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1.
Biomedica ; 40(Supl. 2): 159-165, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152199

RESUMEN

INTRODUCTION: Healthcare personnel plays an important role in the prevention of acute respiratory infections in hospital settings. OBJECTIVE: Our aim was to establish the level of knowledge about respiratory virus infections and the attitudes and practices among healthcare workers, leaders of infection control committees in hospitals of Bogotá, Colombia. MATERIALS AND METHODS: We used a self-administered questionnaire of 28 items during the monthly meeting sponsored by the local health authority. "Yes or no" and "true or false" questions were applied to measure knowledge. Attitudes and practices were measured with a Likert-type scale according to the agreement degree. RESULTS: We surveyed 70 healthcare workers. Respondents demonstrated a good level of knowledge as 80% of them answered correctly more than five questions. A total of 54.4% showed a low degree of agreement when asked if their institutions have the policy to stay home when they are sick with respiratory symptoms and 67.1% never or rarely remain at home under such conditions. CONCLUSION: Healthcare worker leaders of infection control committees in Bogotá's ospitals have adequate knowledge about the prevention of seasonal respiratory viruses. There is a need for implementing urgent sick leave policies as a measure to prevent the spread of potential coronavirus infections in hospitals.


Asunto(s)
Planificación en Desastres , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/psicología , Pandemias/prevención & control , Infecciones del Sistema Respiratorio/prevención & control , Absentismo , Adulto , Colombia/epidemiología , Estudios Transversales , Femenino , Humanos , Control de Infecciones/organización & administración , Masculino , Persona de Mediana Edad , Política Organizacional , Ausencia por Enfermedad , Encuestas y Cuestionarios
2.
Biomedica ; 40(Supl. 2): 188-197, 2020 10 30.
Artículo en Inglés, Español | MEDLINE | ID: mdl-33152203

RESUMEN

The COVID-19 pandemic caused by SARS-CoV-2 is a public health problem on a scale unprecedented in the last 100 years, as has been the response focused on the rapid genomic characterization of SARS-CoV-2 in virtually all regions of the planet. This pandemic emerged during the era of genomic epidemiology, a science fueled by continued advances in next-generation sequencing. Since its recent appearance, genomic epidemiology included the precise identification of new lineages or species of pathogens and the reconstruction of their genetic variability in real time, evidenced in past outbreaks of influenza H1N1, MERS, and SARS. However, the global and uncontrolled scale of this pandemic created a scenario where genomic epidemiology was put into practice en masse, from the rapid identification of SARS-CoV-2 to the registration of new lineages and their active surveillance throughout the world. Prior to the COVID-19 pandemic, the availability of genomic data on circulating pathogens in several Latin America and the Caribbean countries was scarce or nil. With the arrival of SARS-CoV-2, this scenario changed significantly, although the amount of available information remains scarce and, in countries such as Colombia, Brazil, Argentina, and Chile, the genomic information of SARS-CoV-2 was obtained mainly by research groups in genomic epidemiology rather than the product of a public health surveillance policy or program. This indicates the need to establish public health policies aimed at implementing genomic epidemiology as a tool to strengthen surveillance and early warning systems against threats to public health in the region.


Asunto(s)
Betacoronavirus/genética , Infecciones por Coronavirus/epidemiología , Genoma Viral , Difusión de la Información , Epidemiología Molecular/tendencias , Pandemias , Neumonía Viral/epidemiología , Vigilancia de la Población , ARN Viral/genética , Análisis de Secuencia de ARN , Secuencia de Bases , Región del Caribe , Enfermedades Transmisibles Emergentes , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/virología , Planificación en Desastres , Brotes de Enfermedades , Humanos , América Latina/epidemiología , Epidemiología Molecular/métodos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Neumonía Viral/virología , Utilización de Procedimientos y Técnicas , Salud Pública , RNA-Seq , Desarrollo Sostenible , Virosis/epidemiología
3.
J Emerg Manag ; 18(5): 373-382, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33174191

RESUMEN

Senior care facilities house populations that are highly vulnerable to impacts from natural hazard events. Recent events in Florida and Texas highlight the need for senior care facilities to prepare to shelter-in-place during and immediately after a natural hazard event occurs and be self-sufficient for extended periods afterward. Interviews with emergency managers and senior facility administrators in New Jersey emphasize how regional planning efforts can be used successfully to improve preparedness at senior facilities and coordination with the emergency response community. While preparedness efforts vary across New Jersey, the southern region has shown success through focused connections between facilities and emergency managers that have led to successful coordination of emergency evacuation of facilities.


