenging times. There was a strong position correlation between preparedness and the perceived response of the participants. CONCLUSION: The community pharmacists in Malaysia are prepared enough for COVID-19 pandemic management and perceive that they can respond during any unprecedented situations, such as COVID-19. Community pharmacists were aware of the challenges that they need to face in their community regarding COVID-19.


Subject(s)
COVID-19 , Civil Defense , Community Pharmacy Services , COVID-19/epidemiology , Cross-Sectional Studies , Humans , Malaysia/epidemiology , Pandemics , Pharmacists , Professional Role , Social Determinants of Health
12.
Int J Pharm Pract ; 30(4): 348-353, 2022 Aug 09.
Article in English | MEDLINE | ID: covidwho-1922274

ABSTRACT

BACKGROUND: Emergency preparedness and disaster management are global phenomena that have a significant impact on the economy and healthcare system. Pharmacists have assumed additional responsibilities in the wake of emergencies and disasters that are beyond their training curricula. Some research highlighted the need for pharmacists to assume these responsibilities in the cause of emergency and disaster. The objective of this study is to evaluate pharmacists' knowledge in relation to emergency preparedness and disaster management. METHOD: A descriptive cross-sectional survey was carried out from April to August 2020, on selected pharmacists from different areas of practice in Kaduna/Nigeria. Participants were evaluated using a self-reported questionnaire which consisted of 15 knowledge questions that were distributed online using pharmacists' social-media platforms. The questionnaire was adapted from previous studies and was validated by the team of expect using face validation and pre-tested. MAIN OUTCOME: The majority of pharmacists have good knowledge of emergency preparedness and disaster management. RESULTS: The online poll received 102 respondents, and their knowledge was evaluated by rating respondents out of 15 questions. 55%, 40%, and 5% scored good, fair, and poor knowledge respectively. At p<0.05, there was a relationship between knowledge score and years of practice experience, level of education, and area of practice. 44% reported being taught emergency, with the majority at the undergraduate level. 78% of respondents have never participated in drills or workshops. CONCLUSION: Pharmacists demonstrated good knowledge of basic emergency and disaster terms, they do, however, need to be more conversant with other emergency areas, which necessitates more training and drills.


Subject(s)
Civil Defense , Disasters , Cross-Sectional Studies , Humans , Nigeria , Pharmacists , Surveys and Questionnaires
13.
Curr Pharm Teach Learn ; 14(7): 900-908, 2022 07.
Article in English | MEDLINE | ID: covidwho-1906925

ABSTRACT

BACKGROUND AND PURPOSE: The American Society of Health-System Pharmacists (ASHP) postgraduate year 2 (PGY2) critical care pharmacy residency program offers an elective competency area, E3: Mass Casualty. Similar elective competencies are also available for PGY2 emergency medicine and postgraduate year 1/2 pharmacotherapy programs. Because of the COVID-19 pandemic, pharmacist proficiency in the management of disasters is even more urgent. However, few residency programs require or include a specific learning experience to achieve this competency. This article provides examples of opportunities that residency programs can implement to offer an Emergency Preparedness/Mass Casualty (EP/MC) learning experience. EDUCATIONAL ACTIVITY AND SETTING: A longitudinal EP/MC learning experience was integrated into a PGY2 critical care program. FINDINGS: A longitudinal EP/MC learning experience within the PGY2 critical care, emergency medicine, and pharmacotherapy residency program curricula is achievable and promotes resident development. Learning experience components included topic discussions, participation on local and state-level emergency preparedness (EP) committees, completion of certification programs, projects, and participation on statewide emergency response teams. SUMMARY: Implementation of a longitudinal EP/MC learning experience formalizes topics and activities that support achievement of the ASHP elective competency area of Mass Casualty for PGY2 residency programs. EP/MC goals and objectives should be a requirement for critical care, emergency medicine, pharmacotherapy, and health-system pharmacy administration and leadership PGY2 programs. By formalizing training, pharmacists can be better prepared for EP and more integrated into multidisciplinary disaster response teams.


