The aim of this study was to report the results of a nationwide critical-care course for non-intensivists to increase staff capacity of intensive care units (ICUs) during the coronavirus disease 2019 (COVID-19) pandemic in Argentina.

Three academic organizations, with special funding from 55 private companies, developed a short virtual course comprised of Web-based videos, virtual tutorials, and a forum chat. Each state assigned scholarships to non-ICU staff from public hospitals. Students received active follow-up for the completion of the course and took a survey upon course completion.

After 4 m, there were 10,123 students registered from 661 hospitals in 328 cities. Of these, 67.8% passed the course, 29.1% were still ongoing, and 3.1% were inactive. Most students were female (74.2%) with a median of 37 y old (IQR 31-44). The group was composed of 56.5% nurses, 36.2% physicians, and 7.4% physiotherapists, of whom 48.3% did not have any experience in critical care. Mean overall satisfaction was 4.4/5 (standard deviation, 0.9), and 90.7% considered they were able to apply the contents to their practice.

This course was effective for rapid training of non-ICU personnel. The assignment strategy, the educational techniques, and the close follow-up led to low dropout and high success rates and satisfaction.

The aim of the current study was to investigate the prevalence of face mask wearing among different groups of people in south Iran. We also investigated the associations between mask wearing hesitancy and various factors.

We surveyed a sample (convenience sampling) of 5 groups of people: general population, people with epilepsy, people with diabetes mellitus (DM), people with cardiac problems, and people with psychiatric problems. The survey included 4 general questions (age, sex, education, and medical/psychiatric problem) and 4 coronavirus disease 2019 (COVID-19)-specific questions (contracting COVID-19, relatives with COVID-19, wearing a face mask while in crowded places, and the frequency of daily hand washings).

A total of 582 people (153 people with epilepsy, 127 patients with DM, 98 people with cardiac problems, 96 patients with psychiatric disorders, and 108 healthy individuals) participated. Twenty-eight (4.8%) people expressed that they do not wear a face mask when at crowded places. A lower education and less frequent daily hand washings had associations with mask wearing hesitancy.

Mask wearing hesitancy is a concern during a respiratory viral disease pandemic. Paying attention to personal variables, especially if they are modifiable (eg, education and hygiene), is probably productive and practical in promoting mask wearing culture.

While carrying out a scoping review of earthquake response, we found that there is no universal standardized approach for assessing the quality of disaster evidence, much of which is variable or not peer reviewed. With the lack of a framework to ascertain the value and validity of this literature, there is a danger that valuable insights may be lost. We propose a theoretical framework that may, with further validation, address this gap.

Existing frameworks – quality of reporting of meta-analyses (QUORUM), meta-analysis of observational studies in epidemiology (MOOSE), the Cochrane assessment of bias, Critical Appraisal Skills Programme (CASP) checklists, strengthening the reporting of observation studies in epidemiology (STROBE), and consensus guidelines on reports of field interventions in disasters and emergencies (CONFIDE)–were analyzed to identify key domains of quality. Supporting statements, based on these existing frameworks were developed for each domain to form an overall theoretical framework of quality. This was piloted on a data set of publications from a separate scoping review.

Four domains of quality were identified: robustness, generalizability, added value, and ethics with 11 scored, supporting statements. Although 73 out of 111 papers (66%) scored below 70%, a sizeable portion (34%) scored higher.

Our theoretical framework presents, for debate and further validation, a method of assessing the quality of non-traditional studies and thus supporting the best available evidence approach to disaster response. (Disaster Med Public Health Preparedness. 2019;13:147–151)

Although much attention is now being paid to the health risks associated with nuclear disasters, reliable information is lacking. We retrospectively evaluated the health effects of living in highly contaminated radioactive areas in Japan.

The health evaluation was conducted in Tamano district, Fukushima prefecture, in 2011 and 2012. The surface deposition density of cesium in Tamano was 600 to 1000 kBq/m2 shortly after the Fukushima nuclear accident. Clinical parameters included body mass index, blood pressure, and laboratory examinations for blood cell counts, glucose levels, and lipid profiles. A screening program for internal and external exposure was also implemented.

One hundred fifty-five residents participated in the health evaluation. Significant decreases in average body mass index and blood pressure were observed from 2011 to 2012. Annual internal exposure levels did not exceeded 1 mSv in any participants. The levels of external exposure ranged from 1.3 to 4.3 mSv/y measured in the first test period but decreased to 0.8 to 3.6 mSv/y in the second test period.

These findings suggest that inhabiting nuclear contaminated areas is not always associated with short-term health deterioration and that radiation exposure can be controlled within safety limitations. (Disaster Med Public Health Preparedness. 2016;10:34–37)

This study explores the impact of economic hazard areas on hospital-based emergency departments to determine whether economically hazardous environments, characterized by the change of population, income per capita, and unemployment rate, experience a higher number of emergency room visits than areas of lower rated economic hazard risk in the United States.

A cross-sectional design was used of a nationally constructed data set of hospital-based emergency departments of over 6,000 hospitals in the United States. We identified our quality outcome measure as the emergency room visits rate within a hospital service area. We created the variable by dividing the number of emergency room visits by the population of the hospital services area in which the emergency room was located.

