On April 17, 2013, a fire and subsequent explosion occurred at the West Fertilizer Company plant in West, Texas, and caused extensive damage to the adjacent neighborhood. This investigation described the fatal and nonfatal injuries caused by the explosion.

Persons injured by the fertilizer plant explosion were identified through death certificates, medical examination reports, medical records, and survivor interviews. Data on patient characteristics, type of injury, and location of injury were collected.

Medical record review indicated that 252 individuals sought medical care for nonfatal injuries directly related to the explosion immediately after the explosion. Fifteen patients died of injuries sustained by the blast. Almost one-quarter of patients were admitted for treatment of injuries. Injuries sustained in the explosion included abrasions/contusions, lacerations/penetrating trauma, traumatic brain injuries/concussions, tinnitus/hearing problems, eye injuries, and inhalational injuries. Patients located closer to the explosion were more likely to be admitted to the hospital for treatment of injuries than were those who were located further away.

Explosions of this magnitude are rare, but can inflict severe damage to a community and its residents. This investigation could be a useful planning resource for other communities, public health agencies, first responders, and medical facilities. (Disaster Med Public Health Preparedness. 2016;10:583–590)

The purpose of this study was to investigate the factors related to flood preparedness literacy and the relationship between flood preparedness literacy and behaviors.

A quantitative descriptive correlational study. The sample included 134 people residing in a central Thai province. Descriptive statistics, point-biserial correlation coefficient, and Spearmanʼs rank correlation were used in the data analysis.

The results revealed that the factors related to flood preparedness literacy with a statistical significance were marital status (rpb = 0.207; P < 0.01), hearing ability (r = 0.197; P < 0.05), instrumental activities of daily living (r = 0.226; P < 0.01), and social support (r = 0.388; P < 0.01). Flood preparedness literacy was correlated with flood preparedness behaviors (r = 0.281; P < 0.01).

The factors related to flood preparedness literacy as mentioned above should be assessed to identify vulnerable groups for specific care provision. Furthermore, nurses should promote these factors to contribute to effective responses during flood disasters.

Based on experiences following the Great East Japan Earthquake and nuclear power plant accident in 2011, Nuclear Emergency Core Hospitals (NECHs) were designated as centers for radiation disaster management in Japan. This study aimed to investigate their current status and identify areas for improvement.

This cross-sectional study was conducted in October 2018. Demographic data were collected by a questionnaire with free text responses about attitudes toward NECHs. Considerations regarding risk communications during a radiation disaster were analyzed using qualitative text mining analysis.

A total of 36 hospitals participated in this study. Only 31% of NECHs anticipated a radiation disaster. The importance of business continuity plans and risk communications was shown. Text analysis identified 7 important categories for health care workers during a radiation disaster, including media response, communications to hospital staff, risk communications, radiation effects on children, planning for a radiation disaster in the region, rumors, and the role in the region.

The radiation disaster medical system and NECHs in Japan were surveyed. The importance of risk communications, planning for a radiation disaster in each region, and the role in the region are identified as issues that need to be addressed.

The aim of this study was to (1) understand types and amounts of Ebola-related information that health organization employees wanted and obtained through formal, informal, internal, and external organizational communication channels; (2) determine potential discrepancies between information wanted and obtained; and (3) investigate how organizational structure might affect information wanted and obtained through these communication channels.

Primary data were collected from 526 health workers in 9 hospitals and 13 public health departments in Texas from June to November 2015. Survey data were collected for 7 types of Ebola-related information health organization employees wanted and obtained through various types of organizational communication channels. Descriptive statistical analyses, mixed design analysis of variance, regression analyses, and multilevel analyses were used to analyze the data.

Hospital employees (mostly nurses in our sample) received more self-care information than they wanted from every communication channel. However, they received less about all other types of information than they wanted from every communication channel separately and combined. Public health department employees wanted more information than they received from every communication channel separately and combined for all 7 types of information.

Discrepancies existed between the types of Ebola-related information wanted and obtained by employees of hospitals and public health departments.

A need exists for public health strategies regarding extreme weather disasters, which in recent years have become more frequent. This study aimed to understand the public’s perception of extreme cold and its related health risks, which may provide detailed information for public health preparedness during an extreme cold weather event.

To evaluate public perceptions of cold-related health risk and to identify vulnerable groups, we collected responses from 891 participants in a face-to-face survey in Harbin, China. Public perception was measured by calculating the score for each perception question.

Locals perceived that extreme cold weather and related health risks were serious, but thought they could not avoid these risks. The significant difference in perceived acceptance level between age groups suggested that the elderly are a “high health risk, low risk perception” group, meaning that they are relatively more vulnerable owing to their high susceptibility and low awareness of the health risks associated with extreme cold weather.

