Natural disasters have a significant impact on the health sector. On April 25, 2015, Nepal was struck by a 7.8 magnitude earthquake. The aim of the study was to compare patient volumes and clinical conditions presenting to the emergency department pre- and post-earthquake.

A retrospective study was done at Patan Hospital Emergency Department in Kathmandu, Nepal. Volume, demographics, and patient diagnoses were collected for 4 months post-disaster and compared with cases seen the same months the year before the disaster to control for seasonal variations.

After the 2015 Nepal earthquake, 12,180 patients were seen in the emergency department. This was a significant decrease in patient volume compared with the 14,971 patients seen during the same months in 2014 (P=0.04). Of those, 5496 patients (4093 pre-disaster and 1433 post-disaster) had a chief complaint or diagnosis recorded for analysis. An increase in cardiovascular and respiratory cases was seen as well as an increase in psychiatric cases (mostly alcohol related) and cases of anemia. There was a decrease in the number of obstetrics/gynecology, infectious disease, and poisoning cases post-earthquake.

Understanding emergency department utilization after the earthquake has the potential to give further insight into improving disaster preparedness plans for post-disaster health needs. (Disaster Med Public Health Preparedness. 2019;13:211–216).

The hazardous environmental conditions hurricanes create might increase injury incidence almost 7 times. Therefore, a cohort study was performed at the Puerto Rico Trauma Hospital to compare morbidity and mortality patterns of patients after Hurricane Maria with a control period.

Admissions from September 20, 2017, through January 20, 2018, constituted the post-Maria period (473 patients); the corresponding months of the previous year comprised the pre-Maria period (439 patients). Comparisons were done using Pearson’s chi-square or Mann-Whitney U-tests, as appropriate. A logistic regression was performed to assess the association between mortality and the study period.

Postlandfall admissions among patients aged 40-64 y increased by 6.6%, while among subjects between ages 18 and 39 y dropped by 7.0% (P = 0.03). Falls, gunshots, and burns were the injury mechanisms that varied the most across the exposure period. The median Injury Severity Score (13 vs 12; P = 0.05) and the frequency of Glasgow Coma Scale scores ≤8 (17.1% vs 10.9%; P = 0.03) were higher among poststorm patients. Moreover, a 2-fold (odds ratio = 1.93; 95% CI: 1.07-3.47) increase in mortality was observed after Maria, when adjusting for covariates.

Following a hurricane, trauma centers might expect an older population, with more severe injuries and a 2-fold increased mortality risk.

Literature investigating the change in psychological problems of the health care workers (HCWs) throughout the coronavirus disease (COVID-19) pandemic is lacking. We aimed at comparing the psychological problems and attitudes toward work among HCWs over two waves of the COVID-19 pandemic in India.

A survey was conducted involving HCWs (n = 305, first wave, 2020; n = 325, second wave, 2021). Participants’ demographic and professional and psychological characteristics (using attitude toward COVID-19 questionnaire [ATCQ]; Depression, Anxiety, and Stress Scale – 21 Items and impact of event scale – 22) were recorded. The unpaired t-test/chi-squared test was used for comparison.

Significant improvements (χ2(1) = 7.3 to 45.6, P < 0.05) in level of depression (42.2% vs 9.6%), anxiety (41.3% vs 16.3%), stress (30.1% vs 6.7%), event-related stress symptoms (31.2% vs 27%), work-related stress (89.8% vs 76.8%), and stigma (25.9% vs 22.8, though marginally significant) were found among the participants of the second wave (vs first wave). However, on subgroup analysis, allied-HCWs (housekeeping staff and security personnel) reported lesser concerns over the domains of the ATCQ vis-a-viz frontline-HCWs (doctors and nurses).

This improvement could be attributed to greater awareness about the illness, better coping skills, vaccination, and so forth; however, more research is warranted to investigate these determinants.

In this work, in order to establish a better comprehension of the association between Argentina and its neighbor countries’ capacity, and COVID-19 burden during the first 3 months, different indicators were evaluated.

We analyzed the association between GHSI, INFORM index and COVID-19 burden (number of confirmed cases and deaths), also the number of tests, lethality and the stringency of Governmental policies were evaluated.

Uruguay, Paraguay, and Bolivia started earlier different prevention measures. The number of tests differs, as Chile is the 1 that makes more. Uruguay and Paraguay register fewer positive cases and deaths from COVID-19. The GHS index is led by Brazil, followed by Argentina, and then Chile. However, the INFORM index is led by Uruguay followed by Argentina, while Chile and Paraguay are on par.

The countries that took preventive measures earlier and carried out a more tests are the ones that are obtaining the best results against COVID-19.

