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1.
Int J Environ Res Public Health ; 19(1)2021 12 21.
Article in English | MEDLINE | ID: covidwho-1580861

ABSTRACT

Although evidence suggests that successive climate disasters are on the rise, few studies have documented the disproportionate impacts on communities of color. Through the unique lens of successive disaster events (Hurricane Harvey and Winter Storm Uri) coupled with the COVID-19 pandemic, we assessed disaster exposure in minority communities in Harris County, Texas. A mixed methods approach employing qualitative and quantitative designs was used to examine the relationships between successive disasters (and the role of climate change), population geography, race, and health disparities-related outcomes. This study identified four communities in the greater Houston area with predominantly non-Hispanic African American residents. We used data chronicling the local community and environment to build base maps and conducted spatial analyses using Geographic Information System (GIS) mapping. We complemented these data with focus groups to assess participants' experiences in disaster planning and recovery, as well as community resilience. Thematic analysis was used to identify key patterns. Across all four communities, we observed significant Hurricane Harvey flooding and significantly greater exposure to 10 of the 11 COVID-19 risk factors examined, compared to the rest of the county. Spatial analyses reveal higher disease burden, greater social vulnerability, and significantly higher community-level risk factors for both pandemics and disaster events in the four communities, compared to all other communities in Harris County. Two themes emerged from thematic data analysis: (1) Prior disaster exposure prepared minority populations in Harris County to better handle subsequent disaster suggesting enhanced disaster resilience, and (2) social connectedness was key to disaster resiliency. Long-standing disparities make people of color at greater risk for social vulnerability. Addressing climate change offers the potential to alleviate these health disparities.


Subject(s)
COVID-19 , Cyclonic Storms , Disaster Planning , Disasters , Climate Change , Humans , Pandemics , SARS-CoV-2 , Social Vulnerability , Texas
2.
J Emerg Manag ; 19(7): 9-18, 2021.
Article in English | MEDLINE | ID: covidwho-1497648

ABSTRACT

The COVID-19 pandemic has created new workforce considerations for emergency management community in addressing cumulative and cascading disasters. This research identifies how emergency management planning for both the changing dynamics of COVID-19 and the upcoming hurricane season may change under a compound threat. Many jurisdictions have faced challenges in providing adequate staffing of shelters before the pandemic. Now, fatigue among staff further exacerbates these challenges as resources are stretched thin. Six workshops, involving 265 national, state, and local leaders, staff, experts, and advocates from 22 states, and a range of disciplines (disaster planning, public health, social services, academia, and healthcare), were convened to identify concerns and potential strategies to address staffing, training, logistics, and support. Strategies proposed to increase the number and skill set of staff available involve increased reliance upon volunteers and nonprofit organizations. Mental health resources, personal protective equipment, sanitation supplies, and defining roles within emergency shelters were recommended to reduce fatigue and redistribute responsibilities. Findings illuminate additional research avenues regarding assessing the underlying stressors contributing to the planning process and effective means of implementing these interventions to bolster emergency management shelter operations during a prolonged pandemic and in the future.


Subject(s)
COVID-19 , Cyclonic Storms , Disaster Planning , Disasters , Humans , Pandemics , SARS-CoV-2 , Workforce
4.
BMJ Glob Health ; 6(9)2021 09.
Article in English | MEDLINE | ID: covidwho-1467698

ABSTRACT

In early 2019, following the 2015-2016 severe drought, the provinces of Sofala and Cabo Delgado, Mozambique, were hit by Cyclones Idai and Kenneth, respectively. These were the deadliest and most destructive cyclones in the country's history. Currently, these two provinces host tens of thousands of vulnerable households due to the climatic catastrophes and the massive influx of displaced people associated with violent terrorist attacks plaguing Cabo Delgado. The emergence of the COVID-19 pandemic added a new challenge to this already critical scenario, serving as a real test for Mozambique's public health preparedness. On the planetary level, Mozambique can be viewed as a 'canary in the coal mine', harbingering to the world the synergistic effects of co-occurring anthropogenic and natural disasters. Herein, we discuss how the COVID-19 pandemic has accentuated the need for an effective and comprehensive public health response in a country already deeply impacted by health problems associated with natural disasters and population displacement.


