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El 31 de agosto de 2023, el Gobierno de Chile puso fin a la alerta sanitaria por COVID-19. Este hito invita a reflexionar sobre lecciones aprendidas respecto a la preparación y respuesta ante emergencias, que sean sensibles e informadas sobre la experiencia de la población migrante de nuestro país. En este marco, se presentan tres perspectivas. La primera se centra en evitar la responsabilización individual en el incumplimiento de las medidas de prevención del contagio, ya que este enfoque ignora las inequidades estructurales e históricas. Las recomendaciones de emergencia se deben construir bajo un abordaje colectivo y con la consideración de los diversos contextos socioculturales y políticos. La segunda perspectiva llama a tomar en cuenta y abordar la migración como determinante social de la salud de la población en la preparación y respuesta ante emergencias. Durante la pandemia, los cambios en la gobernanza de la migración en todo el mundo precarizaron los procesos migratorios, con riesgos para la salud física y mental de las personas que migran. Esto requiere una mejor planificación y decisiones informadas en evidencia científica para futuras pandemias. La tercera perspectiva se enfoca en promover la interculturalidad, dado que la comunicación de los riesgos de contagio y de las medidas preventivas se vio dificultada entre poblaciones migrantes con diversas cosmovisiones e interpretaciones de los procesos de salud y enfermedad. Asimismo, el responder a las necesidades de aquellas comunidades históricamente marginadas, requiere establecer modos de vida que respeten la diversidad en las narrativas y las prácticas cotidianas. Los gobiernos y sistemas sanitarios deben incorporar la migración a sus estrategias de preparación y respuesta ante emergencias, con la construcción de las condiciones para su cumplimiento óptimo.
On August 31, 2023, the Chilean government ended the health alert for COVID-19. This milestone invites us to reflect on lessons learned in emergency preparedness and response regarding migrant populations in the country. In this context, three perspectives are presented. The first focuses on avoiding pointing to individual responsibility for non-compliance with prevention measures, as this approach ignores structural and historical inequities. Emergency recommendations should be constructed considering a collective approach and diverse sociocultural and political contexts. The second perspective calls for considering and addressing migration as a social determinant of health. During the pandemic, changes in the governance of migration around the world made migration processes more precarious, with risks to the physical and mental health of migrants, which needs better planning and evidence-based decision-making in future pandemics. The third perspective focuses on promoting intercultural health, as effective communication of contagion risks and preventive measures were hampered among migrant populations with diverse worldviews and interpretations of health and disease processes. Responding to the needs of historically marginalized communities requires establishing ways of life that respect diversity in narratives and everyday practices. Governments and health systems must incorporate migration into their emergency preparedness and response strategies, creating the conditions for optimal compliance.
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Background: Contact tracing is a traditional pillar of infectious disease control, especially for illnesses involving direct transmission from person to person, such as COVID-19. Several challenges have arisen from COVID-19 contact tracing activities, particularly in low-resource settings. These include refusal of positive clients to disclose their close contacts, difficulties in conducting risk assessment for contacts traced, among others. Objectives: To explore the activities and identify challenges of contact tracing during COVID -19 pandemic response in a tertiary hospital in Northwestern Nigeria from May, 2020 to March, 2021. Methodology: Amixed method approach was done with quantitative secondary data analysis of COVID-19 contacts traced, and qualitative assessment through Key Informant Interviews (KII) of Ahmadu Bello University Teaching Hospital staff involved in COVID-19 outbreak response during the period. Results: Atotal of 2,249 clients were tested for COVID-19, of which 925 (41.1%) were healthcare workers. The identified challenges included problems with contact identification, delay in notification of results, refusal to disclose contacts by cases, contacts refusing to allow risk assessment, and health workers being overwhelmed by the task of contact tracing. Conclusion: Challenges identified include refusal of cases to disclose their contacts, overwhelming number of contacts, and delay in notification of results. There is need to institute contact tracing protocols to mandate cases to disclose their contacts, train more manpower to reduce the burden of contact tracing, and improve the notification of results.
