The outbreak of coronavirus disease 2019 (COVID-19) has exerted unprecedented pressure on healthcare systems throughout the world. This study was designed to develop a national health emergency management program based on risk assessment for COVID-19.

Mixed-methods research was used. Based on recommendations of the national epidemiology committee, 2 risk scenarios were used as basic scenarios for risk assessment. Two rounds of Focus Group Discussions (FGDs) were conducted between January and May 2020 with 30 representatives of the health system. The data were collected, analyzed, and integrated by the research team.

In the risk matrix, “contamination of environment and individuals” and “burnout of medical staff” occupied the red zone (intolerable risk). “Defects in screening and admissions,” “process disruption in medical care and rehabilitation,” “increased mental disorders,” “social dissatisfaction,” “the decline in healthcare services,” and “loss of medical staff” were identified as the orange zone (significant risk) of the matrix.

The avoidance of environmental and individual contamination and healthcare worker burnout are the priorities in Iran. Attention to intersectoral cooperation, the involvement of non-governmental organizations and private center capacities, integration of information health systems, and developing evidence-based protocols are other measures that can improve the health system’s capacity in the response COVID-19.

The aim of this study was to evaluate the management mode for the prevention and control of coronavirus disease 2019 (COVID-19) transmission used at a general hospital in Shenzhen, China, with the aim to maintain the normal operation of the hospital.

From January 2, 2020, to April 23, 2020, Hong Kong–Shenzhen Hospital, a tertiary hospital in Shenzhen, has operated a special response protocol named comprehensive pandemic prevention and control model, which mainly includes 6 aspects: (1) human resource management; (2) equipment management; (3) logistics management; (4) cleaning, disinfection, and process reengineering; (5) environment layout; (6) and training and assessment. The detail of every aspect was described, and its efficiency was evaluated.

A total of 198,802 patients were received. Of those, 10,821 were hospitalized; 26,767 were received by the emergency department and fever clinics; 288 patients were admitted for observation with fever; and 324 were admitted as suspected cases for isolation. Under the protocol of comprehensive pandemic prevention and control model, no case of hospital-acquired infection with COVID-19 occurred among the inpatients or staff.

The present comprehensive response model may be useful in large public health emergencies to ensure appropriate management and protect the health and life of individuals.

Vaccine acceptance and trust in vaccines pose a complex process affected by many factors. The present study was conducted to determine coronavirus disease 2019 (COVID-19) vaccine acceptance, trust in vaccines, anxiety levels, and related factors in Turkish society.

The data of this cross-sectional and descriptive-correlational study were collected with the snowball method by using an online questionnaire throughout Turkey. The study was conducted between March 15 and April 3, 2021, with 3148 participants from 7 regions and 81 cities in Turkey.

It was found that the participants accepted the vaccine at 72.8%, and the trust rate in the vaccine was 66.0%. It was also found that women, single participants, those who had immune system diseases, and with COVID-19 had higher Coronavirus Anxiety Scale scores at significant levels. According to Logistic Regression Analysis, gender, age, trust in the vaccine, perception of risk levels regarding COVID-19, and coronavirus anxiety levels are factors affecting the intentions of participants to accept/reject the vaccine. It was determined that male participants were more likely to accept the coronavirus vaccine (P = 0.028). It was found that health-care employees had higher trust in the coronavirus vaccine (P = 0.006) and acceptance rates (P = 0.010) at significant levels compared with the general population.

The COVID-19 vaccine acceptance rate in Turkish society was found to be high, and the level of trust in vaccines and anxiety levels were above the moderate level.

Restrictions to minimize social contact was necessary to prevent the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus but may have impacted individuals’ mental well-being. Emotional responses are modulated by contextual information. Living abroad during the coronavirus disease 2019 (COVID-19) pandemic may have boosted the feeling of isolation as the context is unfamiliar.

This study compared the psychological impact of social distancing in national students (living in a familiar context) versus international students (living in an unfamiliar context).

During March/April 2020 (first lockdown in the Netherlands), 850 university students completed an online survey. Structural equation modeling (SEM) was conducted to compare how students’ responses to the virus were predicted by health anxiety, emotional distress, and personal traits.