Results indicate that there is a difference in the incident rate ratio of emergency room visits between environments considered to be experiencing greater amounts of hazard, compared to lower amounts of hazard.

Hospital administrators and health policy-makers need to work in conjunction to focus efforts on public safety as a key objective in the delivery of emergency medical care. One crucial effort that hospital administrators need to focus on is improving emergency room capacity and efficiency as part of the disaster preparedness plan (Disaster Med Public Health Prep. 2019;13:470-475)

To assist communities who suffered from hurricane-inflicted damages, emergency responders may monitor social media messages. We present a case-study using the event of Hurricane Matthew to analyze the results of an imputation method for the location of Twitter users who follow school and school districts in Georgia, USA.

Tweets related to Hurricane Matthew were analyzed by content analysis with latent Dirichlet allocation models and sentiment analysis to identify needs and sentiment changes over time. A hurdle regression model was applied to study the association between retweet frequency and content analysis topics.

Users residing in counties affected by Hurricane Matthew posted tweets related to preparedness (n = 171; 16%), awareness (n = 407; 38%), call-for-action or help (n = 206; 19%), and evacuations (n = 93; 9%), with mostly a negative sentiment during the preparedness and response phase. Tweets posted in the hurricane path during the preparedness and response phase were less likely to be retweeted than those outside the path (adjusted odds ratio: 0.95; 95% confidence interval: 0.75, 1.19).

Social media data can be used to detect and evaluate damages of communities affected by natural disasters and identify users’ needs in at-risk areas before the event takes place to aid during the preparedness phases.

Health-Care Coalitions (HCCs) provide an important emergency response safety net function across the United States in preparedness and responses to disasters. A key challenge is the variation in the maturity and operational readiness of HCCs. The purpose of this study was to identify key tenets that define high-functioning HCCs and help mature HCCs into a higher-functioning state of operations.

This was a qualitative study based on grounded theory methodology using semi-structured interviews for data collection and thematic analysis. Participants were stakeholders (n = 39) of HCCs from across the United States at local, state, and federal levels.

Through an institutional logics lens, the 3 key attributes for high functioning-HCCs were identified as (1) having an established and growing partnership, (2) being value-driven culture, and (3) being response ready. In addition, 3 logics were deemed essential for guiding HCCs: sources of governance, sources of partner engagement, and sources of sustainability. Participant responses describe the importance of these attributes and logics in influencing decision-making processes, supporting a community’s resilience during a disaster, and fostering robust relationships among community partners.

Addressing these attributes and logics in planning and management of HCCs can help establish the foundation for partner collaborations and high-functioning HCCs.

The COVID-19 pandemic resulted in millions of deaths worldwide and is considered a significant mass-casualty disaster (MCD). The surge of patients and scarcity of resources negatively impacted hospitals, patients and medical practice. We hypothesized ICUs during this MCD had a higher acuity of illness, and subsequently had increased lengths of stay (LOS), complication rates, death rates and costs of care. The purpose of this study was to investigate those outcomes.

This was a multicenter, retrospective study that compared intensive care admissions in 2020 to those in 2019 to evaluate patient outcomes and cost of care. Data were obtained from the Vizient Clinical Data Base/Resource Manager (Vizient Inc., Irvine, Texas, USA).

Data included the number of ICU admissions, patient outcomes, case mix index and summary of cost reports. Quality outcomes were also collected, and a total of 1304981 patients from 333 hospitals were included. For all medical centers, there was a significant increase in LOS index, ICU LOS, complication rate, case mix index, total cost, and direct cost index.

The MCD caused by COVID-19 was associated with increased adverse outcomes and cost-of-care for ICU patients.

To describe hospitals’ perceptions of the New York City Medical Reserve Corps (NYC MRC); clarify administrative, legal, and clinical obstacles to the use of NYC MRC volunteers; and identify possible strategies to overcome these barriers.

We administered an informational questionnaire to 33 NYC hospitals and conducted 2 facilitated discussion groups comprising 62 hospital representatives.

The most commonly reported hospital barriers to the use of MRC volunteers were concerns about the clinical competence of the volunteers, their lack of familiarity with medical technology used clinically in a hospital setting, and the potential for institutional liability.

Although the NYC MRC has the potential to assist the health care system in the event of a disaster, NYC hospitals will need clarification of the clinical and legal issues involved in the use of MRC volunteers for patient care. (Disaster Med Public Health Preparedness. 2015;9:391–395)

We sought to better understand the tools used by public health officials in the control of tuberculosis (TB).

We conducted a series of in-depth interviews with public health officials at the local, state, and federal levels to better understand how health departments around the country use isolation measures to control TB.

State and local public health officials’ use of social distancing tools in infection control varies widely, particularly in response to handling noncompliant patients. Judicial and community support, in addition to financial resources, impacted the incentives and enablers used to maintain isolation of infectious TB patients.

Instituting social distancing requires authorities and resources and can be impacted by evidentiary standards, risk assessments, political will, and community support. Awareness of these factors, as well as knowledge of state and local uses of social distancing measures, is essential to understanding what actions are most likely to be instituted during a public health emergency and to target interventions to better prepare health departments to utilize the best available tools necessary to control the spread of disease. (Disaster Med Public Health Preparedness. 2017;11:337–342)