Subject(s)
Humans , Pneumonia , Contact Tracing , Severe Acute Respiratory Syndrome , Communicable Diseases , COVID-19ABSTRACT
Background@#Due to the COVID-19 pandemic, health care for patients who experienced out-of-hospital cardiac arrest (OHCA) has been suboptimal.@*Objective@#To describe the demographic, clinical, and logistical characteristics of patients who experienced OHCA during the peak of the COVID-19 pandemic. @*Design@#Descriptive study. @*Participants@#136 males and 58 females, aged 8 days to 89 years old, who experienced OHCA and were subsequently sent to the emergency department of Southern Philippines Medical Center (SPMC). @*Setting@#Southern Philippines Medical Center, Davao City, March 15 to December 31, 2020. @*Main outcome measures@#Demographic, clinical, and logistical characteristics of patients. @*Main results@#Of the 194 patients, 149 (76.80%) experienced OHCA at home. Among them, 42 (21.65%) received initial CPR at the scene, with 36 (85.71%) of these procedures performed by ambulance crews. Only one (0.52%) patient received automated extracorporeal defibrillation performed by a bystander. There were 147 (75.77%) patients who were transported by private vehicles. The average times for dispatch, response and turnaround of the emergency medical services (EMS) were 8 minutes, 19 minutes, and 56 minutes, respectively. Of the 194 patients, 176 (90.72%) were transported without ongoing resuscitation. Upon arrival at the emergency department, 184 (94.84%) patients had unknown arrest rhythm. Only one (0.52%) patient had a return of spontaneous circulation and was admitted to the ICU. All the other patients expired within 10 to 15 minutes upon arriving at the emergency department.@*Conclusion@#In this study, most OHCAs happened at home, with few receiving CPR at the scene, primarily from ambulance crews. The average EMS response time was 19 minutes. Most patients were transported from the scene without ongoing resuscitation, and had an unknown arrest rhythm upon arrival at the emergency department. All patients expired shortly after arriving at the emergency department.
Subject(s)
Resuscitation , AmbulancesABSTRACT
Objective:To explore the effect of emergency rescue ability training of operating room nurses based on video tracking method, and provide reference for improving emergency ability of operating room nurses.Methods:This study was a quasi-experimental study. In March 2021, 85 nurses working in the Department of Anesthesiology and Surgery of the Provincial Hospital Affiliated to Shandong First Medical University were selected by cluster sampling method. We implemented a training program of rescue emergency ability based on video tracking and adopted the inspection list of rescue emergency ability assessment and doctors′ satisfaction questionnaire of operating room nurses to evaluate the scores of each item in the nurses' rescue emergency ability list and doctors' satisfaction of rescue cooperation of operating room nurses.Results:The scores of the dimensions of recognition of fatal arrhythmias, fatal arrhythmia, several situations that can directly call help, writing of emergency state nursing records and handover of medical records, use of defibrillator, correct use and maintenance of negative pressure attraction, use and management of rescue vehicle and situation disposal in the inspection list of rescue ability after training were 9.80 ± 1.61, 26.06 ± 2.20, 17.34 ± 1.29, 13.00 ± 1.57, 7.35 ± 0.74, 10.24 ± 1.14, 33.89 ± 2.73, which were higher than before training 9.24 ± 1.18, 24.92 ± 2.15, 15.69 ± 1.92, 12.21 ± 1.66, 6.55 ± 0.92, 8.94 ± 1.32, 32.94 ± 2.20. The differences were statistically significant ( t values were -6.83 to -2.51, all P<0.05); after the training, in the questionnaire of doctors' satisfaction with nurses, surgical materials and instruments preparation, first aid skill operating level, attention to surgical progress, active and correct delivery, orderly and busy, coordination and communication ability, professional knowledge, evaluation ability and foresight, ability to deal with emergencies, clear division of labor and good cooperation, and responsibility scores were 4.22 ± 0.58, 4.52 ± 0.54, 4.53 ± 0.47, 4.43 ± 0.58, 4.44 ± 0.44, 4.37 ± 0. 59, 4.45 ± 0.51, 4.51 ± 0.53, 4.51 ± 0.57, 4.17 ± 0.63, which were higher than the pre-training 4.05 ± 0.58, 4.38 ± 0.56, 4.26 ± 0.76, 4.04 ± 0.67, 4.25 ± 0.62, 4.19 ± 0.74, 4.25 ± 0.74, 4.34 ± 0.67, 4.21 ± 0.84 and 3.56 ± 0.58. All differences were statistically significant ( t values were -8.22 to -2.10, all P<0.05). Conclusions:The training method based on video tracking method improved the emergency rescue ability of operating room nurses and the doctor's satisfaction with rescue cooperation, and provided a reference for the training of operating room nurses.
