Disaster medicine and public health preparedness
-
Disaster Med Public Health Prep · Oct 2020
Strategies for Optimizing the Supply of N95 Filtering Facepiece Respirators During the Coronavirus Disease 2019 (COVID-19) Pandemic.
N95 respirators are personal protective equipment most often used to control exposures to infections transmitted via the airborne route. Supplies of N95 respirators can become depleted during pandemics or when otherwise in high demand. ⋯ Consultation with federal, state, and local public health officials is also important. We use the framework of surge capacity and the occupational health and safety hierarchy of controls approach to discuss specific engineering control, administrative control, and personal protective equipment measures that may help in optimizing N95 respirator supplies.
-
Disaster Med Public Health Prep · Oct 2020
Historical ArticleHow to Surge to Face the SARS-CoV-2 Outbreak: Lessons Learned From Lombardy, Italy.
Italy is fighting against one of the worst medical emergency since the 1918 Spanish Flu. Pressure on the hospitals is tremendous. ⋯ Unfortunately, hospitals are not prepared: even where a plan for massive influx of patients is present, it usually focuses on sudden onset disaster trauma victims (the most probable case scenario), and it has not been tested, validated, or propagated to the staff. Despite this, the All Hazards Approach for management of major incidents and disasters is still valid and the "4S" theory (staff, stuff, structure, systems) for surge capacity can be guidance to respond to this disaster.
-
Disaster Med Public Health Prep · Sep 2020
Impact of a Physician Clinical Support Supervisor in Supporting Patients and Families, Staff, and the Health-Care System During the COVID-19 Pandemic.
As coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV2), became a pandemic, hospitals activated Hospital Incident Command Systems (HICS). At our institution, we included a role of Physician Clinical Support Supervisor (PCSS) in the HICS structure. ⋯ Through efficient daily 2-way communication between frontline providers, HICS, and hospital leadership, the PCSS role facilitated rapid change and improved support for frontline staff, patients and families, and the health-care system. We recommend including the role of PCSS in HICS structure in the event of future pandemics or other crises.
-
Disaster Med Public Health Prep · Sep 2020
Assessing Socioeconomic Vulnerabilities Related to COVID-19 Risk in India: A State-Level Analysis.
There is a paucity of scientific analysis that has examined spatial heterogeneities in the socioeconomic vulnerabilities related to coronavirus disease 2019 (COVID-19) risk and potential mitigation strategies at the sub-national level in India. The present study examined the demographic, socioeconomic, and health system-related vulnerabilities shaping COVID-19 risk across 36 states and union territories in India. ⋯ This study emphasizes that concerted socially inclusive policy action and sustained livelihood/economic support for the most vulnerable population groups is critical to mitigate the impact of the COVID-19 pandemic in India.
-
Disaster Med Public Health Prep · Sep 2020
Optimizing Scarce Resource Allocation During COVID-19: Rapid Creation of a Regional Health-Care Coalition and Triage Teams in San Diego County, California.
Successful management of an event where health-care needs exceed regional health-care capacity requires coordinated strategies for scarce resource allocation. Publications for rapid development, training, and coordination of regional hospital triage teams to manage the allocation of scarce resources during coronavirus disease 2019 (COVID-19) are lacking. Over a period of 3 weeks, over 100 clinicians, ethicists, leaders, and public health authorities convened virtually to achieve consensus on how best to save the most lives possible and share resources. ⋯ Because many cities are facing COVID-19 surges, we share a process for successful rapid formation of health-care care coalitions, Crisis Standard of Care, and training of Triage Teams. Incorporation of continuous process improvement and methods for communication is essential for successful implementation. Use of our regional health-care coalition communications, incident command system, and the crisis care committee helped mitigate crisis care in the San Diego and Imperial County region as COVID-19 cases surged and scarce resource collaborative decisions were required.