The aim of this study was to investigate the performance of key hospital units associated with emergency care of both routine emergency and pandemic (COVID-19) patients under capacity enhancing strategies.

This investigation was conducted using whole-hospital, resource-constrained, patient-based, stochastic, discrete-event, simulation models of a generic 200-bed urban U.S. tertiary hospital serving routine emergency and COVID-19 patients. Systematically designed numerical experiments were conducted to provide generalizable insights into how hospital functionality may be affected by the care of COVID-19 pandemic patients along specially designated care paths, under changing pandemic situations, from getting ready to turning all of its resources to pandemic care.

Several insights are presented. For example, each day of reduction in average ICU length of stay increases intensive care unit patient throughput by up to 24% for high COVID-19 daily patient arrival levels. The potential of 5 specific interventions and 2 critical shifts in care strategies to significantly increase hospital capacity is also described.

These estimates enable hospitals to repurpose space, modify operations, implement crisis standards of care, collaborate with other health care facilities, or request external support, thereby increasing the likelihood that arriving patients will find an open staffed bed when 1 is needed.

The novel 2019 coronavirus outbreak that first appeared in Wuhan has quickly gained global attention, due to its high transmissibility and devastating clinical and economic outcomes. The aim of this study was to assess the possible roles of Jordanian pharmacists in minimizing the stage of community transmission.

A cross-sectional survey using Google forms targeting Jordanian pharmacists was conducted during March 2020 and distributed electronically by means of social media. Using the survey tool, we measured the pharmacists’ knowledge, the educative activities they perform, and their perceptions regarding undertaking traditional and untraditional roles during the COVID-19 outbreak, as specified by the International Pharmaceutical Federation (FIP). Collected data were analyzed using SPSS version-19.

Jordanian pharmacists (n = 449) reported performing various educative activities, and in general, they were knowledgeable about various aspects of the COVID-19 disease (median knowledge score: 20 [range, 13-25]), but certain gaps in knowledge were detected that must be addressed. Pharmacists had positive perceptions about both their traditional and untraditional roles specified by the FIP, the median perceptions score was 4 (range, 1-5).

Jordanian pharmacists can be used to reduce community transmission of the outbreak. However, more actions are required to keep pharmacists knowledgeable with recent disease updates to enable them to perform their tasks effectively during times of crisis.

To determine prevalence and factors associated with psychological distress among nurses caring for war victims in Sri Lanka.

Descriptive, cross-sectional study design was used to collect data from 241 nurses from 2 hospitals with stratified random sampling according to workstation. Self-administered 30-item General Health Questionnaire was used to detect psychological distress.

The prevalence of psychological distress was 21%. Female sex was found to be the most significant predictor of psychological distress among nurses. Factors, such as being married, having children, or both, were found to be protective. High exposure to war victims, measured by the frequency with which a nurse tended to those patients, also resulted in less psychological distress.

The prevalence of psychological distress is higheramong nurses in this study compared with that among the general population. Brief screening instruments, such as the General Health Questionnaire, can be used to identify individuals at risk for psychological distress. Results suggest that the presence of a social support network helped to psychologically buffer these nurses. Findings also imply the importance of promoting positive attitudes and beneficial stress (eustress) to complement a well-developed focus on distress prevention. (Disaster Med Public Health Preparedness. 2013;7:278-286)

Understanding people’s perception of community resilience to disaster is important. This study explores the correlations of household livelihood assets, the adopted household disaster preparedness activities, and individuals’ assessment of community resilience.

The data was collected in 2018 by surveying a group of survivors affected by the 2008 Wenchuan earthquake in China. The CART (Community Advancing Resilience Toolkit) was used to measure individuals’ perception of community resilience, while the livelihood assets included financial, physical, natural, human, and social capitals owned by the family, and the preparedness contained 13 activities. Ordinary least squares (OLS) regression models were used to test our hypotheses.

Social capital is consistently and positively associated with the overall individuals’ perceived community resilience, while the natural, human, and financial capitals’ effects are not significant. The awareness and participation preparedness activities are positively correlated with the perceived community resilience, but the material preparedness activities are not.

Social capital and disaster preparedness activities are critical in building community resilience. Community resilience can be achieved by making the community more connected and by providing disaster preparedness interventions.

We aimed to investigate knowledge, attitudes, and practices regarding the new coronavirus in a sample of the general Pakistani population.

This survey was carried out through The University of Faisalabad (TUF), Pakistan, between February 2020 and April 2020. The questionnaire was circulated on various online platforms to gather information. The data were analyzed on SPSS-22.