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Objective To construct a rapid prediction system to improve the accuracy and efficiency of evaluation of the consequences of nuclear accidents at a field scale. Methods Base on a diagnostic wind field model and Lagrangian particle diffusion, we established a rapid prediction method for wind field and pollutant dispersion around complex underlying surfaces within a field scale, in a way of visual discrimination of buildings and vegetation distribution. With data simulation and the use of a real urban field example, the simulated results were compared with wind tunnel test measurements and computational fluid dynamics results to study the influence of complex underlying surfaces on wind field and pollutant transport in the region. Results The rapid prediction system could clearly simulate the high-resolution wind field and pollutant concentration distribution of the region in about five minutes. It could interface with geographic information software and couple with a mesoscale weather prediction model. In terms of accuracy, the system performed well in wind field simulation, with the fractional deviations of wind speed and wind direction being 0.33 and −0.08, respectively. Concentration field simulation was greatly affected by the wind field, and the ratios of simulated concentrations to observed concentrations were between 0.05 and 3.4, except for a few low concentration points. Conclusion The rapid prediction system can effectively simulate the distribution characteristics of the flow field and improve calculation efficiency when ensuring calculation accuracy, which provides an important reference for emergency response to nuclear accidents.
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ObjectiveTo conduct on-site epidemiological investigation， emergency response， tracing of infection source and analysis of a confirmed COVID-19 case of a foreign airline cargo service staff member in Shanghai’s international airport， aiming to provide reference for prevention of imported COVID-19 cases under regular prevention and control of COVID-19. MethodsA retrospective field epidemiological investigation was conducted to collect information of basic characteristics， illness onset， diagnosis， treatment， clinical manifestations， exposure history and risk factors within 14 days before onset， close contacts， close contacts of close contacts， and key places related to activity trajectories. Respiratory tract specimens of cases and contacts were collected for detection of SARS-CoV-2 by real time RT-PCR （rRT-PCR）. Emergency response， including infection source analysis and contact management， was conducted. ResultsThe case developed pharyngeal itch on July 28， 2021， and fever on the 30th， and went to the hospital for treatment twice on the 31st. Because his specimen was positive for SARS-CoV-2 by rRT-PCR on August 1， he was isolated and treated on August 2 and diagnosed as a confirmed case of COVID-19. The case was a foreign airline cargo service member at an international airport. The two regular nucleic acid screenings of him as a high-risk occupation on July 21 and 28 were negative. He did not leave Shanghai within 14 days before the onset of illness. During July 22nd and 23rd， he was repeatedly exposed during work to the high-risk environment that may have been contaminated by SARS-CoV-2 and had contact with the crew of foreign airlines， and the personal protection was not standardized. None of the 67 close contacts and 567 close contacts of close contacts in Shanghai showed symptoms during the 14-day medical quarantine， and the specimens of them were all negative for SARS-CoV-2 by rRT-PCR. The results of genome sequencing analysis showed that the genomic homology between the virus of the case and the one of recent domestic local epidemic and the recent imported cases was low， and the homology with the overseas Delta mutant strain was higher than that of the domestic Delta mutant strain. ConclusionThe situation of prevention of COVID-19 import is still serious. It is necessary to conduct regular nucleic acid screening for high-risk occupational groups， strengthen the diagnosis and reporting awareness of medical institutions， effectively implement the prevention and control measures for people， objects， and environment at international airports， and further enhance the public's awareness of personal protection.