The elderly should be a priority in risk communication and health protective interventions. This study demonstrated that introducing risk perception into the public health field can identify vulnerable groups with greater needs, which may improve the decision-making of public health intervention strategies. (Disaster Med Public Health Preparedness. 2017;11:417–421)

This study seeks to determine the capacity of community primary care practices to meet the needs of patients during public health emergencies and to identify the barriers and resources necessary to participate in a coordinated response with public safety agencies.

The self-administered web-based survey was distributed in January 2014 via e-mail to primary care providers in Pennsylvania using the listservs of several professional societies.

A total of 179 primary care providers participated in the survey. In total, 38% had practice continuity of operations plan in place and 26% reported that they had a plan for patient surge in the outpatient setting. Thirty percent reported that they were registered on the state Health Alert Network and 41% said they were able to communicate with patients during disasters. Only 8% of providers reported that they believed that their patients with special health care needs were prepared for a disaster, although over two-thirds of responding practices felt they could assist these patients with disaster preparedness. Providers indicated that more information regarding government agency plans and community resources, patient education materials, and more time to devote to counseling during patient encounters would improve their ability to prepare their patients with special health care needs for disasters. Providers also reported that they would benefit from partnerships to help the practice during emergencies and communications technology to reach large numbers of patients quickly.

Community-based primary care practices can be useful partners during public health emergencies. Efforts to promote continuity of operations planning, improved coordination with government and community partners, as well as preparedness for patients with special health care needs, would augment their capabilities and contribute to community resilience. (Disaster Med Public Health Preparedness. 2019;13:128–132).

To explore the psychological and economic effects of the COVID-19 epidemic and identify those at higher risk of suffering financial consequences.

A cross-sectional study using an online survey was conducted in Saudi Arabia between June 27 and September 27, 2020. Logistic regression was conducted to determine who was more likely to suffer financially from the COVID-19 epidemic.

A total of 440 individual participated in this study, of whom, 86.8% were aged 19 – 49 years, and 60.0% were females. Around 57.0% reported that they have been affected economically by the pandemic. Around 11.0% of the participants reported that they feel anxious; around 18.0% reported feeling depressed or fearful because of COVID-19. Males were around twice (OR: 1.83; 95% CI: 1.24 – 2.72) as likely to be affected economically during the COVID-19 pandemic (P < 0.01). Saudis were 59.0% less likely to be affected (OR: 0.41; 95% CI: 0.27 – 0.60; P < 0.001).

The COVID-19 pandemic has affected the psychological and economic status of individuals in Saudi Arabia deeply. To prevent long-term psychological and economic deterioration and to hasten social recovery, mental, financial, supportive strategies, and programs to aid the entire community in coping with the pandemic are recommended.

After Super Typhoon Haiyan, a category 5 tropical cyclone, insufficient resources were available for medical management. Many patients in the Philippines were wounded as a result of the disaster. We examined the prevalence, risk factors, and consequences of disaster-related wounds and wound infection in the post-disaster period.

We performed a retrospective review of consecutive patients admitted to a Korean Disaster Relief Team clinic at St. Paul’s Hospital, Tacloban City, Republic of Philippines, between December 9 and 13, 2013. Traumatic injury patients were included; patients not exhibiting a wound were excluded.

Of the 160 patients enrolled in the study, 71 (44.4%) had infected wounds. There were no significant differences in the age, sex, past medical history, wound site, wound depth, injury mechanism, or inducer of injury between the uninfected and infected groups. In the univariate analysis, a foreign-body-contaminated wound, a chronic wound, elapsed time from injury to medical contact, an inadequately cared for wound, and need for subsequent wound management were associated with wound infection (P<0.05). The multivariate analysis revealed that foreign body contamination and having an inadequately cared for wound were associated with wound infection (odds ratio [OR]: 10.12, 95% confidence interval [CI]: 3.59-28.56; OR: 3.51, 95% CI: 1.07-11.51, respectively).

In the post-disaster situation, many wound infections required definitive care. Wound infection was associated with inadequately cared for wounds and foreign-body-contaminated wounds. (Disaster Med Public Health Preparedness. 2016;10:28–33)

Coronavirus disease 2019 (COVID-19) is a communicable disease transmitted via respiratory droplet from 1 person to another caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aims to investigate the knowledge, attitudes, and practice of Jordanian people toward COVID-19 during the COVID-19 pandemic. In addition, the paper explores the lack of perception and adherence to preventive measures toward COVID-19.

A quantitative, cross-sectional, descriptive online survey was used to explore study variables. A convenience sample of individual who are of Jordanian nationality, were aged 18 years or older, understood the content of the questionnaire, and agreed to participate voluntarily was surveyed.

The average correct score of COVID-19 knowledge was 84.44% (12.66/15). In addition, knowledge scores significantly differed across demographic characteristics of participants. Moreover, 93.8% (1009) of the study sample had confidence that Jordan can win the battle against the COVID-19 virus. However, study participants acknowledged that they did not visit crowded places in recent days (91.6%), while 71.3% (767) wore masks when leaving home.

