In case of an outbreak of Nankai Trough Mega-earthquake, it is predicted that a tsunami would invade Nagoya City within 100 minutes, hitting about one third of the City of Nagoya. If the administrative plan of the city and midwives’ expertise are coordinated, pregnant women’s chances of survival will increase. The authors carried out this simulation study in an attempt to improve consistency of the two efforts.

We estimated the number of pregnant women using a machine learning model. The evacuation distance of pregnant women was estimated on the basis of the data of road center line.

Through this simulation study, it became clear that preparation for approximately 2600 pregnant women escaping from tsunami predicted area and for about 1200 pregnant women possibly left in the area is needed.

Our study suggests that triage point planning is needed in areas where pregnant women are evacuated. The triage makes it possible to transport women to appropriate hospitals.

This study aims at exploring the dynamics of health-care provision during recent unplanned public mass gatherings in Beirut, and how the health-care system adapts to mass movements in protests.

A qualitative study was conducted using semi-structured interviews with 12 health-care providers who volunteered at medical tents set during protests in Beirut, Lebanon. Responses were transcribed and coded.

Three themes were noted: preparedness and logistics, encountered cases, and participants’ proposed recommendations. In terms of preparedness and logistics, participants lacked knowledge of field medicine protocols and an organizational structure. They faced difficulties in securing equipment and advertising their services. Most encountered cases were physical injuries rather than mental health problems. The participants proposed both short-term recommendations, including advice on how to boost care provided, and long-term recommendations on structuring the health-care system to be better prepared.

On-site health-care provision during unplanned mass gatherings is a vital need. We recommend forming a task force of health-care workers from various fields led by the Ministry of Public Health in every respective country to plan protocols, train personnel, and secure resources beforehand.

To determine the case-fatality rate (CFR) of coronavirus disease 2019 (Covid-19) and its associated determinants in order to understand the true magnitude of the problem during the ongoing conflict in Yemen.

The CFR among the confirmed Covid-19 cases in Yemen was calculated. The data was retrieved from national Covid-19 surveillance between April 10, when the first COVID-19 case reported, and May 31, 2020.

A total of 419 confirmed Covid-19 cases were reported. There were 14.1% and 5.7% of cases who required intensive care and mechanical ventilators, respectively. Out of the total cases, 95 deaths were reported, giving a CFR of 22.6% which is much higher compared to other countries. CFR was significantly higher among elderly people compared to young adults and varied between governorates. Mortality was associated with pre-existing hypertension (OR: 2.30; 95% CI: 1.58, 3.54) and diabetes (OR: 1.68; 95% CI: 1.08, 2.61).

The elderly and those with comorbidities, in particular hypertension and diabetes, have higher risk for poor outcomes and therefore should receive more attention in the clinical setting. Preventive measures should also be prioritized to protect those groups in order to reduce the severe cases and deaths-associated COVID-19 in armed-conflict.

This study examined the characteristics of severe patients after the Great East Japan Earthquake in 2011.

Cases in the Futaba area were extracted using the dispatch database of the doctor helicopter and flight-nurse records from March 11, 2008, till March 10, 2014. The period before March 11, 2011, was defined as ‘pre-earthquake’ and the period after March 11, 2011, as ‘post-earthquake’ to compare the recorded data.

Of the 128 total recorded cases, 78 were dispatched during the pre-earthquake period and 50 during the post-earthquake period. The number of patients with physical trauma following the earthquake included 4 patients (33.3%) in 2011, 7 patients (43.7%) in 2012, and 13 patients (59.1%) in 2013. However, the increase in number of requests was not statistically significant (P = 0.33). All 4 incidents of physical trauma in 2011, and 3 out of 7 incidents in 2012, occurred at the power plants. A total of 4 incidents occurred at decontamination worksites in 2013.

It is of primary importance for hospitals to anticipate physical trauma cases during the reconstruction phase following a disaster, and develop a system for patients with physical trauma in the short- and long-term.

Environmental health assessments of disaster shelters are critical for monitoring the living conditions of the occupants. However, knowledge and levels of utilization of these assessments have never been estimated in the United States or its territories. We aimed to conduct a cross-sectional survey to ascertain knowledge and Utilization of environmental health disaster shelter assessments.

The State and Territorial Use of Shelter Assessments Survey (STUSA) of environmental health department directors (N=56) was carried out in 2013.

Survey responses were received from 55 of 56 targeted jurisdictions. Of those respondents, 92% of state jurisdictions and 100% of territories reported having knowledge about shelter assessments. However, only 40% of states and 60% of territories reported receiving formal training, and 53% of states and 50% of territories reported having operational procedures for shelter assessments. High levels of knowledge and familiarity and low levels of training and processes for operationalizing assessments were assessed.

Because environmental health assessments may provide useful information in disaster settings, we need to understand the barriers to their implementation. The results of these assessments may also help to validate their usefulness in protecting shelter occupants during disasters. (Disaster Med Public Health Preparedness. 2017;11:11–14)

We examined the representativeness of the nonfederal hospital emergency department (ED) visit data in the National Syndromic Surveillance Program (NSSP).

We used the 2012 American Hospital Association Annual Survey Database, other databases, and information from state and local health departments participating in the NSSP about which hospitals submitted data to the NSSP in October 2014. We compared ED visits for hospitals submitting data with all ED visits in all 50 states and Washington, DC.

Approximately 60.4 million of 134.6 million ED visits nationwide (~45%) were reported to have been submitted to the NSSP. ED visits in 5 of 10 regions and the majority of the states were substantially underrepresented in the NSSP. The NSSP ED visits were similar to national ED visits in terms of many of the characteristics of hospitals and their service areas. However, visits in hospitals with the fewest annual ED visits, in rural trauma centers, and in hospitals serving populations with high percentages of Hispanics and Asians were underrepresented.