Subject(s)
COVID-19 , Cyclonic Storms , Emergencies , Humans , Mozambique/epidemiology , Pandemics , Public Health , SARS-CoV-2
5.
J Affect Disord ; 295: 594-603, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1461230

ABSTRACT

BACKGROUND: Network analytic studies indicate that posttraumatic stress disorder (PTSD) may be comorbid with depression at the symptom level, but it remains unclear whether these findings are replicable and generalizable across trauma types. OBJECTIVE: This study aim was to examine and compare PTSD-depression comorbidity networks of two types of trauma related to Typhoon Lekima and COVID-19 epidemic. METHODS: Participants were 1605 and 601 adolescents recruited following Typhoon Lekima and the COVID-19 outbreak, respectively. RESULTS: COVID-19 and Lekima PTSD-depression networks had considerable similarities, including adequate stability and accuracy, connected symptoms of PTSD and depression, symptoms with high centralities, and bridge symptoms. PTSD-depression comorbid symptoms were more complicated in the COVID-19 network but may show more persistence in the Lekima network. Distinct bridge symptoms contributed to the heterogeneity of PTSD-depression comorbidity characteristics between the two networks. Specifically, restricted affect and felt down and unhappy were two important bridge symptoms with high centrality unique to the COVID-19 network. CONCLUSIONS: PTSD-depression comorbidity network has considerable replicability across trauma types, but specific symptom-level associations and some bridge symptoms may vary across trauma types. These findings also highlight the importance of negative emotions to comorbid PTSD and depression in adolescents following the COVID-19 outbreak compared with Typhoon Lekima.


Subject(s)
COVID-19 , Cyclonic Storms , Epidemics , Stress Disorders, Post-Traumatic , Adolescent , Comorbidity , Depression/epidemiology , Humans , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology
6.
J Med Internet Res ; 23(9): e31264, 2021 09 01.
Article in English | MEDLINE | ID: covidwho-1443994

ABSTRACT

BACKGROUND: Patient portals play an important role in connecting patients with their medical care team, which improves patient engagement in treatment plans, decreases unnecessary visits, and reduces costs. During natural disasters, patients' needs increase, whereas available resources, specifically access to care, become limited. OBJECTIVE: This study aims to examine patients' health needs during a natural crisis by analyzing the electronic messages sent during Hurricane Harvey to guide future disaster planning efforts. METHODS: We explored patient portal use data from a large Greater Houston area health care system focusing on the initial week of the Hurricane Harvey disaster, beginning with the date of landfall, August 25, 2017, to August 31, 2017. A mixed methods approach was used to assess patients' immediate health needs and concerns during the disruption of access to routine and emergent medical care. Quantitative analysis used logistic regression models to assess the predictive characteristics of patients using the portal during Hurricane Harvey. This study also included encounters by type (emergency, inpatient, observation, outpatient, and outpatient surgery) and time (before, during, and after Hurricane Harvey). For qualitative analysis, the content of these messages was examined using the constant comparative method to identify emerging themes found within the message texts. RESULTS: Out of a total of 557,024 patients, 4079 (0.73%) sent a message during Hurricane Harvey, whereas 31,737 (5.69%) used the portal. Age, sex, race, and ethnicity were predictive factors for using the portal and sending a message during the natural disaster. We found that prior use of the patient portal increased the likelihood of portal use during Hurricane Harvey (odds ratio 13.688, 95% CI 12.929-14.491) and of sending a portal message during the disaster (odds ratio 14.172, 95% CI 11.879-16.907). Having an encounter 4 weeks before or after Hurricane Harvey was positively associated with increased use of the portal and sending a portal message. Patients with encounters during the main Hurricane Harvey week had a higher increased likelihood of portal use across all five encounter types. Qualitative themes included: access, prescription requests, medical advice (chronic conditions, acute care, urgent needs, and Hurricane Harvey-related injuries), mental health, technical difficulties, and provider constraints. CONCLUSIONS: The patient portal can be a useful tool for communication between patients and providers to address the urgent needs and concerns of patients as a natural disaster unfolds. This was the first known study to include encounter data to understand portal use compared with care provisioning. Prior use was predictive of both portal use and message sending during Hurricane Harvey. These findings could inform the types of demands that may arise in future disaster situations and can serve as the first step in intentionally optimizing patient portal usability for emergency health care management during natural disasters.