Compared with national students, international students showed higher levels in 4 identified factors (COVID-19-related worry, perceived risk of infection, distance from possibly contaminated objects, distance from social situations). The factors were mainly predicted by health anxiety across international students, while emotional distress and individual traits (eg, intolerance of uncertainty) played a role across national students.

In the familiar context, individual characteristics (traits) predicted the responses to the virus, while the unfamiliar context drove individuals’ health-focused responses. Living in a foreign country is associated with psychological burdens and this should be considered by universities for more pronounced social support and clear references to health-related institutions.

Recent disruption of medical oxygen during the second wave of coronavirus disease 2019 (COVID-19) has caused nationwide panic. This study attempts to objectively analyze the medical oxygen supply chain in India along the principles of value stream mapping (VSM), identify bottlenecks, and recommend systemic improvements.

Process mapping of the medical oxygen supply chain in India was done. Different licenses and approvals, their conditions, compliances, renewals, among others were factored in. All relevant circulars (Government Notices), official orders, amendments, and gazette notifications pertaining to medical oxygen from April 2020 to April 2021 were studied and corroborated with information from Petroleum and Explosives Safety Organization (PESO) official website.

Steps of medical oxygen supply chain right from oxygen manufacture to filling, storage, and transport up to the end users; have regulatory bottlenecks. Consequently, flow of materials is sluggish and very poor information flow has aggravated the inherent inefficiencies of the system. Government of India has been loosening regulatory norms at every stage to alleviate the crisis.

Regulatory bottlenecks have indirectly fueled the informal sector over the years, which is not under Government’s control with difficulty in controlling black-marketing and hoarding. Technology enabled, data-driven regulatory processes with minimum discretionary human interface can make the system more resilient.

To assess whether exposure to the 2010 Deepwater Horizon oil spill (DHOS) was related to parents’ self-rated health over time.

3 waves of panel data were drawn from the Gulf Coast Population Impact study (2014) and Resilient Children, Youth, and Communities study (2016, 2018).

Coastal Louisiana communities in high-impact DHOS areas.

Respondents were parents or guardians aged 18 - 84, culled from a probability sample of households with a child aged 4 to 18 (N = 526) at the time of the 2010 DHOS.

Self-rated health was measured at each wave. Self-reported physical exposure to the DHOS, economic exposure to the DHOS, and control variables were measured in 2014.

We used econometric random effects regression for panel data to assess relationships between DHOS exposures and self-rated health over time, controlling for potentially confounding covariates.

Both physical exposure (b = −0.39; P < 0.001) and economic exposure (b = −0.34; P < 0.001) to the DHOS had negative associations with self-rated health over the study period. Physical exposure had a larger effect size.

Parents’ physical contact with, and economic disruption from, the 2010 DHOS were tied to long-term diminished health.

This study examined how the multidimensional negative coronavirus disease (COVID-19) impacts contextualized the age differences in psychological distress following exposures to tornadoes and the COVID-19 pandemic.

Data were from a 2-wave panel study conducted at T1 (October 2020–August 2021) and T2 (May–August 2022). Latent class analysis was conducted to explore the patterns of negative COVID-19 impacts based on a sample of 1134 at T1. Negative binomial regressions were performed to examine the age differences in psychological distress at T2, based on the working sample (N = 554), as well as the moderating effect of identified class membership, with baseline psychological distress controlled.

Three latent classes were identified: class 1 “low overall impacts,” class 2 “moderate overall impacts with high emotional distress,” and class 3 “severe overall impacts.” Individuals ages 65 and over reported lower psychological distress at T2 relative to those ages 18–34 and 35–49. However, compared to people ages 18–34, 35–49, and 50–64, those ages 65 and over reported the greatest increases in T2 psychological distress if they had experienced moderate or severe overall COVID-19 impacts at T1.

There is a pressing need for mental health interventions that are tailored to multi-disaster scenarios and age-related differences in long-term disaster recovery.

Determining the health-care experiences, problems, and difficulties of nurses during a pandemic is important to shape the measures of nursing care management. This study aimed to better understand clinical nurses’ challenges and expectations surrounding coronavirus disease 2019 (COVID-19) pandemic.