NSSP nonfederal hospital ED visit data were representative for many hospital characteristics and in some geographic areas but were not very representative nationally and in many locations. Representativeness could be improved by increasing participation in more states and among specific types of hospitals. (Disaster Med Public Health Preparedness. 2016;10:562–569)

Emergency medicine specialists working in the Republic of Turkey Ministry of Health public hospitals are assigned voluntarily or compulsorily along the Turkey-Syria borderline due to the operational conditions. In accordance with this study’s purpose, methods and overcoming problems of emergency medical specialists working at border points are addressed.

The case study design is used as a qualitative research method in this research. Within the context of content analysis, 2 themes and 7 subthemes are created in line with the identified subproblems. Under these themes, the problems experienced by physicians, solutions to them, and recommendations for physicians who will start to work along the borderline are presented with codes and anecdotes.

The results of the study indicate that the problems experienced by physicians working in the border regions are centred on environmental conditions, operation of the system, and security issues. The methods for coping with such problems focus on effective communication and the support of colleagues. The basic suggestion of the participating physicians to improve the system is that the emergency medical specialists who run the border service should undergo training that can be useful for adapting to war conditions. Despite experiencing personal and familial challenges, these physicians express that they feel happy and at peace in their work.

For the physicians assigned to work along the borderlines, high efficiency can be obtained if they are given preassignment training and provided with effective personal communication combined with personal rights adjustment.

Our objective is to forecast the number of coronavirus disease 2019 (COVID-19) cases in the state of Maryland, United States, using transfer function time series (TS) models based on a Social Distancing Index (SDI) and determine how their parameters relate to the pandemic mechanics.

A moving window of 2 mo was used to train the transfer function TS model that was then tested on the next week data. After accounting for a secular trend and weekly cycle of the SDI, a high correlation was documented between it and the daily caseload 9 days later. Similar patterns were also observed on the daily COVID-19 cases and incorporated in our models.

In most cases, the proposed models provide a reasonable performance that was, on average, moderately better than that delivered by TS models based only on previous observations. The model coefficients associated with the SDI were statistically significant for most of the training/test sets.

Our proposed models that incorporate SDI can forecast the number of COVID-19 cases in a region. Their parameters have real-life interpretations and, hence, can help understand the inner workings of the epidemic. The methods detailed here can help local health governments and other agencies adjust their response to the epidemic.

The aim of this study was to assess the knowledge and practices related to disaster preparedness among pet owners in North Portugal. The present research provides an evaluation of differences among pet owners regarding preparedness in the event of disasters.

A cross-sectional study was conducted among a convenience sample of 155 pet owners between September and November 2018. Subjects were interviewed using a structured questionnaire with items addressing sociodemographic characteristics and questions related to owners’ emergency preparedness and practices.

In this study, 53.5% of the respondents thought about the possibility of a disaster. Only 21.3% of respondents reported having knowledge on the existence of a disaster kit for pets in case of an emergency. The majority (94.8%) of respondents said they were not aware of the preparedness county-level organization plans. Knowledge and preparedness were found to be significantly higher among dog owners compared with owners of other pet species.

The results suggest that Portuguese pet owners have inadequate knowledge on how to prepare for inclusion of their pets in a disaster.

Typhoon Haiyan hit the Philippines in November 2013 and left a trail of destruction. As part of its emergency response, Médecins Sans Frontières distributed materials for reconstructing houses and boats as standardized kits to be shared between households. Community engagement was sought and communities were empowered in deciding how to make the distributions. We aimed to answer, Was this effective and what lessons were learned?

A cross-sectional survey using a semi-structured questionnaire was conducted in May 2014 and included all community leaders and 269 households in 22 barangays (community administrative areas).

All houses were affected by the typhoon, of which 182 (68%) were totally damaged. All households reported having received and used the housing material. However, in 238 (88%) house repair was incomplete because the materials provided were insufficient or inappropriate for the required repairs.

This experience of emergency mass distribution of reconstruction or repair materials of houses and boats led by the local community was encouraging. The use of “standardized kits” resulted in equity issues, because households were subjected to variable degrees of damage. A possible way out is to follow up the emergency distribution with a needs assessment and a tailored distribution. (Disaster Med Public Health Preparedness. 2017;11:285–289)

The aim of this study was to investigate the long-term outcome of quality of life (QOL) in the lower-limb amputees 10 years after the 2008 Sichuan earthquake.

In the cross-sectional study, 66 lower-limb amputees were recruited. The prosthetics-related QOL was assessed using the Prosthetic Evaluation Questionnaire (PEQ) in terms of the scales of utility, appearance, sounds, residual limb health, perceived response, frustration, social burden, ambulation, and well-being. The score of each PEQ subscale was calculated and compared among the cohorts with different demographic characteristics.

The PEQ scores showed that the scales of sounds, residual limb health, and frustration were still low in the lower-limb amputees 10 years after the 2008 Sichuan earthquake. The comparison of PEQ scales among cohorts with different demographic characteristics indicated that the potential demographic risk factors, namely, age, marital status, educational level, living independence, and comorbidity, were associated with prosthesis-related QOL.

The prosthesis-related QOL of the lower-limb amputees 10 years after the 2008 Sichuan earthquake has been partly documented in this study. The potential demographic risk factors associated with QOL of amputees were also identified. These findings could enhance the understanding of prosthesis-related QOL of lower-limb amputees sustained in an earthquake and facilitate the optimization of post-disaster rehabilitation strategies.