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2.
Euro Surveill ; 25(21)2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32489176

RESUMO

The coronavirus disease (COVID-19) pandemic has caused tremendous pressure on hospital infrastructures such as emergency rooms (ER) and outpatient departments. To avoid malfunctioning of critical services because of large numbers of potentially infected patients seeking consultation, we established a COVID-19 rapid response infrastructure (CRRI), which instantly restored ER functionality. The CRRI was also used for testing of hospital personnel, provided epidemiological data and was a highly effective response to increasing numbers of suspected COVID-19 cases.


Assuntos
Defesa Civil/organização & administração , Infecções por Coronavirus/epidemiologia , Coronavirus , Surtos de Doenças , Administração dos Cuidados ao Paciente , Pneumonia Viral/epidemiologia , Adulto , Betacoronavirus , Alemanha/epidemiologia , Humanos , Pessoa de Meia-Idade , Pandemias , Medição de Risco , Centros de Atenção Terciária , Triagem
3.
Ann Glob Health ; 86(1): 51, 2020 05 18.
Artigo em Inglês | MEDLINE | ID: mdl-32477887

RESUMO

The developed countries of the world were ill-prepared for the pandemic that they have suffered. When we compare developed to developing countries, the sophisticated parameters we use do not necessarily address the weaknesses in the healthcare systems of developed countries that make them susceptible to crises like the present pandemic. We strongly suggest that better preparation for such events is necessary for a country to be considered developed.


Assuntos
Infecções por Coronavirus/epidemiologia , Assistência à Saúde , Países Desenvolvidos/classificação , Regulamento Sanitário Internacional , Pandemias , Pneumonia Viral/epidemiologia , Saúde Pública , Betacoronavirus/isolamento & purificação , Defesa Civil/organização & administração , Defesa Civil/normas , Assistência à Saúde/organização & administração , Assistência à Saúde/normas , Humanos , Regulamento Sanitário Internacional/organização & administração , Regulamento Sanitário Internacional/normas , Saúde Pública/normas
4.
Eur Heart J Acute Cardiovasc Care ; 9(3): 222-228, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32375487

RESUMO

Hospitals play a critical role in providing communities with essential medical care during all types of disaster. Depending on their scope and nature, disasters can lead to a rapidly increasing service demand that can overwhelm the functional capacity and safety of hospitals and the healthcare system at large. Planning during the community outbreak of coronavirus disease 2019 (Covid-19) is critical for maintaining healthcare services during our response. This paper describes, besides general measures in times of a pandemic, also the necessary changes in the invasive diagnosis and treatment of patients presenting with different entities of acute coronary syndromes including structural adaptations (networks, spokes and hub centres) and therapeutic adjustments.


Assuntos
Síndrome Coronariana Aguda/epidemiologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/complicações , Serviço Hospitalar de Emergência/organização & administração , Pneumonia Viral/complicações , Síndrome Coronariana Aguda/diagnóstico , Síndrome Coronariana Aguda/terapia , Defesa Civil/organização & administração , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Assistência à Saúde/organização & administração , Assistência à Saúde/estatística & dados numéricos , Desastres , Surtos de Doenças/estatística & dados numéricos , Emergências/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Utilização de Instalações e Serviços/estatística & dados numéricos , Utilização de Instalações e Serviços/tendências , Hospitais , Humanos , Pandemias , Segurança , Capacidade de Resposta ante Emergências/estatística & dados numéricos
5.
Am J Gastroenterol ; 115(6): 801-804, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32427684
6.
AAPS PharmSciTech ; 21(5): 153, 2020 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-32449007

RESUMO

The supply of affordable, high-quality pharmaceuticals to US patients has been on a critical path for decades. In and beyond the COVID-19 pandemic, this critical path has become tortuous. To regain reliability, reshoring of the pharmaceutical supply chain to the USA is now a vital national security need. Reshoring the pharmaceutical supply with old know-how and outdated technologies that cause inherent unpredictability and adverse environmental impact will neither provide the security we seek nor will it be competitive and affordable. The challenge at hand is complex akin to redesigning systems, including corporate and public research and development, manufacturing, regulatory, and education ones. The US academic community must be engaged in progressing solutions needed to counter emergencies in the COVID-19 pandemic and in building new methods to reshore the pharmaceutical supply chain beyond the pandemic.