Out of 2121 respondents (13.7% were male, and 86.3% were females), 7.4% were married, 4.5% had a high income, and 5.8% had fewer family members. Coronavirus disease (COVID-19) knowledge scores were significantly low in the < 21 years age group as compared to the 21 to 25 years age group (P < 0.001) and > 25 years age group (P < 0.001). The males, married community, high income people, and few family members groups had significantly higher coronavirus knowledge than their respective groups (P = 0.033; P = 0.001; P < 0.001; P = 0.042, respectively).

Our findings suggest that the knowledge score among our study population was not up to the mark. However, a positive correlation between the correct knowledge and appropriate attitude and practice was found among study participants. Older age groups and the high income group were associated with adequate knowledge scores.

The Mt Merapi volcanic eruption in October 2010 claimed more than 386 lives, injured thousands of survivors, and devastated the surrounding environment. No instrument was available in Indonesia to assess the psychosocial impact on survivors of environmental degradation caused by such natural disasters. We developed, translated, and tested an Indonesian version of the Environmental Distress Scale (EDS) for use as a tool to reliably measure environmental distress related to environmental damage in Indonesia.

The EDS, a prospective translation and psychometric study, was modified for use in a volcano disaster setting in Indonesia; translated into Indonesian; and pilot tested to determine meaning and cultural appropriateness. A test-retest study with 80 survivors of the 2010 Mt Merapi volcanic eruption measured the reliability of the tool.

The Indonesian version of the EDS (I-EDS) captured the content of the original EDS with appropriate adaptations for cultural differences of Indonesian natural disaster survivors.

The I-EDS can be considered a reliable tool for assessing the psychosocial impact of environmental degradation from natural disasters such as volcanic eruptions, which might be useful for Indonesian researchers. (Disaster Med Public Health Preparedness. 2014;0:1–10)

A survey was conducted to describe the characteristics of patients treated for hypothermia after the Great East Japan Earthquake.

Written questionnaires were distributed to 72 emergency medical hospitals in Miyagi Prefecture. Data were requested regarding inpatients with a temperature less than 36ºC admitted within 72 hours after the earthquake. The availability of functional heating systems and the time required to restore heating after the earthquake were also documented.

A total of 91 inpatients from 13 hospitals were identified. Tsunami victims comprised 73% of the patients with hypothermia. Within 24 hours of the earthquake, 66 patients were admitted. Most patients with a temperature of 32ºC or higher were treated with passive external rewarming with blankets. Discharge without sequelae was reported for 83.3% of patients admitted within 24 hours of the earthquake and 44.0% of those admitted from 24 to 72 hours after the earthquake. Heating systems were restored within 3 days of the earthquake at 43% of the hospitals.

Hypothermia in patients hospitalized within 72 hours of the earthquake was primarily due to cold-water exposure during the tsunami. Many patients were successfully treated in spite of the post-earthquake disruption of regional social infrastructure.(Disaster Med Public Health Preparedness. 2014;0:1-11)

The purpose of this article was to describe how the Hospital Preparedness Program (HPP) and other health care coalitions conceptualize and measure progress or success and to identify strategies to improve coalition success and address known barriers to success.

We conducted a structured literature review and interviews with key leaders from 22 HPPs and other coalitions. Interview transcripts were analyzed by using constant comparative analysis.

Five dimensions of coalition success were identified: strong member participation, diversity of members, positive changes in members’ capacity to respond to or recover from disaster, sharing of resources among members, and being perceived as a trendsetter. Common barriers to success were also identified (eg, a lack of funding and staff). To address these barriers, coalitions suggested a range of mitigation strategies (eg, establishing formal memoranda of agreement). Both dimensions of and barriers to coalition success varied by coalition type.

Currently, the term health care coalition is a one-size-fits-all term. In reality, this umbrella term describes a variety of different configurations, member bodies, and capabilities. The analysis offered a typology to categorize health care coalitions by primary function during a disaster response. Developing a common typology that could be used to specify capabilities or functions of coalitions may be helpful to advancing their development. (Disaster Med Public Health Preparedness. 2015;9:690–697)

We conducted a systematic review to determine the prevalence and characteristics of earthquake-associated head injuries for better disaster preparedness and management.

We searched for all publications related to head injuries and earthquakes from 1985 to 2018 in MEDLINE and other major databases. A search was conducted using “earthquakes,” “wounds and injuries,” and “cranio-cerebral trauma” as a medical subject headings.

Included in the analysis were 34 articles. With regard to the commonly occurring injuries, earthquake-related head injury ranks third among patients with earthquake-related injuries. The most common trauma is lower extremity (36.2%) followed by upper extremity (19.9%), head (16.6%), spine (13.1%), chest (11.3%), and abdomen (3.8%). The most common earthquake-related head injury was laceration or contusion (59.1%), while epidural hematoma was the most common among inpatients with intracranial hemorrhage (9.5%) followed by intracerebral hematoma (7.0%), and subdural hematoma (6.8%). Mortality rate was 5.6%.

