Widespread disasters can obstruct all external supports and isolate hospitals. This report aimed to extract key preparedness measures from 1 such hospital in Australia, which was flood-affected and cut off from surrounding supports.

Nine interviews with key personnel behind a flood-affected hospital’s evacuation and field hospital setup were conducted, and a narrative analysis of interview transcripts, meeting notes, and published accounts of hospital evacuation was conducted to highlight important preparedness measures for other hospitals.

Findings indicate hospitals should compile a comprehensive list of resources needed to set up a field hospital. The analysis highlighted the importance of effective patient communication and in-transit tracking for safe evacuation, and revealed that staff can be better prepared if trained to expect disruptions and initiate pre-evacuation discharges.

Increase in climate change-driven extreme weather events requires a proportional increase in hospitals’ abilities to respond and adapt. This report points to key measures that can prepare hospitals to move their patients to improvised makeshift field facilities, if no external support is available.

Stable iodine intake is an essential preventive strategy against thyroid cancer following a nuclear disaster. However, the rate of stable iodine intake during pregnancy and thyroid outcomes among their children have remaifned unclear.

This observational study used data from a thyroid screening program at Research Institute of Radiation Safety for Disaster Recovery Support in Fukushima, Japan. The participants were children from Miharu Town, which implemented stable iodine intake during the Fukushima Nuclear Disaster, born between March 15, 2011 and March 31, 2012. Thyroid ultrasound results were stratified according to stable iodine intake.

This study included 86 children born after the disaster. A total of 34.9% (30 of 86) of their mothers reported taking stable iodine during pregnancy. As for thyroid screening outcomes, none of the children required detailed thyroid examination.

The intake rate of stable iodine during pregnancy was about 1/3 within the traceable municipality after the Fukushima Nuclear Disaster, which was lower than the previously reported number of 63.5% among children. Awareness-raising and effective communication toward pregnant women would be important for nuclear disaster preparedness. There were no participants who required further thyroid examination in this study.

Experts recommend preparedness to manage chronic diseases in case of disaster-related resource disruption. This study’s goal is to identify factors underlying personal medical preparedness (PMP) among participants from a hurricane-prone region.

A cross-sectional survey was completed during the 2023 Atlantic hurricane season with 120 insured adults age ≥50 in Southeast Louisiana with hypertension and ≥1 regular medication. PMP was measured using the validated Household Emergency Preparedness Instrument Access and Functional Needs Section (HEPI-AFN). Multivariable logistic regression analysis tested associations between PMP and exposure variables, including demographics, health, and hurricane experience.

The sample included 50% women, 43% Black, with mean age 62.6 (SD = 8.1) years and mean 51.3 (SD = 18.1) years living in hurricane-impacted area. Participants were prepared on an average 79% (SD = 21) of applicable HEPI-AFN items; 42 (35%) were prepared on 100% of PMP items. The most missed item was having 2 weeks of extra medication; open-responses noted refill policies as a common barrier to PMP. No factors were associated with increased odds of PMP.

While many participants in this insured, disaster-experienced sample are medically prepared, restrictive pharmaceutical refill policies may be a barrier. Research is needed to understand the impact of prescription refill and other policies on PMP.

Climate change is contributing to increased frequency and intensity of wildfires in California. This study evaluated the self-reported impacts of the California Oak Fire on the health of a medically at-risk population and identified their wildfire preparedness and information needs.

A cross-sectional mixed-methods survey was conducted from April-July of 2023 of those with self-identified special needs in emergencies. The survey assessed self-reported wildfire preparedness, information needs, evacuation response, and health impacts.

A total of 53 surveys were completed for a response rate of 23.1%. Most respondents had medical conditions (94%). One-fifth (21%) of respondents reported missed or delayed medical appointments and harm to their health from the Oak Fire; these groups reported significantly more medical conditions (4.1 v. 2.5, P = 0.0055) and use of more medical devices (3.5 v 2, P = 0.007) than those without harm to their health. The most common way respondents learned about the Oak Fire was by seeing fire plumes/smelling smoke (59%); the most trusted information source was county officials (77%). Less than half of respondents (40%) evacuated during the Oak Fire.

Wildfires are associated with interruptions in medical care that harm health, particularly for medically at-risk populations.

Wildfire smoke causes respiratory health concerns. The study estimates respiratory hospitalization risk from wildfires, determines distance to a hospital, and identifies concentrations of smoke-sensitive groups far from a hospital to facilitate public health and emergency preparedness in Oregon using spatial analysis.