A qualitative study with semi-structured interviews was conducted. The study sampling comprised of 48 clinical nurses who have worked in pandemic hospitals. Interviews were recorded, transcribed, and evaluated based on the content analysis method.

In this study, 6 main themes were determined as intrapersonal, interpersonal, institutional/organizational, community, policies and system challenges, and expectations. Based on the results, nurses’ perceived challenges were psychological distress, dilemma, safety and security issues, workload increased, disruption in family and social relationships, stigmatization encountered, and not making their voices heard enough due to the lack of nurses in the scientific advisory board. Nurses’ expectations were determined as improvement of their personal rights and institutional psychosocial support.

The results of this study can be used as a guide for action plans to support nurses, develop health-care protocols for safe patient care, and create family and pandemic support systems.

The objectives of this study were to: validate current capacity estimates for radiological emergency response by collecting time motion observations from stations that would be used for screening and decontaminating populations, and use collected times to evaluate potential impact on current throughput calculations.

Time observations were collected at 11 functional radiation exercises across the country and aggregated for analysis for population monitoring activities, including contamination screening, decontamination, and registration. Collected times were compared to published estimates in current planning guidance, and evaluated to determine the suitability of using exercise observations to estimate throughput capacity.

2532-time observations were collected from 11 functional exercises. Of those, 2380 were validated and used for analysis. Contamination screening times varied greatly from current guidance, ranging from 19% below to 267% above existing estimates. Measurements indicate that capacity to perform contamination screening is significantly overestimated when using current estimates of service times and calculations when compared to observed aggregate service times.i

Aggregate service time data presented in this study can be used to yield a more realistic estimate of capacity to respond to a radiation event.

We aimed to compare the prognostic accuracy of shock indexes in terms of mortality in patients hospitalized with coronavirus disease 2019 (COVID-19) pneumonia.

Hospitalized patients whose COVID-19 reverse transcriptase-polymerase chain reaction (RT-PCR) test results were positive, had thoracic computed tomography (CT) scan performed, and had typical thoracic CT findings for COVID-19 were included in the study.

Eight hundred one patients were included in the study. Chronic obstructive pulmonary disease, congestive heart failure, chronic neurological diseases, chronic renal failure, and a history of malignancy were found to be chronic diseases that were significantly associated with mortality in patients with COVID-19 pneumonia. White blood cell, neutrophil, lymphocyte, C reactive protein, creatinine, sodium, aspartate aminotransferase, alanine aminotransferase, total bilirubin, high sensitive troponin, d-dimer, hemoglobin, and platelet had a statistically significant relationship with in-hospital mortality in patients with COVID-19 pneumonia. The area under the curve (AUC) values of shock index (SI), age shock index (aSI), diastolic shock index (dSI), and modified shock index (mSI) calculated to predict mortality were 0.772, 0.745, 0.737, 0.755, and Youden Index J (YJI) values were 0.523, 0.396, 0.436, 0.452, respectively.

The results of this study show that SI, dSI, mSI, and aSI are effective in predicting in-hospital mortality.

The aim of this review is to identify, evaluate, and graphically display gaps in the literature related to scarce health resource allocation in humanitarian aid settings.

A systematic search strategy was utilized in MEDLINE (via Ovid), Scopus, EMBASE, CINAHL Complete, and ProQuest Central. Articles were reviewed by 2 reviewers with a third reviewer remedying any screening conflicts. Articles meeting inclusion criteria underwent data extraction to facilitate evaluation of the scope, nature, and quality of experience-based evidence for health resource allocation in humanitarian settings. Finally, articles were mapped on a matrix to display evidence graphically.

The search strategy identified 6093 individual sources, leaving 4000 for screening after removal of duplicates. Following full-text screening, 12 sources were included. Mapping extracted data according to surge capacity domains demonstrated that all 4 domains were reflected most of all the staff domain. Much of the identified data was presented without adhering to a clear structure or nomenclature. Finally, the mapping suggested potential incompleteness of surge capacity constructs in humanitarian response settings.

Through this review, we identified a gap in evidence available to address challenges associated with scarce resource allocation in humanitarian settings. In addition to presenting the distribution of existing literature, the review demonstrated the relevance of surge capacity and resource allocation principles underpinning the developed framework.