Assuntos
Antivirais/provisão & distribução , Betacoronavirus/efeitos dos fármacos , Defesa Civil/organização & administração , Infecções por Coronavirus/terapia , Necessidades e Demandas de Serviços de Saúde/organização & administração , Determinação de Necessidades de Cuidados de Saúde/organização & administração , Pandemias , Pneumonia Viral/terapia , Vacinas Virais/provisão & distribução , Antivirais/economia , Betacoronavirus/patogenicidade , Defesa Civil/economia , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/economia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Custos de Medicamentos , Necessidades e Demandas de Serviços de Saúde/economia , Humanos , Determinação de Necessidades de Cuidados de Saúde/economia , Pandemias/economia , Pneumonia Viral/economia , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Estados Unidos , Vacinas Virais/economia
7.
Can J Cardiol ; 36(6): 956-960, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32299750

RESUMO

The novel coronavirus 2019 disease (COVID-19) pandemic has placed intense pressure on health care organizations around the world. Among other concerns, there has been an increasing recognition of common and deleterious cardiovascular effects of COVID-19 based on preliminary studies. Furthermore, patients with preexisting cardiac disease are likely to experience a more severe disease course with COVID-19. As case numbers continue to increase exponentially, a surge in the number of patients with new or comorbid cardiovascular disease will translate into more frequent and, in some cases, prolonged rehabilitation needs after acute hospitalization. This report describes the current status of post-discharge cardiac care in Canada and provides suggestions regarding steps that policymakers and health care organizations can take to prepare for the COVID-19 pandemic.


Assuntos
Assistência ao Convalescente , Reabilitação Cardíaca/métodos , Doenças Cardiovasculares , Defesa Civil , Infecções por Coronavirus , Controle de Infecções/organização & administração , Pandemias , Alta do Paciente/normas , Pneumonia Viral , Assistência ao Convalescente/métodos , Assistência ao Convalescente/organização & administração , Canadá , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , Defesa Civil/métodos , Defesa Civil/organização & administração , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Gestão de Riscos
8.
Int J Cardiol ; 312: 24-26, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32339543
10.
Am J Trop Med Hyg ; 102(6): 1181-1183, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32323644

RESUMO

Novel coronavirus disease (COVID-19), named a pandemic by the WHO, is the current global health crisis. National and international collaboration are indispensable for combating COVID-19 and other similar potential outbreaks. International efforts to tackle this complex problem have led to remarkable scientific advances. Yet, as a global society, we can and must take additional measures to fight this pandemic. Undoubtedly, our approach toward COVID-19 was not perfect, and testing has not been deployed fast enough to arrest the epidemic early on. It is critical that we revise our approaches to be more prepared for pandemics as a united body by promoting global cooperation and commitment.


Assuntos
Betacoronavirus/patogenicidade , Defesa Civil/organização & administração , Infecções por Coronavirus/epidemiologia , Cooperação Internacional/legislação & jurisprudência , Pandemias , Pneumonia Viral/epidemiologia , Antivirais/síntese química , Antivirais/uso terapêutico , Ásia/epidemiologia , Betacoronavirus/efeitos dos fármacos , Técnicas de Laboratório Clínico/normas , Técnicas de Laboratório Clínico/estatística & dados numéricos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/prevenção & controle , Europa (Continente)/epidemiologia , Humanos , Oriente Médio/epidemiologia , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/prevenção & controle , Vacinas Virais/biossíntese , Vacinas Virais/uso terapêutico
12.
J Emerg Manag ; 18(2): 163-169, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32181871

