Experiences of supported isolation in returning travellers during the early COVID-19 response: a qualitative interview study.

OBJECTIVES: (1) To understand the experiences and perceptions of those who underwent supported isolation, particularly in relation to factors that were associated with improved compliance and well-being; (2) to inform recommendations for the management of similar supported isolation procedures. DESIGN: We carried out a qualitative study using semistructured interviews to capture participants' experiences and perceptions of supported isolation. Data were analysed using the framework approach, a type of thematic analysis that is commonly used in research that has implications for policy. SETTING: Telephone interviews carried out within approximately 1 month of an individual leaving supported isolation. PARTICIPANTS: 26 people who underwent supported isolation at either Arrowe Park Hospital (n=18) or Kents Hill Park Conference Centre (n=8) after being repatriated from Wuhan in January to February 2020. RESULTS: Six key themes were identified: factors affecting compliance with supported isolation; risk perceptions around catching COVID-19; management of supported isolation; communication with those outside supported isolation; relationship with others in supported isolation; and feelings on leaving supported isolation. Participants were willing to undergo supported isolation because they understood that it would protect themselves and others. Positive treatment by staff was fundamental to participants' willingness to comply with isolation procedures. Despite the high level of compliance, participants expressed some uncertainty about what the process would involve. CONCLUSIONS: As hotel quarantine is introduced across the UK for international arrivals, our findings suggest that those in charge should: communicate effectively before, during and after quarantine, emphasising why quarantine is important and how it will protect others; avoid coercion if possible and focus on supporting and promoting voluntary compliance; facilitate shared social experiences for those in quarantine; and ensure all necessary supplies are provided. Doing so is likely to increase adherence and reduce any negative effects on well-being.

Public Perceptions of the "Remove, Remove, Remove" Information Campaign Before and During a Hazardous Materials Incident: A Survey.

In the event of an incident involving the release of hazardous material (eg, chemical, biological, radiological, or nuclear agents), key actions can be taken to reduce harm and protect the people involved. The quicker actions can be taken, the less harm will occur. Guidance is, therefore, needed to help nonspecialist members of the public to act rapidly before emergency responders arrive. The "Remove, Remove, Remove" campaign includes critical information for anyone who is at or near the immediate scene of a hazardous material release. Using a representative sample of 1,000 members of the UK population, this study examined the impact of the information campaign on knowledge and perceptions both before and during the immediate response to an incident. Findings showed that perceptions of the information were positive, with respondents stating that the information was useful and that the recommended actions would be effective. Respondents also stated they would be willing and able to perform the actions during a real incident. Additionally, the respondents' knowledge and confidence in taking protective actions increased significantly after receiving the campaign information, and they overwhelmingly agreed that they would want to receive this information if it were available before an incident. The findings of the survey support the use of the "Remove, Remove, Remove" information before and during hazardous materials incidents.

Early Post-trauma Interventions in Organizations: A Scoping Review.

BACKGROUND: In some organizations, traumatic events via direct or indirect exposure are routine experiences. The National Institute for Health and Care Excellence reviews (2005; 2018) of post-traumatic stress disorder management in primary and secondary care did not address early interventions for trauma within emergency response organizations. AIMS: This scoping review was designed to identify research which evaluates the use of early interventions in emergency and other high-risk organizations following exposure to primary or secondary trauma and to report on the effectiveness of the early intervention models in common use. METHODS: A scoping review was conducted to examine early interventions for workers exposed to trauma, including emergency response, military, and humanitarian aid. Relevant data were extracted from the included studies and the outcomes were assessed using meta-ethnography. RESULTS: Fifty studies of mixed quality met the inclusion criteria for this review. A synthesis of study outcomes found that early interventions help emergency responders to manage post-incident trauma when they are delivered in a manner that (a) respects distinct organizational culture, (b) is supported by organizations and senior management, and (c) harnesses existing social cohesion and peer support systems within teams. CONCLUSION: This review demonstrates that early interventions support emergency responders following exposure to trauma when these are tailored to the needs of the population, are supported by the host organization, and harness existing social cohesion and peer support processes within a team or unit. A number of recommendations for the delivery and evaluation of early interventions for psychological trauma in emergency response organizations were made.

How to inform the public about protective actions in a nuclear or radiological incident: a systematic review.

Studying how the public behaves after a nuclear emergency will help to assess overall morbidity and mortality. Pre-event education might help to shape behaviour, but how best to engage people with emergency communications for low likelihood, high-impact events is unknown. We did a systematic review to identify factors that predict behaviour in preparation for a nuclear incident, factors that predict behaviour in the immediate aftermath of a nuclear incident, and preferences among members of the public for information designed to educate them about which actions to take in the event of a nuclear incident. In general preparedness, behaviour was predicted by factors including perceived coping effectiveness and having children, among others, but absence of preparedness was attributed to fatalistic attitudes. Importantly, for pre-incident communications to be accepted and recommendations adhered to, the source had to be trusted and perceived to be credible. However, it is notable that family needs, such as picking up children from school, were a stronger predictor of behaviour in a nuclear emergency than communicated directives from authorities. If pre-incident education about nuclear incidents is to be used, several factors-including the source and method of communication, the content, and format of messaging-might increase public engagement with messages and promote the uptake of protective behaviours in a radiation event.