Asunto(s)
Planificación en Desastres , Urgencias Médicas , Florida , Humanos , New Jersey , Texas
4.
J Emerg Manag ; 18(5): 399-409, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33174193

RESUMEN

OBJECTIVE: The objective of this study was to explore perceptions of senior leadership in hospitals on the motivations, cost, benefits, barriers, and facilitators of investment in emergency preparedness. STUDY DESIGN: This is a qualitative study which used a grounded theory approach to develop a theory of hospital emergency preparedness. SETTING AND STUDY PARTICIPANTS: A purposive sample of hospital leaders (n = 11) in the US state of Nebraska were interviewed. RESULTS: Results showed that the environmental risk associated with the hospital location, the hospital's position in the community, and the preparedness requirements of the Centers for Medicare and Medicaid Services contribute to investment decisions. Rural hospitals face unique challenges in preparing for disasters, for example, lack of trained personnel. Facilitators of disaster preparedness include the availability of federal funds, the commitment of leadership, and an organizational mission aligned toward emergency preparedness. Hospitals invest in hazard vulnerability assessments; partnerships with other organizations in the community; staff trainings and infrastructure. CONCLUSIONS: The authors concluded that hospitals in Nebraska are committed toward investing in preparedness activities. The theory of hospital emergency preparedness developed will be used in a subsequent study to develop a decision-support framework for hospital investment in preparedness.


Asunto(s)
Defensa Civil , Planificación en Desastres , Anciano , Humanos , Liderazgo , Medicare , Nebraska , Estados Unidos
5.
J Environ Manage ; 276: 111332, 2020 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-33010736

RESUMEN

Suitable and standardized indicators to track progress in disaster and climate resilience are increasingly considered a key requirement for successfully informing efforts towards effective disaster risk reduction and climate adaptation. Standardized measures of resilience which can be used across different geographical and socioeconomic contexts are however sparse. We present and analyze a standardized community resilience measurement framework for flooding. The corresponding measurement tool is modelled based on and adapted from a so-called 'technical risk grading' approach as used in the insurance sector. The grading approach of indicators is based on a two-step process: (i) raw data is collected, and (ii) experts grade the indicators, called sources of resilience, based on this data. We test this approach using approximately 1.25 million datapoints collected across more than 118 communities in nine countries. The quantitative analysis is complemented by content analysis to validate the results from a qualitative perspective. We find that some indicators can more easily be graded by looking at raw data alone, while others require a stronger application of expert judgement. We summarize the reasons for this through six key messages. One major finding is that resilience grades related to subjective characteristics such as ability, feel, and trust are far more dependent on expert judgment than on the actual raw data collected. Additionally, the need for expert judgement further increases if graders must extrapolate the whole community picture from limited raw data. Our findings regarding the role of data and grade specifications can inform ways forward for better, more efficient and increasingly robust standardized assessment of resilience. This should help to build global standardized and comparable, yet locally contextualized, baseline estimates of the many facets of resilience in order to track progress over time on disaster and climate resilience and inform the implementation of the Paris Agreement, Sendai Framework, and the Sustainable Development Goals.


Asunto(s)
Planificación en Desastres , Desastres , Clima , Cambio Climático , Inundaciones , Paris
6.
BMJ Glob Health ; 5(10)2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33106239

RESUMEN

INTRODUCTION: The COVID-19 pandemic powerfully demonstrates the consequences of biothreats. Countries will want to know how to better prepare for future events. The Global Health Security Index (GHSI) is a broad, independent assessment of 195 countries' preparedness for biothreats that may aid this endeavour. However, to be useful, the GHSI's external validity must be demonstrated. We aimed to validate the GHSI against a range of external metrics to assess how it could be utilised by countries. METHODS: Global aggregate communicable disease outcomes were correlated with GHSI scores and linear regression models were examined to determine associations while controlling for a number of global macroindices. GHSI scores for countries previously exposed to severe acute respiratory syndrome (SARS), Middle East respiratory syndrome and Ebola and recipients of US Global Health Security Agenda (GHSA) investment were compared with matched control countries. Possible content omissions in light of the progressing COVID-19 pandemic were assessed. RESULTS: GHSI scores for countries had strong criterion validity against the Joint External Evaluation ReadyScore (rho=0.82, p<0.0001), and moderate external validity against deaths from communicable diseases (-0.56, p<0.0001). GHSI scores were associated with reduced deaths from communicable diseases (F(3, 172)=22.75, p<0.0001). The proportion of deaths from communicable diseases decreased 4.8% per 10-point rise in GHSI. Recipient countries of the GHSA (n=31) and SARS-affected countries (n=26), had GHSI scores 6.0 (p=0.0011) and 8.2 (p=0.0010) points higher than matched controls, respectively. Biosecurity and biosafety appear weak globally including in high-income countries, and health systems, particularly in Africa, are not prepared. Notably, the GHSI does not account for all factors important for health security. CONCLUSION: The GHSI shows promise as a valid tool to guide action on biosafety, biosecurity and systems preparedness. However, countries need to look beyond existing metrics to other factors moderating the impact of future pandemics and other biothreats. Consideration of anthropogenic and large catastrophic scenarios is also needed.