Statistically significant environmental factors were identified with regression and used with wildfire and pollution concentrations to predict respiratory hospitalizations. A weighted overlay of the significant factors formed a statewide risk layer. Proximity to the hospital nearest to each Census block was determined by driving distance. Clusters of smoke-sensitive groups, determined by relevant Census demographics, were identified through a Hot Spot Analysis.

This process allowed for highlighting locations of smoke-sensitive groups in areas at high risk for respiratory hospitalization from wildfire smoke who were far from a hospital. The results allow local officials to identify the type and magnitude of needs they can expect in the event of a wildfire.

The results demonstrate a process to facilitate wildfire preparedness in Oregon. This process could be adapted to inform wildfire resilience strategies in other regions facing similar challenges, such as California. Understanding local needs allows officials to target communications more effectively, stage resources more efficiently, and identify gaps that can be addressed before a disaster strikes.

The roles and responsibilities of the public health emergency preparedness (PHEP) and response workforce have changed since the last iteration of competencies developed in 2010. This project aims to identify current competencies (i.e., knowledge, skills, and abilities) for the PHEP workforce, as well as all public health staff who may contribute to a response.

Five focus groups with members of the PHEP workforce across the US focused on their experiences with workforce needs in preparedness and response activities. Focus group transcripts were thematically analyzed using qualitative methods to identify key competencies needed in the workforce.

The focus groups revealed 7 domains: attitudes and motivations; collaboration; communications; data collection and analysis; preparedness and response; leadership and management; and public health foundations. Equity and social justice was identified as a cross-cutting theme across all domains.

Broad validation of competencies through ongoing engagement with the PHEP practice and academic communities is necessary. Competencies can be used to inform the design of PHEP educational programs and PHEP program development. Implementation of an up-to-date, validated competency model can help the workforce better prepare for and respond to disasters and emergencies.

Few empirical studies have examined the collective impact of and interplay between individual factors on collaborative outcomes during major infectious disease outbreaks and the direct and interactive effects of these factors and their underlying mechanisms. Therefore, this study investigates the effects and underlying mechanisms of emergency preparedness, support and assurance, task difficulty, organizational command, medical treatment, and epidemic prevention and protection on collaborative outcomes during major infectious disease outbreaks.

A structured questionnaire was distributed to medical personnel with experience in responding to major infectious disease outbreaks. SPSS software was used to perform the statistical analysis. Structural equation modeling was conducted using AMOS 24.0 to analyze the complex relationships among the study variables.

Organizational command, medical treatment, and epidemic prevention and protection had significant and positive impacts on collaborative outcomes. Emergency preparedness and supportive measures positively impacted collaborative outcomes during health crises and were mediated through organizational command, medical treatment, and epidemic prevention and protection.

The results underscore the critical roles of organizational command, medical treatment, and epidemic prevention and protection in achieving positive collaborative outcomes during health crises, with emergency preparedness and supportive measures enhancing these outcomes through the same key factors.

For the National Health Service (NHS) in England, incidents are defined as events that disrupt, or might disrupt, an organisation’s normal service provision below acceptable levels and require special arrangements to be put in place. NHS England is responsible for coordinating regional responses to incidents. Integrated Care Boards (ICBs) are responsible for coordinating local responses to incidents. This review assessed the records of regional and local incident responses held by NHS England and ICBs respectively.

The outcome of interest was the quantity of information regarding days at an incident response level held by organisations responsible for coordinating that level of incident response.

NHS England had a record of the number of days at regional incident response level for 3 of its 7 regions. 24 of the 42 ICBs had records of the number of days at local incident response level.

NHS England and ICB records of incident responses for which they are responsible were incomplete. They might benefit from reviewing how they measure and record this information. This review may also be of interest to other bodies at local, regional and state level which coordinate hospitals in response to incidents.

The COVID-19 pandemic resulted in a mental health crisis in adolescents. To evaluate resource needs, we attempted to collect data from Children’s Health Fund’s national network of pediatric practices working in resource-limited settings.

Data could not be collected largely due to other disaster response priorities for our network. Using a STROBE flowchart, we characterize the inability to collect data, provide insight into network challenges, and offer this report as a case example for the limitations in collecting data during disaster response.

Only 2 of 24 programs had the capacity and the data to participate. Causes of non-participation included shifting work toward other aspects of disaster response, limiting collection of data, or lack of human resources to extract it.

