63 - Rehabilitation and Reconstruction

Recovery is a multifactorial process including the physical reconstruction of homes and public buildings, transportation, and basic services infrastructure, the psychological mending of the community, and the economic recovery of lost time and resources. This phase of the disaster cycle cannot be considered in isolation from the others, because mitigation, for example, must be integrated into recovery for it to be sustainable. Moreover, the historical perspective of the recovery phases is also inevitably enriched by the SARS-CoV-2 pandemic. Indeed, this pandemic highlights the overlap between the different phases of the disaster cycle: in particular, the mitigation, the planning/preparation, and the recovery phases with that of response, making the recovery phase even more difficult.

The Challenge of Mass Casualty Incident Response Simulation Exercise Design and Creation: A Modified Delphi Study.

BACKGROUND: A Mass Casualty Incident response (MCI) full scale exercise (FSEx) assures MCI first responder (FR) competencies. Simulation and serious gaming platforms (Simulation) have been considered to achieve and maintain FR competencies. The translational science (TS) T0 question was asked: how can FRs achieve similar MCI competencies as a FSEx through the use of MCI simulation exercises? METHODS: T1 stage (Scoping Review): PRISMA-ScR was conducted to develop statements for the T2 stage modified Delphi (mD) study. 1320 reference titles and abstracts were reviewed with 215 full articles progressing for full review leading to 97 undergoing data extraction.T2 stage (mD study): Selected experts were presented with 27 statements derived from T1 data with instruction to rank each statement on a 7-point linear numeric scale, where 1 = disagree and 7 = agree. Consensus amongst experts was defined as a standard deviation ≤ 1.0. RESULTS: After 3 mD rounds, 19 statements attained consensus and 8 did not attain consensus. CONCLUSIONS: MCI simulation exercises can be developed to achieve similar competencies as FSEx by incorporating the 19 statements that attained consensus through the TS stages of a scoping review (T1) and mD study (T2), and continuing to T3 implementation, and then T4 evaluation stages.

The EU-MODEX Blended Full-Scale Exercise: A Review

Background/Introduction:Amidst the COVID-19 pandemic, the EU-MODEX exercise had to rethink its logistics in order to promote safer environments for its participants.1Objectives:To describe the Blended EU-MODEX exercise as a method to minimize the risk of COVID-19 contagion and the role of CRIMEDIM during such innovative approach.Method/Description:The first post-COVID-19 EU-MODEX exercise was performed in October 2021. To avoid travels, three EMTs from Austria, Romania, and Estonia virtually deployed in a fictious country hit by a typhoon, operated independently in their own country. The Excon worked remotely from Germany. The interoperability among the EMTs was simulated using an online tool. When a patient, simulated by a local role player, needed a transfer from the EMT1 in Romania or Austria, all clinical information were shared online and a new role player was prepared with that information to continue the simulation in Estonia. CRIMEDIM personnel located at each EMT were tasked to ensure the consistency and the quality of all the clinical cases, matching the clinical information of the incoming patient with the new role player, especially regarding the treatment received and the makeup instruction.Results/Outcomes:During the exercise, 425 clinical cases were played by the three EMTs. The exercise lasted for 60 hours and provided unique challenges due to its blended nature. No COVID-19 outbreaks were registered following the exercise.Conclusion:The experience of the Blended EU-MODEX exercise showed the potentiality of the virtual simulation environment as an effective alternative to avoid secondary contagion as well as reduce costs.

A Proposed COVID-19 Testing Algorithm.

The 2019 coronavirus disease (COVID-19) pandemic has led to physical distancing measures in numerous countries in an attempt to control the spread. However, these measures are not without cost to the health and economies of the nations in which they are enacted. Nations are now looking for methods to remove physical distancing measures and return to full functioning. To prevent a massive second wave of infections, this must be done with a data-driven methodology. The purpose of this article is to propose an algorithm for COVID-19 testing that would allow for physical distancing to be scaled back in a stepwise manner, which limits ensuing infections and protects the capacity of the health care system.

Preparing for the Second Surge: Preventing Posttraumatic Stress Disorder and Building Resilience for Health Care Workers in the Face of COVID-19.

The global community needs to be aware of the potential psychosocial consequences that may be experienced by health care workers who are actively managing patients with coronavirus disease (COVID-19). These health care workers are at increased risk for experiencing mood and trauma-related disorders, including posttraumatic stress disorder (PTSD). In this concept article, strategies are recommended for individual health care workers and hospital leadership to aid in mitigating the risk of PTSD, as well as to build resilience in light of a potential second surge of COVID-19.