Asunto(s)
Control de Enfermedades Transmisibles/organización & administración , Infecciones por Coronavirus/epidemiología , Salud Global , Cooperación Internacional , Neumonía Viral/epidemiología , Medidas de Seguridad/organización & administración , Betacoronavirus , Planificación en Desastres , Brotes de Enfermedades/prevención & control , Política de Salud , Humanos , Pandemias/prevención & control , Práctica de Salud Pública
7.
J Prev Med Public Health ; 53(5): 307-310, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33070501

RESUMEN

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has placed unprecedented pressure on healthcare systems, even in advanced economies. While the number of cases of SARS-CoV-2 in Africa compared to other continents has so far been low, there are concerns about under-reporting, inadequate diagnostic tools, and insufficient treatment facilities. Moreover, proactiveness on the part of African governments has been under scrutiny. For instance, issues have emerged regarding the responsiveness of African countries in closing international borders to limit trans-continental transmission of the virus. Overdependence on imported products and outsourced services could have contributed to African governments' hesitation to shut down international air and seaports. In this era of emerging and re-emerging pathogens, we recommend that African nations should consider self-sufficiency in the health sector as an urgent priority, as this will not be the last outbreak to occur. In addition to the Regional Disease Surveillance Systems Enhancement fund (US$600 million) provided by the World Bank for strengthening health systems and disease surveillance, each country should further establish an epidemic emergency fund for epidemic preparedness and response. We also recommend that epidemic surveillance units should create a secure database of previous and ongoing pandemics in terms of aetiology, spread, and treatment, as well as financial management records. Strategic collection and analysis of data should also be a central focus of these units to facilitate studies of disease trends and to estimate the scale of requirements in preparation and response to any future pandemic or epidemic.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Planificación en Desastres/legislación & jurisprudencia , Política de Salud/legislación & jurisprudencia , Pandemias/prevención & control , Neumonía Viral/prevención & control , Viaje/legislación & jurisprudencia , África/epidemiología , Infecciones por Coronavirus/transmisión , Gobierno , Humanos , Pandemias/legislación & jurisprudencia , Neumonía Viral/transmisión
8.
PLoS One ; 15(10): e0241332, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33112931

RESUMEN

In this work we present a three-stage Machine Learning strategy to country-level risk classification based on countries that are reporting COVID-19 information. A K% binning discretisation (K = 25) is used to create four risk groups of countries based on the risk of transmission (coronavirus cases per million population), risk of mortality (coronavirus deaths per million population), and risk of inability to test (coronavirus tests per million population). The four risk groups produced by K% binning are labelled as 'low', 'medium-low', 'medium-high', and 'high'. Coronavirus-related data are then removed and the attributes for prediction of the three types of risk are given as the geopolitical and demographic data describing each country. Thus, the calculation of class label is based on coronavirus data but the input attributes are country-level information regardless of coronavirus data. The three four-class classification problems are then explored and benchmarked through leave-one-country-out cross validation to find the strongest model, producing a Stack of Gradient Boosting and Decision Tree algorithms for risk of transmission, a Stack of Support Vector Machine and Extra Trees for risk of mortality, and a Gradient Boosting algorithm for the risk of inability to test. It is noted that high risk for inability to test is often coupled with low risks for transmission and mortality, therefore the risk of inability to test should be interpreted first, before consideration is given to the predicted transmission and mortality risks. Finally, the approach is applied to more recent risk levels to data from September 2020 and weaker results are noted due to the growth of international collaboration detracting useful knowledge from country-level attributes which suggests that similar machine learning approaches are more useful prior to situations later unfolding.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Planificación en Desastres , Aprendizaje Automático , Modelos Teóricos , Pandemias , Neumonía Viral/epidemiología , Medición de Riesgo/métodos , Algoritmos , Clasificación , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/transmisión , Árboles de Decisión , Predicción , Salud Global , Humanos , Cooperación Internacional , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , Neumonía Viral/transmisión , Juego de Reactivos para Diagnóstico/provisión & distribución , Máquina de Vectores de Soporte
12.
Rev Sci Tech ; 39(2): 615-623, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33046915

