Hurricanes cause substantial mortality, especially in developing nations, and climate science predicts that powerful hurricanes will increase in frequency during the coming decades. This study examined the association of wind speed and national economic conditions with mortality in a large sample of hurricane events in small countries.

Economic, meteorological, and fatality data for 149 hurricane events in 16 nations between 1958 and 2011 were analyzed. Mortality rate was modeled with negative binomial regression implemented by generalized estimating equations to account for variable population exposure, sequence of storm events, exposure of multiple islands to the same storm, and nonlinear associations.

Low-amplitude storms caused little mortality regardless of economic status. Among high-amplitude storms (Saffir-Simpson category 4 or 5), expected mortality rate was 0.72 deaths per 100,000 people (95% confidence interval [CI]: 0.16–1.28) for nations in the highest tertile of per capita gross domestic product (GDP) compared with 25.93 deaths per 100,000 people (95% CI: 13.30–38.55) for nations with low per capita GDP.

Lower per capita GDP and higher wind speeds were associated with greater mortality rates in small countries. Excessive fatalities occurred when powerful storms struck resource-poor nations. Predictions of increasing storm amplitude over time suggest increasing disparity between death rates unless steps are taken to modify the risk profiles of poor nations. (Disaster Med Public Health Preparedness. 2016;10:832–837)

Two of the 5 great earthquakes have occurred in Iran between 1990 and 2005. Informal volunteers’ management is a determinant factor in disaster management. This research was conducted to investigate the management challenges of informal volunteers after the Kermanshah earthquake.

The study is qualitative, done by content analysis. Data were gathered by observation and semi-structured interview.

Analysis of 12 interviews resulted in 4 main categories (inappropriate dispatch, volunteers’ inefficiency, decrease in volunteers’ incentive, deficiency of welfare services) and 11 subcategories.

To avoid mistrust and decrease in motivation, proposed actions are: standardize information collection, apply effective communication, create registration networks and accreditation of certificates and expertise, and perform periodic drills.

We recommend the start of extracurricular programs and applying potential volunteers within the preparedness phase, and follow-up at the beginning of the response phase. Decrease of motivation to participate in future events needs to be studied more comprehensively.

Clinical disaster medicine requires providers working collaboratively to care for multiple patients, yet many clinicians lack competency-based training. A 5-hour emergency preparedness training (EPT) curriculum was created using didactics, small group discussion, and scenario-based learning. The goal was to evaluate the effect of a short course on improving clinical-provider knowledge, confidence and skill.

Participants were enrolled in a medical university between 2011 and 2014. The course consisted of didactic lectures, small group exercises, and live mass-casualty training scenarios. Core competencies and performance objectives were developed by a task force and assessed via facilitator observation, pre- and posttesting, and a course evaluation.

A total of 708 participants were trained, including 49.9% physicians, 31.9% medical students, 7.2% nurses, and 11% allied health personnel. The average percentage of correct answers increased from 39% to 60% (P<0.01). Following didactics, trainees met 73% and 96% of small group performance objectives. Trainees also met 68.5% and 61.1% of the mass-casualty performance objectives. Average trainee self-assessment of disaster-preparedness skill improved from 36 to 73 points out of 100.

A brief, intensive EPT course can improve the disaster knowledge and comfort level of a diverse group of clinical providers as well as foster disaster-performance skills. (Disaster Med Public Health Preparedness. 2018;12:121–126)

The coronavirus disease 2019 (COVID-19) outbreak is the most threatening public health challenge in the 21th century, and more than 200 countries are affected. Considering that Iran was one of the first countries influenced by the COVID-19 pandemic, this study aimed to explain the crisis management strategies during the COVID-19 pandemic in Ardabil province.

This study used a qualitative method using content analysis in which 12 health-care managers or decision-makers involved in the management of the COVID-19 crisis were recruited through purposeful sampling. In-depth, semi-structured interviews were used to collect data, which continued until data saturation.

Data analysis led to nine categories, including prior preparation for the COVID-19 crisis; challenges and management of workforce shortages; benefiting from the participation of volunteer staff; challenges and strategies for physical space, supplies, and personal protective equipment (PPE); designation of referral centers for COVID-19; protocolized patient transport; benefiting from donations and charity support; management of information about COVID-19; and learning from the prior stages of crisis.

This study revealed that, in critical situations, managers use multiple and, to some extent, unique strategies for decision-making and crisis control. Therefore, the health system can use the findings of the current study for proper response to similar crises and training of future managers.

The effects of earthquakes on ischemic heart disease (IHD) have often been reported. At a population level, this study examined short-term (60-day) and long-term (5-year) hospitalization events for IHD after the 2008 Sichuan earthquake.

We examined the 10-year medical hospitalization records on IHD in the city of Deyang provided by the Urban Employee Basic Health Insurance program.

Evaluation of 19,083 hospitalizations showed a significantly lower proportional number and cost of hospitalizations in the 60 days after the earthquake (P<0.001). Hospitalizations were 27.81% lower than would have been expected in a normal year; costs were 32.53% lower. However, in the 5 years after the earthquake, the age-adjusted annual incidence of hospitalization increased significantly (P<0.001). In the fifth year after the earthquake, it was significantly higher in the extremely hard-hit area than in the hard-hit area (P<0.01).

