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)

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.

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.

To clarify the pandemic status in Western Pacific countries or territories.

The WHO’s daily situation reports of COVID-19 were reviewed from January 20, 2020, to March 24, 2020. Changes in the infections, deaths, and the case fatality rate (CFR) in Western Pacific countries or territories were counted.

As of March 24, a total of 17 countries or territories had reported the presence of COVID-19 in the Western Pacific Region, 96,580 people have been infected and a total of 3502 deaths. Fifty-three percent (9/17) of these countries or territories had their first case within 2 wk since the WHO’s first report, most are China’s neighbors with a large and dense population. No other country or territory in this region reported a new infection from January 30 to February 28. However, 8 (47.0%) countries or territories have reported the first cases in 3 wk since February 28, almost all are islands. Many countries maintained a small number of infections for a long time after the first report, but a rapid increase occurred later. Deaths occurred in 8 countries with a total CFR of 3.63%, and the CFR varies widely, from 0.39% (Singapore) to 7.14% (Philippines).

The regional spread of COVID-19 urgently requires an aggressive preparedness for the Western Pacific Islands.

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.

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).

This pilot study explored personal disaster preparedness of nursing staff and their ability and willingness to respond following a disaster.

All nurses from a single hospital were invited to participate; 91 completed an online survey asking them to rate their ability and willingness to report to work following the disaster scenarios and to indicate whether they had pursued various preparedness activities. Data were analyzed by descriptive and inferential statistics using Minitab 17 Statistical Software.

Participants reflected a cross-section of major acute care units and nursing specialties. The majority of participants indicated being able and willing to report to work following the disaster scenarios. Personal disaster preparedness varied, with few activities pursued by the majority. Few scenarios produced a relationship between preparedness activities and ability or willingness to report to work.

Despite the majority of participants indicating they would be able and willing to report to work during a disaster, they acknowledged barriers affecting them. Most disaster scenarios showed no statistically significant relationship with preparedness activities. Nurses should consider barriers that affect their own availability for work following a disaster and identify potential solutions. Future research related to mitigation of possible barriers to surge capacity would be useful.

We briefly describe 2 systems that provided disaster-related mortality surveillance during and after Hurricane Sandy in New York City, namely, the New York City Health Department Electronic Death Registration System (EDRS) and the American Red Cross paper-based tracking system.

Red Cross fatality data were linked with New York City EDRS records by using decedent name and date of birth. We analyzed cases identified by both systems for completeness and agreement across selected variables and the time interval between death and reporting in the system.

Red Cross captured 93% (41/44) of all Sandy-related deaths; the completeness and quality varied by item, and timeliness was difficult to determine. The circumstances leading to death captured by Red Cross were particularly useful for identifying reasons individuals stayed in evacuation zones. EDRS variables were nearly 100% complete, and the median interval between date of death and reporting was 6 days (range: 0-43 days).

Our findings indicate that a number of steps have the potential to improve disaster-related mortality surveillance, including updating Red Cross surveillance forms and electronic databases to enhance timeliness assessments, greater collaboration across agencies to share and use data for public health preparedness, and continued expansion of electronic death registration systems. (Disaster Med Public Health Preparedness. 2014;8:489-491)

The aim of this study was to explore (a) the approaches to corporate social responsibility (CSR) implemented by e-commerce platforms in China during the early stage of coronavirus disease 2019 (ESCOVID-19) and (b) the factors associated with the platforms’ choice of these approaches.

We collected the CSR data from the Internet during ESCOVID-19. Conventional content analysis was used to develop the targeted approaches. Finally, based on the frequency analysis of each approach, rank-based nonparametric testing was conducted to answer objective (b).

Three main approaches (ie, donative CSR actions, responsive CSR actions, and strategic CSR actions) and 8 subapproaches were implemented. The strategic approach was the most frequently used approach. The platforms with higher market size implemented more donative and strategic CSR actions than did the platforms with lower market size. Donative CSR actions were significantly implemented in the earlier period, while strategic CSR actions were significantly implemented in the later period.

Our research highlights the importance of e-commerce platforms to help the public survive and identifies that market size and time were associated with the platforms’ CSR choice. The design of prevention and control policies should incorporate and support e-commerce platforms and evaluate the factors when confronting future public health crises.

The aim of this study was to examine emergency preparedness behaviors among women with a recent live birth in Hawaii.

Using the 2016 Hawaii Pregnancy Risk Assessment Monitoring System, we estimated weighted prevalence of 8 preparedness behaviors.

Among 1010 respondents (weighted response rate, 56.3%), 79.3% reported at least 1 preparedness behavior, and 11.2% performed all 8 behaviors. The prevalence of women with a recent live birth in Hawaii reporting preparedness behaviors includes: 63.0% (95% CI: 58.7-67.1%) having enough supplies at home for at least 7 days, 41.3% (95% CI: 37.1-45.6%) having an evacuation plan for their child(ren), 38.7% (95% CI: 34.5-43.0%) having methods to keep in touch, 37.8% (95% CI: 33.7-42.1%) having an emergency meeting place, 36.6% (95% CI: 32.6-40.9%) having an evacuation plan to leave home, 34.9% (95% CI: 30.9-39.2%) having emergency supplies to take with them if they have to leave quickly, 31.8% (95% CI: 27.9-36.0%) having copies of important documents, and 31.6% (95% CI: 27.7-35.8%) having practiced what to do during a disaster.

One in 10 women practiced all 8 behaviors, indicating more awareness efforts are needed among this population in Hawaii. The impact of preparedness interventions implemented in Hawaii can be tracked with this question over time.