Subject(s)
COVID-19 , Civil Defense , Mass Casualty Incidents , Pharmacy Service, Hospital , Pharmacy , COVID-19/drug therapy , Humans , Pandemics , United States
14.
Health Secur ; 20(3): 238-245, 2022.
Article in English | MEDLINE | ID: covidwho-1882965

ABSTRACT

During the COVID-19 pandemic, academic health centers suspended clinical clerkships for students. A need emerged for innovative virtual curricula to continue fostering professional competencies. In March 2020, a multidisciplinary team from the University of Nebraska Medical Center had 2 weeks to create a course on the impact of infectious diseases that addressed the COVID-19 pandemic in real time for upper-level medical and physician assistant students. Content addressing social determinants of health, medical ethics, population health, service learning, health security, and emergency preparedness were interwoven throughout the course to emphasize critical roles during a pandemic. In total, 320 students were invited to complete the survey on knowledge gained and attitudes about the course objectives and materials and 139 responded (response rate 43%). Students documented over 8,000 total hours of service learning; many created nonprofit organizations, aligned their initiatives with health systems efforts, and partnered with community-based organizations. Thematic analysis of qualitative evaluations revealed that learners found the greatest value in the emphasis on social determinants of health, bioethics, and service learning. The use of predeveloped, asynchronous e-modules were widely noted as the least effective aspect of the course. The COVID-19 pandemic introduced substantial challenges in medical education but also provided trainees with an unprecedented opportunity to learn from real-world emergency preparedness and public health responses. The University of Nebraska Medical Center plans to create a health security elective that includes traditional competencies for emergency preparedness and interrogates the social and structural vulnerabilities that drive disproportionately worse outcomes among marginalized communities. With further evaluation, many components of the curriculum could be broadly scaled to meet the increasing need for more public health and health security medical education.


Subject(s)
COVID-19 , Civil Defense , Communicable Diseases , Curriculum , Humans , Pandemics/prevention & control
15.
Public Health Rep ; 137(5): 820-825, 2022.
Article in English | MEDLINE | ID: covidwho-1879190

ABSTRACT

Upon request from tribal nations, and as part of the Centers for Disease Control and Prevention's (CDC's) emergency response, CDC staff provided both remote and on-site assistance to tribes to plan, prepare, and respond to the COVID-19 pandemic. From April 2, 2020, through June 11, 2021, CDC deployed a total of 275 staff to assist 29 tribal nations. CDC staff typically collaborated in multiple work areas including epidemiology and surveillance (86%), contact tracing (76%), infection prevention control (72%), community mitigation (72%), health communication (66%), incident command structure (55%), emergency preparedness (38%), and worker safety (31%). We describe the activities of CDC staff in collaboration with 4 tribal nations, Northern Cheyenne, Hoopa Valley, Shoshone-Bannock, and Oglala Sioux Tribe, to combat COVID-19 and lessons learned from the engagement.


Subject(s)
COVID-19 , Civil Defense , COVID-19/epidemiology , COVID-19/prevention & control , Centers for Disease Control and Prevention, U.S. , Humans , Pandemics/prevention & control , United States/epidemiology
16.
Health Place ; 76: 102841, 2022 07.
Article in English | MEDLINE | ID: covidwho-1867175