After the 2008 earthquake, short- and long-term patterns of hospitalization for IHD changed greatly, but in different ways. Our findings suggest that medical resources for IHD should be distributed dynamically over time after an earthquake. (Disaster Med Public Health Preparedness. 2016;10:203–210)

In late December 2019, a cluster of patients with pneumonia caused by an unknown pathogen was reported from Wuhan, Hubei Province, China. The pathogen has been identified as a novel coronavirus, severe acute respiratory syndrome 2 (SARS-CoV-2) and the disease has been named as coronavirus disease 2019 (COVID-19). The objective of this study was to perform the first holistic scientometric evaluation of coronavirus publications.

Our main source for this study was Web of Science Collection database. All items published between 1980 and 2019 were included. A distribution map of global production in coronavirus literature and scientometric networks were generated.

The United States, China, Germany, the United Kingdom, and Netherlands were the most productive countries. Publications in coronavirus literature have been produced from almost every country in the world, except for some countries in Asia and Africa.

While in the 1980s, the United States and developed countries from Europe were major source countries and the virus was identified only as an animal disease in the literature and its biological and genetic structure was investigated, in the 2000s, China became a major contributor of coronavirus literature because the SARS outbreak originated from southern China. Almost all most-cited publications in this period are related to SARS and the ACE2 protein.

This study sought to identify how humanitarian actors in natural disasters coordinate (or communicate) with the military to identify the needs of disaster-affected populations, identify how coordination should be undertaken for the delivery of relief goods, perceive the effectiveness of such coordination, perceive the role that training played in preparation for coordinating with the military and the effectiveness of this training, and view the overall civil-military engagement and its implications for the independence of the humanitarian sector.

A survey instrument focused on participant perceptions of the civil-military engagement in response to Typhoon Haiyan in the Philippines was sent to country directors and agency leads who played a role in the response.

Although the data supported anecdotal accounts that the coordination between civilian and military actors during the disaster relief efforts in Typhoon Haiyan worked well, they also revealed that fewer than half of the respondents were familiar with the Guidelines on the Use of Foreign Military and Civil Defence Assets in Disaster Relief (the “Oslo Guidelines”) and only 12% of respondents thought that the Oslo Guidelines were used to develop organizational policy on humanitarian aid agency engagement with military actors.

Humanitarians felt that international militaries and the Philippines Armed Forces played an important role in ensuring that aid reached people in need, particularly in the early days of the response. However, less than half of the respondents were familiar with the Oslo Guidelines. (Disaster Med Public Health Preparedness. 2016;10:7-10)

This case study documents Harris County hospitals’ flood preparedness and mitigation efforts before Hurricane Harvey, their collective response experience during Hurricane Harvey, and their lessons learned in the storm’s aftermath.

The case study was constructed using a survey of hospital emergency managers, semi-structured interviews with local agencies involved in public health, emergency management, and health care, and an analysis of news reports and other documents from a variety of government agencies, local organizations, and hospitals themselves.

Harris County hospitals learned their most valuable lessons through their direct and repeated experience with flooding over the years, leading to improved preparedness before Hurricane Harvey. Hospital emergency response successes included infrastructure improvements, staff resilience, advanced planning, and pre-established collaboration. However, hospitals still experienced challenges with staff burnout, roadway flooding, and patient evacuation.

Although the current state of hospital flood preparedness and mitigation is rather advanced and mature, it is advisable that Harris County takes steps to strengthen emergency management efforts in hospitals with fewer financial and staffing resources and less direct flood experience.

The intent of this study was to determine whether there are differences in disaster preparedness between urban and rural community hospitals across New York State.

Descriptive and analytical cross-sectional survey study of 207 community hospitals; thirty-five questions evaluated 6 disaster preparedness elements: disaster plan development, on-site surge capacity, available materials and resources, disaster education and training, disaster preparedness funding levels, and perception of disaster preparedness.

Completed surveys were received from 48 urban hospitals and 32 rural hospitals.There were differences in disaster preparedness between urban and rural hospitals with respect to disaster plan development, on-site surge capacity, available materials and resources, disaster education and training, and perception of disaster preparedness. No difference was identified between these hospitals with respect to disaster preparedness funding levels.

The results of this study provide an assessment of the current state of disaster preparedness in urban and rural community hospitals in New York. Differences in preparedness between the two settings may reflect differing priorities with respect to perceived threats, as well as opportunities for improvement that may require additional advocacy and legislation. (Disaster Med Public Health Preparedness. 2019;13:424-428)

To explore the 3-tiered treatment model for medical treatment after an earthquake.

Based on the practices of the national emergency medical rescue services in the Lushan earthquake zone, the 3-tiered treatment classification approach was retrospectively reviewed.

Medical rescue teams assembled and reported quickly to the disaster areas after the earthquake. The number of injured people had reached 25,176 as of April 30; of these, 18,611 people were treated as outpatients, 6565 were hospitalized, and 977 were seriously or severely injured.

The 3-tiered treatment model was the main approach used by rescue services after the Lushan earthquake. Primary and secondary treatments were of the highest importance and formed the basis of the Lushan model of earthquake rescue and treatment. (Disaster Med Public Health Preparedness. 2018; 12: 301–304)