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Currently, the national schistosomiasis control program of China is moving from transmission control and transmission interruption to elimination; however, there is still a threat of schistosomiasis outbreak in area where the transmission of schistosomiasis has not been interrupted, and in areas where transmission interruption and even elimination have been achieved because of the complex factors relating to schistosomiasis transmission, as well as socioeconomic factors and natural environments, which greatly affects the consolidation of schistosomiasis control outcomes and the achievement of the goal of schistosomiasis elimination in the country. Here, we summarized the outbreaks of schistosomiasis in China during the past six decades, evaluated the impact of schistosomiasis outbreak on the national schistosomiasis control program and proposed management of schistosomiasis outbreak and prevention of schistosomiasis resurgence as the key point and difficulty for schistosomiasis control in the current stage. Improving the surveillance-response mechanisms and minimizing the development of schistosomiasis outbreak and the resultant damages and losses are recommended to provide technical supports for elimination of schistosomiasis in China.
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Based on the relevant guidelines published by the International Atomic Energy Agency and the Ministry of Ecology and Environment of the People's Republic China, this article summarizes the process of conducting a comprehensive radiological emergency exercise by reviewing the achievements and experience of radiological emergency exercises in various provinces of China since 2014. In addition, based on the actual combat requirements of the exercises, this article details the technical requirements and standard methods of exercise planning, preparation, implementation, and evaluation, so as to provide a reference for conducting radiological emergency exercises.
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Objective:To explore the effect of applying scaffolding teaching to infectious disease teaching.Methods:The study selected 259 undergraduate nursing students of Batch 2017 as the research objects, and they were randomly divided into an experimental group (126 students) and a control group (133 students) according to the odd and even numbers of their student numbers. The experimental group carried out scaffolding teaching, and the control group adopted traditional teaching. After the teaching, the two groups of students were assessed on the theory of infectious diseases and scenario simulation excercises. The teaching satisfaction of the two groups was assessed through questionnaire surveys. SPSS was used for t test and chi-square test. Results:The experimental group's theoretical assessment and scenario simulation excercises scores were both higher than those of the control group, and the difference was statistically significant ( P<0.05). The results of the questionnaire survey showed that the experimental group students were more satisfied with the scaffolding teaching model [80.2% (101/126)], which was higher than that of the control group [54.1% (72/133)], with statistically significant differences ( P<0.001). Conclusion:Scaffolding teaching is helpful to improve teaching quality and satisfaction in infectious disease teaching, and it is worthy of further promotion and application in educational practice.
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In recent years， the increasing scale and scope of public health emergencies have brought serious challenges to China's health emergency system. It is in urgent need to develop the existing health emergency system toward the goal of multi-industry， multi-discipline， multi-professional and multi-regional， while the concept of standardization is essential to achieve this goal. This article describes the construction process of health emergency standardization system by the World Health Organization， the International Organization for Standardization， the United States， and China； analyzes the problems of China's health emergency standardization system by comparing the system between China and the United States， proposes the construction dimensions of China's health emergency standard system， and suggests development strategies targeting the shortcomings of China's health emergency standardization.
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High-energy radiation derived from X-ray, γ-ray, neutrons, and other radioisotopes has been widely used for disease diagnosis and treatmentin clinical practice. Notably, high-energy radiation has been proven to increase the cure rate, prolong the survival time, and improve the quality of life among patients with malignant tumors. However, radiation poses huge threats to human health and life. Establishment of effective emergency management information systems for medical radiation is therefore of great significance to evaluate the radiation safety, predict the leakage of radioactive materials, and propose effective responses. This review summarizes the development and application of currently main emergency management information systems for medical radiation, so as to provide a reference for the establishment of sensitive and effective hospital-based radiation emergency management information systems.