RESUMO

OBJECTIVE: The objective of this article is to trace the hospital emergency preparedness movement in the United States, strengthen the case for hospital investments in emergency preparedness, and make recommendations to ensure sustainability of the program. Design/Approach: This article is a narrative review. Main themes from the literature about the US Hospital Preparedness Program (HPP) are discussed, beginning with the trends in funding levels of the HPP, the rise of regional healthcare coalitions, preparedness performance measures, and the challenges faced over the past 15 years of HPP activities. Finally, recommendations are made about ways to sustain the program. FINDINGS: The HPP was established in 2002 and funding for the program has seen a 56 percent decrease over the last 16 years. Beyond the initial investment in supplies and equipment, hospitals have received very little of the healthcare preparedness funding. Disaster drills and exercises to test emergency plans in hospitals are perceived as a costly distraction from daily work. The biggest challenge is the lack of engagement and support from hospital leadership. CONCLUSIONS: To ensure the sustainability of the HPP, the positive impact of preparedness activities on the hospital's day-to-day operations must be demonstrated.


Assuntos
Defesa Civil/organização & administração , Planejamento em Desastres/organização & administração , Desastres , Hospitais , Coalizão em Cuidados de Saúde , Administração Hospitalar , Humanos , Estados Unidos
14.
Pediatrics ; 145(2)2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31988168

RESUMO

Children are potential victims of chemical or biological terrorism. In recent years, children have been victims of terrorist acts such as the chemical attacks (2017-2018) in Syria. Consequently, it is necessary to prepare for and respond to the needs of children after a chemical or biological attack. A broad range of public health initiatives have occurred since the terrorist attacks of September 11, 2001. However, in many cases, these initiatives have not ensured the protection of children. Since 2001, public health preparedness has broadened to an all-hazards approach, in which response plans for terrorism are blended with those for unintentional disasters or outbreaks (eg, natural events such as earthquakes or pandemic influenza or man-made catastrophes such as a hazardous-materials spill). In response to new principles and programs that have evolved over the last decade, this technical report supports the accompanying update of the American Academy of Pediatrics 2006 policy statement "Chemical-Biological Terrorism and its Impact on Children." The roles of the pediatrician and public health agencies continue to evolve, and only their coordinated readiness and response efforts will ensure that the medical and mental health needs of children will be met successfully. In this document, we will address chemical and biological incidents. Radiation disasters are addressed separately.


Assuntos
Bioterrorismo/psicologia , Terrorismo Químico/psicologia , Defesa Civil , Planejamento em Desastres , Obstrução das Vias Respiratórias/induzido quimicamente , Asfixia/induzido quimicamente , Fatores Biológicos/classificação , Fatores Biológicos/toxicidade , Criança , Defesa Civil/educação , Defesa Civil/legislação & jurisprudência , Defesa Civil/organização & administração , Contenção de Riscos Biológicos , Descontaminação/métodos , Planejamento em Desastres/legislação & jurisprudência , Surtos de Doenças , Exposição Ambiental/efeitos adversos , Regulamentação Governamental , Humanos , Irritantes/classificação , Irritantes/toxicidade , Saúde Mental , Agentes Neurotóxicos/classificação , Agentes Neurotóxicos/toxicidade , Pediatria , Papel do Médico , Centros de Controle de Intoxicações/organização & administração , Vigilância da População , Atenção Primária à Saúde , Ricina/toxicidade , Varíola/prevenção & controle , Capacidade de Resposta ante Emergências , Estados Unidos
15.
PLoS One ; 14(12): e0226489, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31869359

RESUMO

BACKGROUND: Disasters and emergencies from infectious diseases, extreme weather and anthropogenic events are increasingly common. While risks vary for different communities, disaster and emergency preparedness is recognized as essential for all nation-states. Evidence to inform measurement of preparedness is lacking. The objective of this study was to identify and define a set of public health emergency preparedness (PHEP) indicators to advance performance measurement for local/regional public health agencies. METHODS: A three-round modified Delphi technique was employed to develop indicators for PHEP. The study was conducted in Canada with a national panel of 33 experts and completed in 2018. A list of indicators was derived from the literature. Indicators were rated by importance and actionability until achieving consensus. RESULTS: The scoping review resulted in 62 indicators being included for rating by the panel. Panel feedback provided refinements to indicators and suggestions for new indicators. In total, 76 indicators were proposed for rating across all three rounds; of these, 67 were considered to be important and actionable PHEP indicators. CONCLUSIONS: This study developed an indicator set of 67 PHEP indicators, aligned with a PHEP framework for resilience. The 67 indicators represent important and actionable dimensions of PHEP practice in Canada that can be used by local/regional public health agencies and validated in other jurisdictions to assess readiness and measure improvement in their critical role of protecting community health.