The current study added a new knowledge that generally the Jordanian people during the quarantine period have a high knowledge and optimistic attitudes and practices toward COVID-19.

Stop the Bleed (STB) is a national initiative that provides lifesaving hemorrhagic control education. In 2019, pharmacists were added as health-care personnel eligible to become STB instructors. This study was conducted to evaluate the efficacy of pharmacist-led STB trainings for school employees in South Texas.

Pharmacist-led STB trainings were provided to teachers and staff in Laredo, Texas. The 60-min trainings included a presentation followed by hands-on practice of tourniquet application, wound-packing, and direct pressure application. Training efficacy was assessed through anonymous pre- and postevent surveys, which evaluated changes in knowledge, comfort level, and willingness to assist in hemorrhage control interventions. Student volunteers (predominantly pharmacy and medical students) assisted in leading the hands-on portion, providing a unique interprofessional learning opportunity.

Participants with previous training (N = 98) were excluded, resulting in a final cohort of 437 (response rate 87.4%). Compared with baseline, comfort level using tourniquets (mean, 3.17/5 vs 4.20/5; P < 0.0001), opinion regarding tourniquet safety (2.59/3 vs 2.94/3; P < 0.0001), and knowledge regarding tourniquets (70.86/100 vs 75.84/100; P < 0.0001) and proper tourniquet placement (2.40/4 vs 3.15/4; P < 0.0001) significantly improved.

Pharmacist-led STB trainings are efficacious in increasing school worker knowledge and willingness to respond in an emergency hemorrhagic situation.

For the past decade, emergency preparedness campaigns have encouraged households to meet preparedness metrics, such as having a household evacuation plan and emergency supplies of food, water, and medication. To estimate current household preparedness levels and to enhance disaster response planning, the Virginia Department of Health with remote technical assistance from the Centers for Disease Control and Prevention conducted a community health assessment in 2013 in Portsmouth, Virginia.

Using the Community Assessment for Public Health Emergency Response (CASPER) methodology with 2-stage cluster sampling, we randomly selected 210 households for in-person interviews. Households were questioned about emergency planning and supplies, information sources during emergencies, and chronic health conditions.

Interview teams completed 180 interviews (86%). Interviews revealed that 70% of households had an emergency evacuation plan, 67% had a 3-day supply of water for each member, and 77% had a first aid kit. Most households (65%) reported that the television was the primary source of information during an emergency. Heart disease (54%) and obesity (40%) were the most frequently reported chronic conditions.

The Virginia Department of Health identified important gaps in local household preparedness. Data from the assessment have been used to inform community health partners, enhance disaster response planning, set community health priorities, and influence Portsmouth’s Community Health Improvement Plan. (Disaster Med Public Health Preparedness. 2016;10:193–198)

The public's expectations of hospital services during disasters may not reflect current hospital disaster plans. The objective of this study was to determine the public's expected hospital service utilization during a pandemic, earthquake, and terrorist bombing.

A survey was distributed to adult patients or family members at 3 emergency departments (EDs). Participants identified resources and services they expect to need during 3 disaster scenarios. Linear regression was used to describe factors associated with higher expected utilization scores for each scenario.

Of the 961 people who participated in the study, 66.9% were women, 47.5% were white, and 44.6% were black. Determinants of higher pandemic resource utilization included persons who were younger (P < .01); non-white (P < .001); had higher ED visits (P < .01), hospitalization (P = .001), or fewer primary care provider visits (P = .001) in the past year; and did not having a reunification plan (P < .001). Determinants of higher earthquake resource utilization included persons who were non-white (P < .001); who were a patient or spouse (vs parent) participating in the study (P < .05 and P = .001); and had higher ED visits in the past year (P = .001). Determinants of higher bombing resource utilization included persons who were female (P = .001); non-white (P < .001); had higher ED (P = .001) or primary care provider (P < .01) visits in past year; and experienced the loss of home or property during a past disaster (P < .05).

Public expectations of hospitals during disasters are high, and some expectations are inappropriate. Better community disaster planning and public risk communication are needed. (Disaster Med Public Health Preparedness. 2013;0:1–8)

This article investigates how a Chinese local government responded to the ongoing coronavirus disease 2019 (COVID-19) outbreak, and the lessons can be valuable for the ongoing response efforts worldwide.

This case study used primarily participant observations and interviews with stakeholders.

We find that nonpharmaceutical interventions, especially the physical distancing measures, are the primary tools used to contain the spread of the virus, and these actions keep changing to adapt to the situation of the local cases and the directions from the central government. Medical countermeasures, maintenance of essential public services, and effective public communications tactics are important allies of the strict physical distancing measures, which can enforce the public’s compliance.

Local governments are the frontlines of emergency response. Both regulated policies (eg, physical distancing) and supportive services (eg, medical and essential living support) are necessary to the success of public health emergency response.