Vaccine hesitancy impacts the ability to cope with coronavirus disease 2019 (COVID-19) effectively in the United States. It is important for health organizations to increase vaccine acceptance. Addressing this issue, this study aimed to predict citizens’ acceptance of the COVID-19 vaccine through a synthetic approach of public segmentation including cross-situational and situational variables. Controlling for demographics, we examined institutional trust, negative attitudes toward, and low levels of knowledge about vaccines (ie, lacuna public characteristics), and fear of COVID-19 during the pandemic. Our study provides a useful framework for public segmentation and contributes to risk and health campaigns by identifying significant predictors of COVID-19 vaccine acceptance.

We conducted an online survey on October 10, 2020 (N = 499), and performed hierarchical regression analyses to predict citizens’ COVID-19 vaccine acceptance.

This study demonstrated that trust in the Centers for Disease Control and Prevention (CDC) and federal government, vaccine attitude, problem recognition, constraint recognition, involvement recognition, and fear positively predicted COVID-19 vaccine acceptance.

This study outlines a useful synthetic public segmentation framework and extends the concept of lacuna public to the pandemic context, helping to predict vaccine acceptance. Importantly, the findings could be useful in designing health campaign messages.

The present study aims to explore whether a relationship exists between the immediate sharp increase in intensive care unit (ICU) admissions and the mortality rates in Italy.

Official epidemiological data on coronavirus disease (COVID-19) were employed. The forward lagged (0, 3, 7, 14 days) daily variations in the number of deaths according to the number of days after the outbreak started and the daily increases in ICU admissions were estimated.

A direct relationship between the sharp increase of ICU admissions and mortality rates has been shown. Furthermore, the analysis of the forward lagged daily variations in the number of deaths showed that an increase in the daily number of ICU admissions resulted in significantly higher mortality after 3, 7, and 14 days. The most pronounced effect was detected after 7 days, with 250 deaths (95% CI: 108.1-392.8) for the highest increase in the ICU admissions, from 100 to 200.

These results would serve as a warning for the scientific community and the health care decision-makers to prevent a quick and out-of-control saturation of the ICU beds in case of a relapse of the COVID-19 outbreak.

To assess the health of community residents following a coal fly ash spill at the Tennessee Valley Authority Kingston Fossil Plant in Harriman, Tennessee, on December 22, 2008.

A uniform health assessment was developed by epidemiologists at Oak Ridge Associated Universities and medical toxicologists at Vanderbilt University Medical Center. Residents who believed that their health may have been affected by the coal fly ash spill were invited to participate in the medical screening program.

Among the 214 individuals who participated in the screening program, the most commonly reported symptoms were related to upper airway irritation. No evidence of heavy metal toxicity was found.

This is the first report, to our knowledge, regarding the comprehensive health evaluation of a community after a coal fly ash spill. Because this evaluation was voluntary, the majority of residents screened represented those with a high percentage of symptoms and concerns about the potential for toxic exposure. Based on known toxicity of the constituents present in the coal fly ash, health complaints did not appear to be related to the fly ash. This screening model could be used to assess immediate or baseline toxicity concerns after other disasters. (Disaster Med Public Health Preparedness. 2014;0:1–8)

The present study aimed to investigate the effect of the socioeconomic status and interpersonal trust of elderly victims of the Ya’an earthquake on their ability to perform activities of daily living (ADLs).

Random sampling was done in the 8 counties of Ya’an in Sichuan, China (N=691). A multistage random sampling method was used. Samples were selected from counties, towns, and villages, respectively. The Faith in People Scale was used to measure interpersonal trust, and the Barthel ADL Index was used to measure ADLs. Both scales have strong reliability.

A total of 37.34% of elderly earthquake victims relied on others moderately to live, and their self-rating of interpersonal trust was relatively unfavorable. Factors such as being female, being widowed, having a low educational level, and income negatively affected ADLs, among which education had the greatest influence. Interpersonal trust was vital in enhancing the level of ADLs of elderly victims.

A high level of interpersonal trust can significantly improve the ADLs of elderly persons. However, this may be achieved by weakening the negative effect of deteriorating social structure of victims. Attention should be focused on elderly victims whose social network worsens to improve their ADLs. (Disaster Med Public Health Preparedness. 2016;page 1 of 7)

This study aimed to examine the prevalence of deep vein thrombosis (DVT) among evacuees in Minamiaso, a village which was temporarily isolated after the earthquakes, from the acute to recovery phase after the 2016 Kumamoto Earthquakes (GLIDE no: EQ-2016-000033-JPN).

This prospective study, which was approved by Fukui University Medical Research Ethics Committee (approval no. 20160024 and 20160089), enrolled 181 evacuees (73.9 ± 11.6 y) who participated in a series of 3 DVT screenings using portable ultrasound machines conducted over 19 mo. All participants completed a questionnaire before the screenings, and none of the participants attended all 3 screenings. Data analysis was performed using EZR version 1.41.

The DVT prevalence was 14.3% (79.4 ± 8.2 y) at first screening of evacuees staying in shelters and 18.5% (71.5 ± 13.1 y) and 12.2% (72.8 ± 10.9 y) in second and third screenings of evacuees staying in temporary housing, respectively. Multivariate analysis revealed age ≥75 y and alcohol consumption as independent risk factors in the entire cohort and in patients aged ≤74 y, respectively.