RESUMEN

National Veterinary Services (NVS) are increasingly called upon to respond to a wide range of disasters. The health, safety and wellness of Veterinary Services personnel are essential to maintaining a capable workforce and sustaining operational and organisational effectiveness. Disasters can generate hazards with potential impacts on health, including physical trauma, environmental exposure and psychological stress. Maintaining health, safety and wellness in the workforce requires leadership and training. Individuals and teams must be well equipped and well practised to address hazards and their mitigation, to prevent injury. Of particular concern for veterinarians are the behavioural health aspects of disasters. This issue has not received the attention required considering the scale and scope of the problem which, according to a recent survey, affects up to 50% of veterinary disaster responders. The symptoms cited in this survey range from anxiety to suicidal thoughts. Accordingly, more and better resources, including protective equipment, guidelines and training, must be developed to strengthen the capabilities of NVS to respond to disasters.


Asunto(s)
Planificación en Desastres , Desastres , Veterinarios , Animales , Humanos , Encuestas y Cuestionarios
13.
Rev Sci Tech ; 39(2): 599-613, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33046916

RESUMEN

Statistics show that disasters have expanded in scope and scale, with impacts on both humans and animals. As animals are valued not only for their economic value, but also for their companionship, people sometimes risk their lives to protect them, and emergency responders are expected to safeguard their welfare during emergencies. This paper discusses experiences from different regions of the world in animal disaster risk reduction and management in terms of legislation, funding streams, planning, capacity development, and communications. It is widely recognised that human, animal and environmental well-being are interconnected; therefore, as this is the case, and as veterinarians are at the forefront in ensuring animal welfare, they should be involved throughout the disaster management cycle. While animals and their welfare should always be considered in national disaster management plans, sub-regional authorities must be empowered to integrate animal welfare principles when responding to emergencies and implementing risk reduction programmes. Capacity development is key for Veterinary Services personnel who work in the fields of disaster management and risk reduction. Training tools and curricula developed by different organisations are available to foster skills such as incident coordination, risk communication, or response planning using tools such as the Livestock Emergency Guidelines and Standards (LEGS). Intergovernmental organisations also play a significant role in setting the standards and frameworks within which professionals operate.


Asunto(s)
Planificación en Desastres , Desastres , Veterinarios , Bienestar del Animal , Animales , Urgencias Médicas/veterinaria , Humanos
14.
Rev Sci Tech ; 39(2): 551-559, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33046920

RESUMEN

Disaster and disaster risk management are described differently by various agencies, but the underlying principles remain the same. Disaster risk management is a continuous and integrated multidisciplinary and multisectoral process of planning and implementing measures that establish a culture of risk avoidance by building resilient communities. Such communities can only be created through a systematic process of education, training and development, involving all stakeholders. A researched comprehensive disaster management plan should be developed, but will only be successful if it sets clear priorities; is practised, tested, adapted and/or amended where necessary; and is practical, feasible and well understood by all those who are involved. Everyone who plays a role in implementing this plan must recognise that role and be well trained in its execution. Capacity building for disaster management is also a multisectoral, multidisciplinary, integrative process, achieved through a system of integrated education, training and public awareness programmes.


Asunto(s)
Planificación en Desastres , Desastres , Animales
15.
Rev Sci Tech ; 39(2): 445-450, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33046931

RESUMEN

Technological disasters present a unique set of requirements for national Veterinary Services, encompassing complex issues of risk to human health, animal health and the environment. Cooperation among agencies and Ministries that do not routinely coordinate with one another during transboundary animal disease incidents or natural disaster responses may be required in technological disasters. Effective preparedness and response requires additional planning, training, exercises, and equipping to safely and efficiently provide the necessary services in a technological disaster.


Asunto(s)
Planificación en Desastres , Desastres , Animales , Humanos
16.
Rev Sci Tech ; 39(2): 435-443, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33046932

RESUMEN

Complex emergencies, also known as major humanitarian emergencies, differ from emergencies related to natural disasters or major disease outbreaks, in that they are essentially political in nature and will, in most cases, erode the cultural, civil, political and economic stability of societies. They can be exacerbated by natural disasters and eventually require external interventions. National Veterinary Services are usually weakened or partially or totally disrupted. Interventions to support livestock-dependent communities should build on local capacity. Multisector, integrated disaster management plans should be in place and should include not only preparedness and response, but also mitigation, prevention and recovery strategies. National Veterinary Services and their partners should work in close collaboration and are encouraged to look beyond animal-health-related interventions, also addressing access to feed and water, and keeping marketing chains for livestock open. This paper also touches on the specific needs of displaced people, host communities, and pastoralists, as well as addressing disease eradication programmes in the context of complex emergencies.