Subject(s)
Cyclonic Storms , Disaster Planning , Disasters , Natural Disasters , Humans , Mental Health
8.
BMJ Open ; 11(9): e050700, 2021 09 22.
Article in English | MEDLINE | ID: covidwho-1435054

ABSTRACT

OBJECTIVE: The aim of this study is to improve the understanding of the characteristics of health system resilience in Myanmar's response to Cyclone Nargis and to explore ways to improve resilience at the system level. DESIGN AND SETTING: This is an explanatory qualitative study exploring the institutional capacity of resilience in Myanmar's health system. Analysis proceeded using a data-driven thematic analysis closely following the framework method. This process enabled comparisons and contrasts of key emergent themes between the participants, which later generated key results describing the foundational assets, barriers and opportunities for achieving resilience in Myanmar. PARTICIPANTS: The study comprised of 12 in-depth interviews conducted with representatives from international organisations and non-governmental organisations (NGOs). The inclusion criteria to recruiting the participants were that they had directly been a part of the Cyclone Nargis response at the time. There was a balanced distribution of participants across UN, bilateral and NGOs, and most of them were either Myanmar citizens or expatriates with extensive working experience based in Myanmar. RESULTS: Key findings elucidate the characteristics of resilience that have been salient or absent in Myanmar's response to Cyclone Nargis. Strong social capital and motivation propelled by its deep-rooted culture and religion served as Myanmar's greatest assets that filled major gaps in the system. Meanwhile, its postcolonial and military legacy posed barriers towards investing in building its long-term foundations towards resilience. CONCLUSIONS: This study revealed that resilience in the health system can be built through strategic investments towards building the foundations of resilience to better prepare for future shocks. In the case of Myanmar, social capital and motivation, which surfaced as its foundational assets, can be channelled into opportunities that can help achieve its long-term health goals, accelerating its journey towards resilience in the health system.


Subject(s)
Cyclonic Storms , Government Programs , Humans , Myanmar , Qualitative Research
12.
Sci Rep ; 11(1): 14694, 2021 07 19.
Article in English | MEDLINE | ID: covidwho-1317817

ABSTRACT

Shaped by human movement, place connectivity is quantified by the strength of spatial interactions among locations. For decades, spatial scientists have researched place connectivity, applications, and metrics. The growing popularity of social media provides a new data stream where spatial social interaction measures are largely devoid of privacy issues, easily assessable, and harmonized. In this study, we introduced a global multi-scale place connectivity index (PCI) based on spatial interactions among places revealed by geotagged tweets as a spatiotemporal-continuous and easy-to-implement measurement. The multi-scale PCI, demonstrated at the US county level, exhibits a strong positive association with SafeGraph population movement records (10% penetration in the US population) and Facebook's social connectedness index (SCI), a popular connectivity index based on social networks. We found that PCI has a strong boundary effect and that it generally follows the distance decay, although this force is weaker in more urbanized counties with a denser population. Our investigation further suggests that PCI has great potential in addressing real-world problems that require place connectivity knowledge, exemplified with two applications: (1) modeling the spatial spread of COVID-19 during the early stage of the pandemic and (2) modeling hurricane evacuation destination choice. The methodological and contextual knowledge of PCI, together with the open-sourced PCI datasets at various geographic levels, are expected to support research fields requiring knowledge in human spatial interactions.


Subject(s)
Social Interaction , Social Media , COVID-19/epidemiology , Cyclonic Storms , Humans , Models, Theoretical , Pandemics , Spatial Analysis , United States
13.
Biosens Bioelectron ; 192: 113499, 2021 Nov 15.
Article in English | MEDLINE | ID: covidwho-1309166