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【Objective】 To explore the current information construction and security status in blood banks in China though sampling. so as to provide feasible suggestions for strengthening security management. 【Methods】 The anonymous online questionnaire was issued to a total of 44 blood banks to investigate the information construction status, development of hierarchical protection work, security precautions at all levels of the information system, information operation and maintenance, and emergency response in these institutions. 【Results】 The average investment concerning information construction of 44 blood banks was 12.64 yuan per donor, with a median of 8.1 yuan. The investments of information security accounted for about 22.86% of the total investment, and the informatization construction investment was mainly concentrated in one-time project. The investment in infrastructure was basically equivalent to the that in the core business information system. The blood banks have paid more attention to the importance of information security. 【Conclusion】 Under the complicated situation of information security, the blood banks should further improve the frame work of information security systems and the management level of information security to secure a stable performance of key infrastructure and the privacy of blood donors and patients.
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Objective:To understand the school absence due to illnesses in the context of emergency response to COVID-19 in Minhang District， so as to provide a basis for epidemic prevention and control in primary and secondary schools. Methods:Descriptive epidemiological analysis was conducted on the data of school absence due to illnesses in primary and secondary schools in Minhang District in the context of emergency response to COVID-19. Results:During the period of emergency response to COVID-19， the incidence of illness-induced absenteeism in Minhang District was 1.50%. Difference in absenteeism between different months was statistically significant （χ2=1 724.31， P<0.01）. The monthly absenteeism rate in 2020 was higher than that from 2016 to 2019， and the difference was statistically significant （P<0.01）. The rate of symptom-induced absenteeism was 1.28%. Fever was the most common symptom of school absence， and the rate of absence due to fever in 2020 was higher than that of the same period in 2019 and 2016-2018， and the difference was statistically significant （χ2=15 281.33， P<0.01）. Acute upper respiratory tract infection was the number one cause of illness-induced absence during the emergency response period， while infectious diseases were the primary causes of diseases from 2016 to 2018 and in 2019. The difference of infectious disease absence in different years was statistically significant （χ2=1 822.62， P<0.01）. Conclusion:The rate of school absence due to illnesses increased significantly in the context of emergency response to COVID-19 in Minhang District， while the rate of school absence due to infectious diseases decreased significantly. The prevention and control measures during the epidemic period can be used for reference in the future for preventing infectious diseases under normal conditions.
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The earthquake occurred in Japan on March 11， 2011 was accompanied by a tsunami， which also led to a leakage accident at the Fukushima Daiichi nuclear power plant. The disaster caused large-scale casualties and property damage. Soma City in Fukushima Prefecture established a disaster response headquarter and held its first meeting 9 minutes after the earthquake. Disaster response can be divided into three stages. In the first phase， life protection is the primary task. In the second phase， the primary tasks are health protection and basic life support. And in the third phase， life quality improvement is the primary task. This article reviewed the public health emergency response of local governments in Japan after the disaster in order to improve the response to public health emergencies in China.
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December 2019 witnessed the outbreak of COVID-19 in Wuhan, Hubei province of China, which has soon spread nationwide and across national borders, posting a menacing pandemic threat. Children are themselves highly susceptible infectious diseases in normal times not to mention an epidemic period. Coupled with the high incidence of seasonal influenza, it is imperative to strengthen epidemiological screening of children, along with effective isolation, treatment, prevention and control measures. In view of specifics of the hospital, the authors proposed to further improve the medical emergency procedure, strictly enforcing screening and isolation regulations, and standardizing medical procedure. They also proposed scientific layout and use of the infection wards. These measures are designed to control the epidemic and protect the safety of medical staff.