Disaster disproportionately affects under-resourced communities. The lack of resources impairs disaster response due to conflicting priorities in those working within these communities.

The use of explosive weapons in populated areas (EWIPA) has a disproportionate impact on civilians. Many humanitarian organizations utilize varying sheltering guidelines to recommend safe positions for civilians affected by explosive threats. It is not known whether these recommendations are standardized or derived from evidence. This study aimed to identify existing recommendations and potential gaps in literature relevant to sheltering guidelines for civilians during explosive events.

A scoping review was conducted of the literature including indexed databases and grey literature to identify reports that described sheltering guidelines for civilians during explosive events. Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology was followed.

The search identified 3582 peer-reviewed records. After title/abstract and full text screening, only 2 peer-reviewed reports remained eligible. These were combined with 13 gray literature reports obtained from humanitarian organizations and internet searches. The peer-reviewed reports included mine and unexploded ordnance guidelines, not guidelines for EWIPA or aerial bombardments. There is a substantial knowledge gap and heterogeneity in existing sheltering guidelines from explosive events, particularly those appropriate for protection from EWIPA.

Findings from this scoping review demonstrate a need for the creation and standardization of evidence-based civilian sheltering guidelines to mitigate the threat of explosive weapons to civilians in conflict.

A public health emergency was declared for the opioid crisis in 2017 and remains in place. Between 2017-2024, there were 164 billion dollar disasters. People who use drugs (PWUDs) are highly susceptible to disasters; however adaptive capacity of opioid treatment programs (OTP) is not well understood. Identifying and addressing gaps to increase resilience and reduce morbidity and mortality among PWUDs is critical.

A semi-structured interview guide with 8 questions was developed to assess how disasters impact service provision and other aspects of OTPs. OTP leaders, government officials, community health navigators, and advocates received an email invitation to complete an interview via Zoom. Transcripts were independently hand coded to inductively identify themes.

Eleven interviews were completed. Four themes were identified including client challenges securing housing and reliable transportation, disaster-related communication barriers, stigma around help seeking, and issues related to policies and practices such as regulations and insurance coverage that are inflexible during a disaster.

Disruptions to OTPs during disasters require preparedness planning adaptations like more flexible guest dosing. The ongoing public health emergency of the opioid epidemic and the increasing frequency and severity of climate and weather emergencies requires adaptations to a highly regulated system to address vulnerabilities.

This study aimed to examine the regional impact of COVID-19 on severe trauma patients in South Korea.

This study utilized Community-based Severe Trauma Survey data from the Korea Disease Control and Prevention Agency. The average treatment effect (ATE) of COVID-19 on severe trauma patients by region was determined using doubly robust estimation (DR). Subgroup analysis was conducted for the greater Seoul area, metropolitan cities in rural areas, and rural areas.

Significant differences were observed in the general characteristics of participants before and after the COVID-19 outbreak, particularly in the mechanisms of injury and types of hospitals to which they were transported. DR revealed that the probability of death among severe trauma patients was higher in metropolitan cities in rural areas than in other regions.

The greater impact of COVID-19 on severe trauma patients in metropolitan cities in rural areas is attributed to their higher population density and the inability of emergency medical systems to manage the spread of COVID-19. Therefore, future national policies related to emergency medical care should focus on enhancing the capacity for managing infectious diseases in large-scale metropolitan cities.

We conducted interviews with state epidemiologists involved in the state-level COVID-19 response to understand the challenges and opportunities that state epidemiologists and state health departments faced during COVID-19 and consider the implications for future pandemic responses.

As part of a broader study on policymaking during COVID-19, we analyzed 12 qualitative interviews with state-epidemiologists from 11 US states regarding the challenges and opportunities they experienced during the COVID-19 response.

Interviewees described the unprecedented demands COVID-19 placed on them, including increased workloads as well as political and public scrutiny. Decades of under-funding and constraints posed particular challenges for meeting these demands and compromised state responses. Emergency funding contributed to ameliorating some challenges. However, state health departments were unable to absorb the funds quickly, which created added pressure for employees. The emergency funding also did not resolve longstanding resource deficits.

State health departments were not equipped to meet the demands of a comprehensive COVID-19 response, and increased funding failed to address shortfalls. Effective future pandemic responses will require sustained investment and adequate support to manage on-going and surge capacity needs. Increased public interest and skepticism complicated the COVID-19 response, and additional measures are needed to address these factors.