A high DVT prevalence over a long time period of 19 mo was observed where survivors were temporarily isolated after the disaster.

In this study, we aimed to evaluate the correlation between the trauma score of individuals wounded in the Lushan earthquake and emergency workload for treatment. We further created a trauma score-emergency workload calculation model.

We included data from patients wounded in the Lushan earthquake and treated at West China Hospital, Sichuan University. We calculated scores per the following models separately: Revised Trauma Score (RTS), Prehospital Index (PHI), Circulation Respiration Abdominal Movement Speech (CRAMS), Therapeutic Intervention Scoring System (TISS-28), and Nursing Activities Score (NAS). We assessed the association between values for CRAMS, PHI, and RTS and those for TISS-28 and NAS. Subsequently, we built a trauma score-emergency workload calculation model to quantitative workload estimation.

Significant correlations were observed for all pairs of trauma scoring models with emergency workload scoring models. TISS-28 score was significantly associated with PHI score and RTS; however, no significant correlation was observed between the TISS-28 score and CRAMS score.

CRAMS, PHI, and RTS were consistent in evaluating the injury condition of wounded individuals; TISS-28 and NAS scores were consistent in evaluating the required treatment workload. Dynamic changes in emergency workload in unit time were closely associated with wounded patient visits.

Natural disasters exacerbate risks of hazardous environmental exposures and adverse health consequences. The present study determined the proportion of previously identified lead industrial sites in urban locations that are at high risk for dispersal of toxic chemicals by natural disasters.

Geographic analysis from publicly available data identified former lead smelting plants that coincide with populated urban areas and with high-risk locations for natural disasters.

From a total of 229 urban smelting sites, 66 (29%) were in relatively high-risk areas for natural disasters: flood (39), earthquake (29), tornado (3), and hurricane (2). States with urban sites at relatively high risk for natural disaster included California (15); Pennsylvania (14); New York (7); Missouri (6); Illinois (5); New Jersey (4); Kentucky (3); Florida, Oregon, and Ohio (2 each); and Indiana, Massachusetts, Rhode Island, Texas, Utah, and Washington (1 each). Incomplete historical records showed at least 10 smelting site locations were affected by natural disaster.

Forgotten environmental hazards may remain hazardous in any community. Uncertainty about risks in disasters causes disruptive public anxiety that increases difficulties in community responses and recovery. Our professional and public responsibility is to seek a better understanding of the risks of latent environmental hazards. (Disaster Med Public Health Preparedness. 2014;0:1–7)

Indonesia has the highest human mortality from highly pathogenic avian influenza (HPAI) A (H5N1) virus infection in the world.

A survey of households (N=2520) measured treatment sources and beliefs among symptomatic household members. A survey of physicians (N=554) in various types of health care facilities measured knowledge, assessment and testing behaviors, and perceived clinical capacity.

Households reported confidence in health care system capacity but infrequently sought treatment for potential HPAI H5N1 signs/symptoms. More clinicians were confident in their knowledge of diagnosis and treatment than in the adequacy of related equipment and resources at their facilities. Physicians expressed awareness of the HPAI H5N1 suspect case definition, yet expressed only moderate knowledge in questioning symptomatic patients about exposures. Self-reported likelihood of testing for HPAI H5N1 virus was high after learning of certain exposures. Knowledge of antiviral treatment was moderate, but it was higher among clinicians in puskesmas. Physicians in private outpatient clinics, the most heavily used facilities, reported the lowest confidence in their diagnostic and treatment capabilities.

Educational campaigns can encourage recall of possible poultry exposure when patients are experiencing signs/symptoms and can raise awareness of the effectiveness of antivirals to drive people to seek health care. Clinicians may benefit from training regarding exposure assessment and referral procedures, particularly in private clinics. (Disaster Med Public Health Preparedness. 2016;10:838–847)

Tropical Cyclone Yasi in North Queensland activated the disaster management plans at The Townsville Hospital, including the establishment of an emergency child minding service to facilitate the return of staff to work.

This report describes the establishment of this service and the results of brief electronic surveys that were distributed in the 2 weeks following the cyclone to gather feedback from staff who had placed their children in the care of the service (consumers), staff who had manned the service (staff), and allied health managers whose staff had manned the service (managers).

Overall, approximately 94 episodes of care were provided by the child minding service. All consumers responded “‘yes’” in answer to the question of whether the emergency child minding service facilitated their return to work in the immediate post-disaster period. The survey also identified that a lack of effective advertising may have prevented further uptake of the child minding service.

The provision of an emergency child minding service facilitated the return to work of health care staff immediately after Tropical Cyclone Yasi. More research is needed to understand the effect disaster type has on the uptake of a child minding service. (Disaster Med Public Health Preparedness. 2014;8:485-488)