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Objective To investigate the core emergency response capabilities of medical workers for corona virus disease 2019 (COVID-19) public health emergency, in order to provide references for improving emergency level. Methods By means of convenient sampling, the general information questionnaire and the medical staff's 2019-new coronavirus (2019-nCoV) core emergency capability questionnaire were used to conduct this survey, and the status of 2019-nCoV core emergency capability of 629 clinical medical staff was analysed. Results The score of core emergency response capability of medical staff for 2019-nCoV was (135.60±21.73)points, with a score rate of 73.3%; the score of preventive capability dimension was (11.69±1.96)points, with a score rate of 77.93%; the score of preparation ability dimension was (20.79±4.18)points, and the score rate was 69.30%; the score of rescue ability was (103.11±16.93)points, with a scoring rate of 73.57%. Conclusion The core emergency response capability of medical worker for 2019-nCoV and its dimensions are at a medium level. At the present stage, the training of core knowledge of medical personnel 2019-nCoV should be strengthened, effective measures should be taken to improve the alleviation of weakness in rescue, and the self-psychological adjustment of medical personnel should be strengthened to improve the core emergency response capability of medical worker.
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OBJECTIVE: To analyze the current status of core emergency response capability of nurses for systematically managing coronavirus disease(COVID-19) in intensive care units and to explore the related influencing factors. METHODS: A total of 100 nurses who systematically manage COVID-19 in the intensive care units from a class 3 grade A hospital in Wuhan City were selected as study subjects by convenience sampling method. The self-designed COVID-19 Core Emergency Response Capability Questionnaire for Nurses was used to investigate the status of COVID-19 core emergency response capability. RESULTS: The total score of the core emergency capability of the nurses averaged 133.1±18.1, and the scoring rate was 80.7%, which was at a high level. The scoring rates of each dimension from high to low were prevention ability, rescue ability and preparation ability, with the score rate of 85.2%, 81.7% and 71.0% respectively. The results of generalized linear regression analysis showed that the level of core emergency response capability of nurses was higher in high-risk departments such as respiratory department, infectious department, intensive care unit, outpatient department and emergency department than that of low-risk departments [partial regression coefficient(β) =11.18, P<0.01]. The levels of core emergency response capability of nurses who were married, once worked in the fever clinic, and were members of the National Health Emergency Rescue Team was higher(β were 8.28, 24.34 and 10.89, respectively, P<0.05). CONCLUSION: The core emergency response capability of nurses who systematically manage COVID-19 in the critical care units in Wuhan City is at a high level. Their core emergency response capability is affected by factors such as personal work experience, marital status, emergency work experience and trainings.
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Given the scope and speed of virus spread, the COVID-19 pandemic is complex and dangerous. Complicated objective factors such as the long-term existence of source of infection, difficulty in completely blocking the transmission route and a large susceptible population determined that the COVID-19 pandemic might stay with us for long term. Therefore, we should be ready for a tough and long battle against the COVID-19 epidemic. The strategy should adhere to the principle of combining emergency response with regular prevention and control measures, and all efforts should be well harnessed in a coordinated way to keep the epidemic under control while securing the economic and social development.
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@#2019 novel coronavirus (2019-nCoV) infection has been spreading in China since December 2019. Neonates are presumably the high-risk population susceptible to 2019-nCoV due to immature immune function. The neonatal intensive care unit (NICU) should be prepared for 2019-nCoV infections as far as possible. The emergency response plan enables the effcient response capability of NICU. During the epidemic of 2019-nCoV, the emergency response plan for the NICU should be based on the actual situation, including diagnosis, isolation, and treatment, as well as available equipment and staffng, and take into account the psychosocial needs of the families and neonatal care staff.
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Earthquake is a serious natural disaster. The earthquake that occurs in schistosomiasis-endemic areas not only causes direct human and economic losses, but also induces secondary disasters that greatly threaten public health safety in affected areas. This paper analyzed the impact of the 2008 Wenchuan Earthquake and 2013 Lushan Earthquake on schistosomiasis transmission in Sichuan Province, and proposed emergency measures and assessment activitiesresponding to schistosomiasis following earthquake disasters. The experiences from schistosomiasis control after two earthquake disasters in Sichuan Province may provide insights into the emergency control in other regions or after other natural disasters.