This study assessed compassion satisfaction, compassion fatigue, and burnout in health care providers from public health care institutions in Ecuador during the COVID-19 pandemic.

A cross-sectional survey was conducted in 2022, involving 111 different public health care institutions in 23 provinces in Ecuador, with 2873 participants recruited via convenience sampling. The survey instrument was the revised Stamm’s Professional Quality of Life Scale Version-5 tool, designed to measure self-reported compassion fatigue, work satisfaction, and burnout among providers. Kruskall-Wallis test assessed subscale score differences by gender, professional role, region, and health care facility level. Dunn’s test was then applied to determine whether groups differed from each other.

On average, health care providers from all facilities had a high rate of compassion satisfaction (84.9%). However, the majority presented moderate levels of burnout (57.1%), and moderate levels of secondary traumatic stress (59.6%). Higher burnout levels were observed in the Amazon regions compared to Coastal regions.

Despite high compassion satisfaction, most surveyed health care providers from Ecuador’s public health institutions experienced moderate burnout and secondary traumatic stress, with higher burnout levels in the Amazon region. Ecuador, similarly to other LMICs, requires mental health policy and legislation targeted to the mental health workforce and these needs. More research is needed on burnout factors among health care providers in resource-challenged low- and middle-income countries.

To describe the protocol and progress of a thyroid study using thyroid ultrasonography in emergency workers who responded to the Fukushima nuclear accident.

Thyroid ultrasonography was performed on Fukushima emergency workers at over 60 health examination institutions. The accuracy of ultrasonography is controlled by standard procedural protocols, examiner training, and a central review system. Thyroid findings are classified into 4 categories: Category A1 (no nodule or cyst), Category A2 (nodules ≤ 5.0 mm and/or cysts ≤ 20.0 mm), Category B (nodules ≥ 5.1 mm and/or cysts ≥ 20.1 mm), and Category C (requires immediate further examination). Participants classified as Categories B or C are recommended for secondary examination.

Among 3398 participants with available ultrasound images obtained at the first health examination between January 2016 and October 2023, 45.2 % were classified as Category A1, 39.2 % as Category A2, 15.5 % as Category B, and 0 % as Category C. Of the 207 participants for whom secondary examination results were available, seven were diagnosed with cancer or suspected cancer.

An accuracy control system of thyroid ultrasonography has been established which will continue to carefully investigate the thyroids of Fukushima emergency workers.

This study exploratively analyzed the associations of well-being with psychological characteristics, socioeconomic status (SES), and the number of relocations after the Fukushima nuclear disaster.

Using a cross-sectional study design, an online questionnaire survey was administered to 416 residents of Fukushima and Tokyo each aged 20-59 years (832 in total) between August 25 and 26, 2018, which was 7 and a half years after the disaster. Categorical factor analysis and multiple regression analysis were performed to investigate associations of 5 well-being scales (positive emotion, negative-free emotion, life satisfaction and general happiness, positive characteristics, and positive functioning) with psychological characteristics, SES, and the number of relocations.

Four of the well-being scales, except for negative-free emotion, were strongly associated with each other and showed similarities in the strength of their associations with psychological characteristics and SES. Among the items surveyed, psychological distress, mindfulness, and marital status were strongly associated with well-being among Fukushima residents. Contrarily, radiation risk perception or the number of relocations were not significantly associated with well-being.

Focusing on psychological distress is expected to have a significant impact on improving well-being after the disaster. In addition, assistance in avoiding unintended family separation may be helpful.

Disaster response plans play a major role in mitigating the impact of climate-related disasters on community food access. This study examined existing disaster response plans in 5 US locations that experienced the costliest hurricanes since 2017 (states: Florida, Texas, Louisiana; territories: Puerto Rico, US Virgin Islands) to assess how existing disaster response plans and response efforts address food-related issues across 4 key domains: availability, accessibility, agency, and acceptability.

A content analysis of disaster response plans was conducted. Disaster response plans were complemented by a review of gray literature and media sources examining the post-hurricane aftermaths. Disaster plans were coded using a deductive analysis approach guided by the Disaster Food Security Framework.

The analysis revealed significant disparities in planning and resources between territories and states. Findings highlight political and structural drivers of disparities in food access, particularly in US territories. State-mandated procedures resulted in a consistent level of effectiveness in their food distribution strategies.

These disparities underscore the need for targeted policy reforms and enhanced federal support to ensure equitable food security during disasters.