Head injuries were found to be a commonly occurring trauma along with extremity injuries. This knowledge is important for determining the demands for neurosurgery and for adequately managing patients, especially in resource-limited conditions.

The aim of this study was to correlate the clinical, laboratory, and radiographic characteristics of patients with a confirmed diagnosis of coronavirus disease 2019 (COVID-19) disease, with fatal outcome.

We reviewed chest X-ray (CXR) features, clinical, and laboratory data of patients with reverse transcriptase polymerase-chain-reaction confirmed diagnosis of COVID-19 infection. The relationship with mortality was investigated by fitting a logistic regression model.

A total of 246 patients were included (170 males; mean age, 63 y). Most of the patients had 1 or more comorbidity (62%); fever (95%), and cough (60%) were the most common symptoms; CXR detected abnormalities in 88.6%, mainly showing ground-glass opacities (GGO) (90%) with bilateral (64%) and peripheral (46%) distribution.

Multivariate analysis showed that age (P < 0.001; mortality of 59% in patients >66 y old; 5% at a younger age) and consolidation at CXR (P = 0.001; mortality of 11% with positive CXR; 2% in those without) represented the 2 most significant independent risk factors of mortality. Chronic pathologies, such as diabetes and chronic obstructive pulmonary disease, and peripheral GGO at CXR also showed a significant correlation with mortality.

We identified predictive factors for the fatal outcome of COVID-19 patients. The prognostic value of these findings can be useful for optimal patient management and resource allocation.

Mental health issues increased during the COVID - 19 pandemic, especially among children. Our past research efforts found that surveillance data can address a variety of health concerns; that personal psychological awareness impacted ability to cope, and mental health outcomes were improved when survivors were triaged to mental health countermeasures. To build upon our public health efforts, we wanted to see if increased screen time due to remote learning caused by the pandemic influenced school aged children’s mental health.

With the hypothesis that excessive time spent isolated during remote learning increased the amount of mental health events in children, we conducted a public health surveillance project on actual diagnoses rather than just symptoms, controlling for historical mental health and emotional disorders.

The entire cohort of children aged 6 to 17 years were studied over time before and during the pandemic for their medically diagnosed mental health and emotional outcomes by the amount of pandemic induced social isolation.

After controlling for historical diagnoses and the rate of COVID - 19, the effect of pandemic - induced social isolation had a linear increase on the amount of anxiety, resulting in a 4-fold increase in pandemic social isolation - induced anxiety.

The aim of this study was to analyze pharmacy functionality, or the volume of operational pharmacies, among areas in North Carolina and South Carolina affected by Hurricane Florence.

Using geographic information system software and data from the Federal Emergency Management Agency and Healthcare Ready, we computed, mapped, and analyzed pharmacy functionality measures for the period of September 12, 2018, through September 20, 2018, among counties in North Carolina and South Carolina to examine health-care–related disaster readiness for and response to Hurricane Florence.

In the Hurricane Florence-impacted region, counties located along the coast had the most suboptimal pharmacy functionality, whereas counties located more centrally within North Carolina and South Carolina had more optimal pharmacy functionality throughout the disaster. Generally, functionality was high at Hurricane Florence’s landfall on September 14, 2018, for which operating pharmacy capacity was reported at 85% in North Carolina and 88% in South Carolina. Both states had the lowest functionality on September 16, 2018, at 71% for North Carolina and 62% for South Carolina.

During the Hurricane Florence event, suboptimal pharmacy functionality was detected for coastal areas and during the disaster response period. Hurricane readiness plans and infrastructure strengthening should be emphasized for community pharmacies in hurricane-prone areas.

We aimed to assess professional stakeholders’ perceptions of the risk-communication difficulties faced during the 2009 influenza A (H1N1) pandemic in Europe.

Semi-structured interviews were conducted with experts involved in the management of the 2009 swine flu pandemic from different European countries. The interviews were recorded, transcribed, and coded.

A total of 25 experts from 8 European countries were interviewed: 9 from the micro-level, 10 from the meso-level, and 6 from the macro-level of employment. The interviews revealed 3 main themes: vaccine issues, communication issues, and general problems. As reasons for the low vaccination coverage, stakeholders mentioned the late arrival of the vaccines, the moderate character of the pandemic, vaccine safety concerns, and a general skepticism toward vaccination. Communication needs varied between the different levels of employment: macro- and meso-level stakeholders preferred fast information but from multiple sources; the micro-level stakeholders preferred one credible source. Throughout Europe, collaboration with the media was perceived as poor and professionals felt misunderstood.

Professional stakeholders should be enabled to access reliable information rapidly through preestablished channels; emphasis should be placed on establishing sustainable cooperations between experts and the media; and measures to improve trust in health authorities, such as the transparent communication of uncertainties, should be encouraged. (Disaster Med Public Health Preparedness. 2015;9:127-133)