A case study of complex disasters within the resilience framework in Zagreb, Croatia: Two earthquakes in one pandemic.

This paper is an analysis of complex crisis management and the importance of resilience on the example of co-occurring disasters. A resilience framework model was analyzed based on epidemiologic data and the interplay of several disasters; the COVID-19 pandemic and two 2020 Zagreb, Croatia earthquakes. A dose-response principle may be applied to a complex crisis scenario, within a resilience-vulnerability framework. The available data present the concept of balance between vulnerability and resilience of the population affected by complex crises as well as possible adaptation mechanisms. Multiple disasters that last for a prolonged period reduce the populations' resilience and increase the risk of the next crisis becoming a disaster as well. Such complex disasters should not be approached by multiple risk management protocols, but rather by a single, multilayered protocol. Health policies that predict the possible effects of complex disasters on health risk management need to provide measures to maintain and promote resilience instead of collapse. These is a clear need to adopt green environmental policies, reduce socioeconomic inequality, train volunteer managers during crises, introduce timely evidence-informed policies and transfer new research and innovations in society rapidly.

Post-COVID-19 Benign Paroxysmal Positional Vertigo.

BACKGROUND: COVID-19 is a disease caused by a new strain of coronavirus (SARS-COVID-19). The WHO first learned about this new virus on December 31, 2019, following a report on a group of cases of "viral pneumonia" in Wuhan, People's Republic of China, and declared a pandemic in March 2020. The disease was an almost complete unknown at the outset, but knowledge of its pathophysiology, clinical picture, and treatment options grew and developed rapidly. OBJECTIVE: Dizziness is a very common symptom that patients report in routine clinical practice and one of the significant clinical manifestations of COVID-19. This short report investigated a possible connection between COVID-19 and benign paroxysmal positional vertigo (BPPV). METHODS: We present two cases of benign paroxysmal positional vertigo (BPPV), which developed within two weeks of SARS-COVID-19 infection, manifesting with mild disease severity in early November 2020. RESULTS: In both cases, the disease manifested by severe, short-lived attacks of vertigo, objective-circular type, with accompanying nausea and vomiting. The symptoms occurred when lying in bed and turning to the right and assuming an upright position. The diagnosis of posterior semicircular canal BPPV (PC-BPPV) was made based on a subjectively and objectively positive right-sided Dix-Hallpike test. CONCLUSIONS: The pathophysiology of post-COVID BPPV is probably similar to that of other viral infections, with some of its specificities such as inducing hypercoagulation and microthrombus formation, which can cause significant circulatory disorders possibly affecting its pathogenesis.

Epistemic responsibilities in the COVID-19 pandemic: Is a digital infosphere a friend or a foe?

Digital technologies have a significant role in collecting, filtering and disseminating information, allowing for social, healthcare and economic activities even in the context of highly restrictive public health measures in the current COVID-19 pandemic. As personal contact is greatly reduced, they also create a shared informational landscape, allowing for a shared threat response. This is a difficult task, since truthfulness of content that leads to actionable knowledge is impossible to consistently validate. So, not only that curation of information is rarely congruent with pressing health issues, but digital spaces may also become fertile ground for misinformation and disinformation, contributing to the devastating effects of an infodemic. Digital intermediaries are useful exactly because their representation of reality is not a true construct, but a result of purposely curated information. However, they are active, dynamic epistemological agents with their own logic and aim. In dealing with a pandemic, we should reconsider the ways how our digital informational landscapes are created and sustained. This urges us to consider ethical governance of digital data curation and dissemination, alongside forms of control of the truthfulness and reach of its content. Some of the most fundamental issues in dealing with the COVID-19 pandemic, including the newly available vaccines are reliant on digital information and data sharing among experts, and the role of informing the general public. The need to create a reproducible, valid and truthful informational landscape is paramount, while allowing for free and rational, behavioral individual choices oriented toward preserving and promoting healthy behavior. These are issues at the heart of dealing with any pandemic, as well as a well-organized health care policy.