ABSTRACT

The devastating effects of inadequate basic utilities such as water, sanitation, hygiene, waste management and environmental cleaning (WASH) is underscored by the current global pandemic declared on March 11, 2020. This paper explores the experiences of key informants (n = 15) ie government and non-government organization officials on the impacts of the COVID-19 pandemic in health care facilities (HCFs) and the role of WASH in emergency preparedness in health settings and the communities they serve using Kisumu, Kenya as a case study. The results from interviews with the key informants indicate socioecological challenges shaping access to hygiene services in HCFs and related disparities in social determinants of health such as WASH that serve as barriers to the pandemic response. All participants indicated the healthcare system was ill-prepared for the pandemic. Health care workers experienced such severe psychosocial impacts due to the lack of preparedness that they subsequently embarked on strikes in protest. These situations influenced citizens' perceptions of the COVID-19 pandemic as a hoax and resulted in a surge in other population health indicators (e.g., increased maternal mortality; decreased vaccination rates for other illnesses such as measles). We recommend authentic partnerships among all stakeholders to develop and implement context-driven sustainable solutions that integrate WASH and emergency preparedness in HCFs and the communities they serve across all spatial scales, from the global to the local.


Subject(s)
COVID-19 , Civil Defense , COVID-19/epidemiology , COVID-19/prevention & control , Humans , Kenya/epidemiology , Pandemics/prevention & control , Sanitation , Water Supply
17.
Eur J Health Law ; 29(1): 79-102, 2022 Mar 04.
Article in English | MEDLINE | ID: covidwho-1752958

ABSTRACT

Governance is a critical upstream tool in public health emergency preparedness, for it provides structure to emergency response. Pandemics, singular public health emergencies, pose challenges to inherently fragmented federal governance systems. Understanding and utilizing the facilitators of response embedded within the system is critical. In its examination of how contemporary federal systems addressed fragmentation in the face of the Covid-19 pandemic, this article uses two mitigation measures, community masking and vaccination administration to compare elements of federal system mechanics in the United States and Germany's respective pursuits of public health goals. With particular focus on federal-state power-sharing, it analyzes the division and application of federal-state authority, therein examining mechanisms of executive expediency, as well as the cooperation of multilevel actors. Comparing the jurisdictions identifies inter-federal coordination, availability of exigency mechanisms, and federal guidance as facilitators of public health goal achievement.


Subject(s)
COVID-19 , Civil Defense , COVID-19/epidemiology , COVID-19/prevention & control , Germany , Humans , Pandemics/prevention & control , Public Health , United States/epidemiology
18.
Nurs Forum ; 57(2): 305-310, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1731222

ABSTRACT

BACKGROUND: Household emergency preparedness, at the individual and family micro-level, is often identified as below national disaster preparedness standards. AIMS: Conceptual clarity of household emergency preparedness is foundational for disaster preparedness research, theory construction, and instrument use. MATERIALS & METHODS: Adhering to Walker and Avant's (2019) concept analysis method, the purpose of this paper is to outline the concept of household emergency preparedness by identifying the uses of the concept, the defining attributes, antecedents, consequences, and empirical referents. Literature sources were identified using the Cumulative Index for Nursing and Allied Health (CINAHL), ProQuest Central, PsycInfo, PubMed, and government websites. CONCLUSION: Concept clarification is critical for future selection of research designs involving multidisciplinary community-based interventions for household emergency preparedness, as well as to understand how preparedness efforts at the individual and family micro-level may influence larger disaster preparedness system outcomes.


Subject(s)
Civil Defense , Concept Formation , Humans
20.
J Womens Health (Larchmt) ; 30(12): 1673-1680, 2021 12.
Article in English | MEDLINE | ID: covidwho-1665857

ABSTRACT

This report provides historical context and rationale for coordinated, systematic, and evidence-based public health emergency preparedness and response (EPR) activities to address the needs of women of reproductive age. Needs of pregnant and postpartum women, and infants-before, during, and after public health emergencies-are highlighted. Four focus areas and related activities are described: (1) public health science; (2) clinical guidance; (3) partnerships, communication, and outreach; and (4) workforce development. Finally, the report summarizes major activities of the Division of Reproductive Health's EPR Team at the Centers for Disease Control and Prevention.


Subject(s)
Civil Defense , Disaster Planning , Centers for Disease Control and Prevention, U.S. , Communication , Female , Humans , Pregnancy , Public Health , Reproductive Health , United States
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