The objective of the research is to estimate the cost of ecosystem service value (ESV) due to the Rohingya refugee influx in Ukhiya and Teknaf upazilas of Bangladesh.

Artificial neural network (ANN) supervised classification technique was used to estimate land use/land cover (LULC) dynamics between 2017 (ie, before the Rohingya refugee influx) and 2021. The ESV changes between 2017 and 2021 were assessed using the benefit transfer approach.

According to the findings, the forest lost 54.88 km2 (9.58%) because of the refugee influx during the study. Around 47.26 km2 (8.25%) of settlement was increased due to the need to provide shelter for Rohingya refugees in camp areas. Due to the increase in Rohingya refugee settlements, the total ESV increased from US $310.13 million in 2017 to US $332.94 million in 2021. Because of the disappearance of forest areas, the ESV for raw materials and biodiversity fell by 13.58% and 14.57%, respectively.

Natural resource conservation for long-term development will benefit from the findings of this study.

In March 2018, the US Department of Defense (DOD) added the smallpox vaccination, using ACAM2000, to its routine immunizations, increasing the number of persons receiving the vaccine. The following month, Fort Hood reported a cluster of 5 myopericarditis cases. The Centers for Disease Control and Prevention and the DOD launched an investigation.

The investigation consisted of a review of medical records, establishment of case definitions, causality assessment, patient interviews, and active surveillance. A 2-sided exact rate ratio test was used to compare myopericarditis incidence rates.

This investigation identified 4 cases of probable myopericarditis and 1 case of suspected myopericarditis. No alternative etiology was identified as a cause. No additional cases were identified. There was no statistically significant difference in incidence rates between the observed cluster (5.23 per 1000 vaccinated individuals, 95% CI: 1.7–12.2) and the ACAM2000 clinical trial outcomes for symptomatic persons, which was 2.29 per 1000 vaccinated individuals (95% CI: 0.3–8.3).

Vaccination with ACAM2000 is the presumptive cause of this cluster. Caution should be exercised before considering vaccination campaigns for smallpox given the clinical morbidity and costs incurred by a case of myopericarditis. Risk of myopericarditis should be carefully weighed with risk of exposure to smallpox.

During natural disasters, hospital evacuation may be necessary to ensure patient safety and care. We aimed to examine perceptions of stakeholders involved in these decisions throughout the Mid-Atlantic region of the United States during Hurricane Sandy in October 2012.

Semistructured interviews were conducted from March 2014 to February 2015 to characterize stakeholders’ perceptions about authority and responsibility for acute care hospital evacuation/shelter-in-place decision-making in Delaware, Maryland, New Jersey, and New York during Hurricane Sandy. Interviews were recorded, transcribed, and thematically analyzed using a framework approach.

We interviewed 42 individuals from 32 organizations. Hospital executives from all states reported having authority and responsibility for evacuation/shelter-in-place decision-making. In New York and Maryland, government officials stated that they could order hospital evacuation, whereas officials in Delaware and New Jersey said the government lacked enforcement capacity and therefore could not mandate evacuation.

Among government officials, perceived authority for hospital evacuation/shelter-in-place decision-making was viewed as a prerequisite to ordering evacuation. When both hospital executives and government officials perceive themselves to possess decision-making authority, there is the potential for inaction. Future work should examine whether a single entity bearing ultimate responsibility or regional emergency response coalitions would improve decision-making. (Disaster Med Public Health Preparedness. 2016;10:320–324)

The aim of this study was to identify factors associated with distress experienced by physicians during their first coronavirus disease 2019 (COVID-19) triage decisions.

An online survey was administered to physicians licensed in New York State.

Of the 164 physicians studied, 20.7% experienced severe distress during their first COVID-19 triage decisions. The mean distress score was not significantly different between physicians who received just-in-time training and those who did not (6.0 ± 2.7 vs 6.2 ± 2.8; P = 0.550) and between physicians who received clinical guidelines and those who did not (6.0 ± 2.9 vs 6.2 ± 2.7; P = 0.820). Substantially increased odds of severe distress were found in physicians who reported that their first COVID-19 triage decisions were inconsistent with their core values (adjusted odds ratio, 6.33; 95% confidence interval, 2.03-19.76) and who reported having insufficient skills and expertise (adjusted odds ratio 2.99, 95% confidence interval 0.91-9.87).

Approximately 1 in 5 physicians in New York experienced severe distress during their first COVID-19 triage decisions. Physicians with insufficient skills and expertise, and core values misaligned to triage decisions are at heightened risk of experiencing severe distress. Just-in-time training and clinical guidelines do not appear to alleviate distress experienced by physicians during their first COVID-19 triage decisions.

Although recent emergencies or disasters have underscored the vital role of nongovernmental (NGO) resources, they remain not well understood or leveraged. We intended to develop an assets framework that identifies relevant NGO resources for disaster preparedness and response that can be used to assess their availability at state and local levels.

We conducted a search of peer-reviewed publications to identify existing asset frameworks, and reviewed policy documents and gray literature to identify roles of NGOs in emergency preparedness, response, and recovery. A standardized data abstraction form was used to organize the results by NGO sector.

We organized NGO assets into 5 categories: competencies, money, infrastructure or equipment, services, relationships, and data for each of the 11 sectors designated by the Centers for Disease Control and Prevention in the 2011 preparedness capabilities.

Our findings showed that the capacity of each sector to capture data on each asset type needs strengthening so that data can be merged for just-in-time analysis to indicate where additional relief is needed. (Disaster Med Public Health Preparedness. 2013;0:1–6)