Disaster medicine and public health preparedness
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Disaster Med Public Health Prep · Jul 2020
Stranger months: how SARS-CoV-2, fear of contagion, and lockdown measures impacted attendance and clinical activity during February and March 2020 at an urban Emergency Department in Milan.
An unprecedented wave of patients with acute respiratory failure due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease 2019 (COVID-19) hit emergency departments (EDs) in Lombardy, starting in the second half of February 2020. This study describes the direct and indirect impacts of the SARS-CoV-2 outbreak on an urban major-hospital ED. ⋯ The COVID-19 outbreak determined an unprecedented upsurge in respiratory failure cases and mortality. Fear of contagion triggered a spontaneous, marked reduction of ED attendance, and, presumably, some as yet unknown quantity of missed or delayed diagnoses for conditions other than COVID-19.
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Disaster Med Public Health Prep · Jul 2020
Five Decades of Global Chemical Terror Attacks: Data Analysis to Inform Training and Preparedness.
Chemical weapons attacks during the recent conflict in Syria and Iraq highlight the need to better understand the changing epidemiology of chemical weapons use, especially among non-state actors. Public health professionals and policy-makers require this data to prioritize funding, training, chemical weapons preparedness, disaster response, and recovery. The purpose of this investigation is to provide descriptive data that can be used by policy-makers and public safety officials to better prepare for these potential attacks. ⋯ Chemical weapon use in global terrorism remains an increasingly common occurrence that requires better characterization. The average number of chemical terrorist attacks per year is increasing, with a large proportion resulting from the conflicts in Iraq and Syria. Choking (chlorine) and vesicant (mustard) agents have become the predominant chemical terror agent since 2001, with a decreased incidence of blood (cyanogenic) and nerve (sarin) agents. Future preparedness initiatives should focus on vulnerable targets such as private citizens and educational institutions. Improving blast injury response is essential, along with prioritizing disaster training focused on choking agents, vesicants, and caustics.
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Disaster Med Public Health Prep · Jul 2020
Effectiveness and Recommendations for the Use of Dental Masks in the Prevention of COVID-19: A Literature Review.
The purpose of this investigation was to identify, synthesize, and compare all the current information on the efficacy of dental masks, emphasizing their use, types, and filters to prevent the spread and infection of COVID-19 and other infectious diseases. A bibliographic search of the main scientific databases was carried out using the words "masks, COVID-19, and dentistry." Articles without language restriction up to May 31, 2020, were obtained. The types of masks, their half-life, method to use, sterilization, and proposed alternatives for dental masks were analyzed. ⋯ Regarding sterilization, most of the articles presented studies using ultraviolet germicidal irradiation as the sterilization method. Regarding respirator mask half-life, we recommend prolonged use, combined with a disposable surgical mask over the respirator mask. Finally, the use of N95 or FFP2 respirators are recommended as part of personal protective equipment for dental use.
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Disaster Med Public Health Prep · Jul 2020
Adaptation of Coronavirus Disease (COVID-19) Protocols to a Parisian Maternity Unit During the 2020 Pandemic: A Managerial Perspective.
The coronavirus disease (COVID-19) pandemic overwhelmed health services in France during March 2020 and, to cope, service delivery was reduced in most disciplines. However, as this was impossible for Obstetrics, the COVID-19 infection had to be added to existing clinical care pathways at the children's hospital, Hôpital Necker-Enfants Malades. This was further complicated by an increasing number of pregnancies affected by infection, in addition to scientific uncertainty about the virus. ⋯ By April 18, with the peak of the COVID-19 epidemic receding, protocols were again readjusted to meet new service delivery requirements. Although a full debrief is yet to occur, from an operational level perspective, staff response was more than satisfactory. While preventing another epidemic may be impossible, this experience will improve our resilience in the future.
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Disaster Med Public Health Prep · Jul 2020
The Role of Emergency Medical Services in Earthquake Response: Integrating the ABC Approach of Israel's Magen David Adom.
Throughout history, earthquakes have caused devastation and loss of life. Emergency medical services (EMS) plays a vital role in the response to any mass-casualty incident or disaster. Magen David Adom, Israel's premier EMS organization, has a unique strategy known as the ABC approach to earthquake response. ⋯ Anyone available outside of the region will come and help. A Level C earthquake is completely devastating, and all workers nationwide will be involved in responding to the catastrophe. The role of EMS responders using the ABC approach to earthquake response, as described here, may be integrated in part or whole in other EMS systems.