Power outage mediates the associations between major storms and hospital admission of chronic obstructive pulmonary disease.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is the third-leading cause of death worldwide with continuous rise. Limited studies indicate that COPD was associated with major storms and related power outages (PO). However, significant gaps remain in understanding what PO's role is on the pathway of major storms-COPD. This study aimed to examine how PO mediates the major storms-COPD associations. METHODS: In this time-series study, we extracted all hospital admissions with COPD as the principal diagnosis in New York, 2001-2013. Using distributed lag nonlinear models, the hospitalization rate during major storms and PO was compared to non-major storms and non-PO periods to determine the risk ratios (RRs) for COPD at each of 0-6 lag days respectively after controlling for time-varying confounders and concentration of fine particulate matter (PM2.5). We then used Granger mediation analysis for time series to assess the mediation effect of PO on the major storms-COPD associations. RESULTS: The RRs of COPD hospitalization following major storms, which mainly included flooding, thunder, hurricane, snow, ice, and wind, were 1.23 to 1.49 across lag 0-6 days. The risk was strongest at lag3 and lasted significantly for 4 days. Compared with non-outage periods, the PO period was associated with 1.23 to 1.61 higher risk of COPD admissions across lag 0-6 days. The risk lasted significantly for 2 days and was strongest at lag2. Snow, hurricane and wind were the top three contributors of PO among the major storms. PO mediated as much as 49.6 to 65.0% of the major storms-COPD associations. CONCLUSIONS: Both major storms and PO were associated with increased hospital admission of COPD. PO mediated almost half of the major storms-COPD hospitalization associations. Preparation of surrogate electric system before major storms is essential to reduce major storms-COPD hospitalization.

Interdisciplinary Collaboration in International Crisis Medical Relief: A Look at the Nepal Earthquake and Ebola Relief Efforts.

OBJECTIVE: This study explores interprofessional collaboration among medical and non-medical personnel planning and implementing international crisis health and medical relief efforts, and how disciplinary and professional background influences these activities. METHODS: This study analyzes semi-structured interviews with individuals involved in organizations medical or health services to the Ebola epidemic in West Africa (2014-2016) or the 2015 Nepal earthquake. RESULTS: Disciplinary background, sometimes coupled with organization role, shaped how relief workers engaged in the process of planning and implementing crisis medical relief. There were 3 thematic areas where these differences emerged: issue focus, problem -solving approaches, and decision-making approaches. Solutions from the field emerged as a fourth theme. CONCLUSIONS: The study demonstrates medical relief required collaboration across medical and non-medical professions and highlights the importance of relief workers' disciplinary background in shaping the planning and implementation of crisis medical relief. Successful collaboration requires that people involved in crisis relief communicate the relevance of their own expertise, identify limits of their own and others' disciplinary perspective(s), seek out strengths in others' expertise, and can identify/ respond appropriately to others who do not see their own disciplinary limits, as well as learn these skills before engaging in relief.

Food Insecurity and COVID-19 Food-Related Perceptions, Practices, and Problems: A 3-State Descriptive Study.

OBJECTIVE: To compare food insecurity (FI) risk and food-related COVID-19 infection risk perceptions, practices, and problems (3P) in Washington (WA), New York (NY), and Louisiana (LA). METHODS: Data from the RAPID Multi-Wave Risk Perception Study was collected via online surveys between May 19 to July 14, 2020 (N = 1260). Multivariable - adjusted logistic and ordinal regressions were performed for odds of FI risk and 3P during these early months of the pandemic. RESULTS: The determinants of FI risk in all states included income, age, and employment. Some determinants were state-specific: households with members at substantial risk for COVID-19 (WA and NY), ethnicity (NY), education, and relationship status (LA). The odds of FI risk were higher among those who perceived higher likelihood of COVID-19 infection via in-store shopping (OR = 1.34, 95% CI: 1.06, 1.70) and improperly cooked food (OR = 1.87, 95% CI: 1.46, 2.41). FI risk was associated with higher odds of problems related to food affordability (OR = 10.66, 95% CI: 7.87, 14.44), preference (OR = 2.51, 95% CI: 1.86, 3.39), sufficiency (OR = 2.63, 95% CI: 1.96, 3.54), food sources (OR = 7.68, 95% CI: 5.73, 10.31), food storage capacity (OR = 0.48, 95% CI: 0.36, 0.66), and knowing where to find help in obtaining food (OR= 7.68, 95% CI: 5.73, 10.31); most of which did not differ by state. No association was found between food insecurity risk and food-related practices. CONCLUSION: Better food preparedness is needed to reduce FI risk during pandemics in specific groups in WA, NY, and LA. Specifically, food affordability, sufficiency, and storage, as well as sources, and increasing knowledge on food programs are limitations that need to be addressed for emergency situations.

A disaster by any other name?: COVID-19 and support for an All-Hazards approach.

Disasters are among the crises that can test the decision making skill of elected and appointed public officials from planning through response and recovery. The COVID-19 crisis, a public health emergency rather than one with immediate damage to the built environment, has affected many aspects of community life. Experiences in responding to the pandemic will likely stimulate fresh planning initiatives for public health emergencies. How then should emergency planners approach planning and response tasks? The All-Hazards approach has been a mainstay of both research and policymaking for over 40 years, but it has come under recent criticism. In this paper, we consider if the All-Hazards approach to disaster management is still viable. Comparing the management needs that emerged in the pandemic with those of disasters from more familiar hazard agents, we conclude that the All-Hazards approach is valid and can continue to guide policymakers in their hazard and disaster management activities.

Los desastres se encuentran entre las crisis que pueden poner a prueba la capacidad de toma de decisiones de los funcionarios públicos electos y designados desde la planificación hasta la respuesta y la recuperación. La crisis de COVID­19, una emergencia de salud pública en lugar de una con daños inmediatos al entorno construido, ha afectado muchos aspectos de la vida comunitaria. Las experiencias en la respuesta a la pandemia probablemente estimularán nuevas iniciativas de planificación para emergencias de salud pública. Entonces, ¿cómo deben abordar los planificadores de emergencias las tareas de planificación y respuesta? El enfoque todos los peligros ha sido un pilar de la investigación y la formulación de políticas durante más de 40 años, pero ha sido objeto de críticas recientes. En este documento, consideramos si el enfoque de todos los peligros para la gestión de desastres sigue siendo viable. Al comparar las necesidades de gestión que surgieron en la pandemia con las de los desastres de agentes de peligro más familiares, llegamos a la conclusión de que el enfoque de todos los peligros es válido y puede seguir guiando a los responsables de la formulación de políticas en sus actividades de gestión de peligros y desastres.