Asunto(s)
Planificación en Desastres , Desastres , Animales , Brotes de Enfermedades/prevención & control , Brotes de Enfermedades/veterinaria , Urgencias Médicas/veterinaria
17.
Rev Sci Tech ; 39(2): 417-425, 2020 Aug.
Artículo en Español, Inglés | MEDLINE | ID: mdl-33046933

RESUMEN

This case study outlines the actions of Cuba's Veterinary Service, as part of the country's disaster risk reduction and management system, in response to Hurricane Irma. The phenomenon affected ten of Cuba's 15 provinces and caused significant damage in 53 of its municipalities (29.6%). During the response effort, the pre-established measures for the various phases (warning, alert and emergency) were deployed according to the disaster reduction plans for each level. In all provinces, animals were protected by moving them to safer locations, allowing for pre-established sanitary measures and technical assistance. Nonetheless, damage was incurred, mainly to the roofs of some animal housing. The following deaths were recorded: 210,150 poultry, 2,752 cattle (of which 73.8% were calves) and 866 pigs (of which 68% were young animals). In addition, 7% of the inventory of hives was damaged and 3.3% of hives were lost. Damage to infrastructure included: 466 poultry houses, 1,422 cattle houses, 431 pig houses, 1,200 wind pumps and 13 of the country's 17 feed concentrate plants. As no major damage was reported to the Veterinary Service's facilities (laboratories and offices), its viability was guaranteed at all times. Rapid damage assessment enabled priorities for rehabilitation and recovery actions to be set, with the result that, just three months after the hurricane had struck, 67% of the poultry houses and 33% of the pig houses had been restored. This article focuses on preparedness, response and lessons learned.


Asunto(s)
Tormentas Ciclónicas , Planificación en Desastres , Desastres , Animales , Bovinos , Cuba , Vivienda para Animales , Porcinos
18.
Rev Sci Tech ; 39(2): 393-398, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33046936

RESUMEN

This paper outlines the role of laboratories in animal-health-related disasters and emergencies, with a particular focus on biological threats - intentional, accidental and natural. Whilst multisectoral coordination is increasingly recognised as necessary for effective preparedness and response to all kinds of disasters, the role of the laboratory is often overlooked. The laboratories' involvement, not just in the response, but across all phases of disaster management - mitigation, planning, response and recovery - is essential, not only for improved animal health but for preservation of livelihoods and for food security, social cohesion and economic stability.


Asunto(s)
Planificación en Desastres , Desastres , Animales , Urgencias Médicas/veterinaria , Laboratorios
19.
Global Health ; 16(1): 94, 2020 10 08.
Artículo en Inglés | MEDLINE | ID: mdl-33032616

RESUMEN

INTRODUCTION: COVID-19 has rapidly and radically changed the face of human health and social interaction. As was the case with COVID-19, the world is similarly unprepared to respond to antimicrobial resistance (AMR) and the challenges it will produce. COVID-19 presents an opportunity to examine how the international community might better respond to the growing AMR threat. MAIN BODY: The impacts of COVID-19 have manifested in health system, economic, social, and global political implications. Increasing AMR will also present challenges in these domains. As seen with COVID-19, increasing healthcare usage and resource scarcity may lead to ethical dilemmas about prioritization of care; unemployment and economic downturn may disproportionately impact people in industries reliant on human interaction (especially women); and international cooperation may be compromised as nations strive to minimize outbreaks within their own borders. CONCLUSION: AMR represents a slow-moving disaster that offers a unique opportunity to proactively develop interventions to mitigate its impact. The world's attention is currently rightfully focused on responding to COVID-19, but there is a moral imperative to take stock of lessons learned and opportunities to prepare for the next global health emergency.


Asunto(s)
Antibacterianos/uso terapéutico , Infecciones por Coronavirus/prevención & control , Farmacorresistencia Microbiana , Pandemias/prevención & control , Neumonía Viral/prevención & control , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/epidemiología , Planificación en Desastres/organización & administración , Predicción , Salud Global , Humanos , Cooperación Internacional , Neumonía Viral/epidemiología
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