ABSTRACT

The recent outbreak of COVID-19 has highlighted the seriousness of airborne diseases and the need for a proper pathogen detection system. Compared to the ample amount of research on biological detection, work on integrated devices for air monitoring is rare. In this work, we integrated a wet-cyclone air sampler and a DC impedance microfluidic cytometer to build a cyclone-cytometer integrated air monitor (CCAM). The wet-cyclone air sampler sucks the air and concentrates the bioaerosols into 10 mL of aqueous solvent. After 5 min of air sampling, the bioaerosol-containing solution was conveyed to the microfluidic cytometer for detection. The device was tested with aerosolized microbeads, dust, and Escherichia coli (E. coli). CCAM is shown to differentiate particles from 0.96 to 2.95 µm with high accuracy. The wet cyclone air-sampler showed a 28.04% sampling efficiency, and the DC impedance cytometer showed 87.68% detection efficiency, giving a total of 24.59% overall CCAM efficiency. After validation of the device performance, CCAM was used to detect bacterial aerosols and their viability without any separate pretreatment step. Differentiation of dust, live E. coli, and dead E. coli was successfully performed by the addition of BacLight bacterial viability reagent in the sampling solvent. The usage could be further extended to detection of specific species with proper antibody fluorescent label. A promising strategy for aerosol detection is proposed through the constructive integration of a DC impedance microfluidic cytometer and a wet-cyclone air sampler.


Subject(s)
Biosensing Techniques , COVID-19 , Cyclonic Storms , Aerosols/analysis , Air Microbiology , Electric Impedance , Environmental Monitoring , Escherichia coli , Humans , Microfluidics , SARS-CoV-2
14.
J Card Surg ; 36(10): 3491-3493, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1295078

ABSTRACT

Patients with end-stage congestive heart failure are at elevated risk for harm when extreme storms threaten and strike their communities. Individuals with compromised heart function require customized hurricane protection and preparedness approaches. We provide mitigation strategies for providers and their teams, as well as the patients themselves to ensure their safety and uninterrupted access to healthcare resources and quality care during hurricane impact and in the aftermath.


Subject(s)
Cyclonic Storms , Heart Failure , Climate Change , Heart Failure/therapy , Humans
17.
Vaccine ; 38(52): 8255-8256, 2020 12 14.
Article in English | MEDLINE | ID: covidwho-911513
18.
Global Health ; 17(1): 32, 2021 03 29.
Article in English | MEDLINE | ID: covidwho-1158212

ABSTRACT

BACKGROUND: The recent outbreak of COVID-19 has impacted adversely upon the mental health of millions of people worldwide. Impacts on the mental health conditions and the associated predictors relating to adults in Pakistan, the fifth most populous country in the world, during the COVID-19 remain understudied. Our aim was to investigate distress, anxiety, and overall mental health and their associated predictors among Pakistani adults in this pandemic. We specifically examine mental health issues based on the distance from the epicenter, (a predictor that has revealed opposing evidence in other countries) based on the theories of typhoon eye effect and ripple effect. The sample consisted of 601 adults who were surveyed online about 2.5 months into the outbreak across Pakistan with varying distances from the epicenter of COVID-19 of Karachi. RESULTS: The results showed that 9.2 and 19.0% of the participants surpassed the cut-off criteria for distress and anxiety disorders, respectively. Overall, the distance from the epicenter positively predicted the mental health of adults in Pakistan, and family size negatively moderated this effect. The distance from the epicenter negatively predicted distress and anxiety disorders for adults in large families, which are quite common in Pakistan. CONCLUSION: The evidence of the study interestingly finds that the prediction of the mental health of people by their distance from the epicenter depends on family size. The evidence of this study can help to provide initial indicators for mental health care providers to screen vulnerable groups in Pakistan, a populous country that continues struggling to cope with the COVID-19 pandemic.


Subject(s)
Anxiety/etiology , COVID-19/psychology , Family Characteristics , Mental Disorders/etiology , Mental Health , Pandemics , Stress, Psychological/etiology , Adaptation, Psychological , Adult , Aged , Anxiety Disorders/etiology , Cyclonic Storms , Female , Humans , Male , Middle Aged , Pakistan , Risk Factors , SARS-CoV-2 , Spatial Analysis , Surveys and Questionnaires , Young Adult
20.
J Public Health (Oxf) ; 43(2): e358-e359, 2021 06 07.
Article in English | MEDLINE | ID: covidwho-1123356

ABSTRACT

A recent correspondence discussed that in trying times, technology can help be applied toward epidemiology to benefit communities by building a basic surveillance system. This suggested development in Honduras can be utilized in the Philippines to improve the State's handling of health emergencies. With this, this paper accentuates the importance of prevention and planning to ensure public health in the Philippines, especially during the COVID-19 pandemic.


Subject(s)
COVID-19 , Cyclonic Storms , Dengue , Honduras , Humans , Pandemics/prevention & control , Philippines/epidemiology , Public Health , SARS-CoV-2
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