Assuntos
Defesa Civil , Técnica Delfos , Planejamento em Desastres/organização & administração , Saúde Pública , Canadá , Defesa Civil/organização & administração , Defesa Civil/normas , Consenso , Planejamento em Desastres/normas , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Emergências , Humanos , Saúde Pública/normas , Indicadores de Qualidade em Assistência à Saúde , Estudos Retrospectivos , Inquéritos e Questionários
16.
Am J Public Health ; 109(S4): S290-S296, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31505149

RESUMO

Objectives. To determine the level of preparedness among New York City community-based organizations by using a needs assessment.Methods. We distributed online surveys to 582 human services and 6017 faith-based organizations in New York City from March 17, 2016 through May 11, 2016. We calculated minimal indicators of preparedness to determine the proportion of organizations with preparedness indicators. We used bivariate analyses to examine associations between agency characteristics and minimal preparedness indicators.Results. Among the 210 human service sector respondents, 61.9% reported emergency management plans and 51.9% emergency communications systems in place. Among the 223 faith-based respondents, 23.9% reported emergency management plans and 92.4% emergency communications systems in place. Only 10.0% of human services and 18.8% of faith-based organizations reported having funds allocated for emergency response. Only 2.9% of human services sector and 39.5% of faith-based sector respondents reported practicing emergency communication alerts.Conclusions. New York City human service and faith-based sector organizations are striving to address emergency preparedness concerns, although notable gaps are evident.Public Health Implications. Our results can inform the development of metrics for community-based organizational readiness.


Assuntos
Defesa Civil/organização & administração , Organizações Religiosas/organização & administração , Serviço Social/organização & administração , Planejamento em Desastres , Sistemas de Comunicação entre Serviços de Emergência , Organizações Religiosas/economia , Humanos , Determinação de Necessidades de Cuidados de Saúde , Cidade de Nova Iorque , Serviço Social/economia , Inquéritos e Questionários
17.
Surgery ; 166(4): 587-592, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31447104

RESUMO

BACKGROUND: Our regional trauma organization, which comprises 7 trauma centers, 30 acute care hospitals and free-standing emergency departments, and 42 emergency medical services agencies, conducted possibly the largest mass-casualty drill to date, totaling 445 victims at 3 sites involving 11 hospitals and 25 agencies and organizations. METHODS: The drill was preceded by a tabletop exercise 4 months beforehand called Operation Continued Care Full-Scale Exercise, which consisted of simulated terrorist events at 3 sites to wound 445 moulaged patients. Four law enforcement and 5 fire and emergency medical services departments and 16 supporting organizations and agencies were involved in transporting patients to 11 different hospitals. The 7 objectives for the event addressed coordinating emergency operations, sustaining adequate communications, updating regional bed status, processing resource requests, triaging patients, tracking patients, and patient identification. RESULTS: Of the 445 transported patients, 270 (60%) were entered correctly into the state patient tracking system; 68 (25.2%) upgrades and 34 (12.6%) downgrades from scene triage categories were noted. Multiple opportunities for improvement were identified, with major weaknesses noted in communication and coordination from event sites to the regional trauma organizations and hospitals. CONCLUSION: The size and complexity of the drill provided experience and knowledge to facilitate future disaster preparedness and highlighted weaknesses in communication and coordination. Large, multijurisdictional, multiagency exercises provide opportunities to stress, evaluate, and improve regional disaster preparedness.


Assuntos
Defesa Civil/organização & administração , Planejamento em Desastres/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Incidentes com Feridos em Massa/mortalidade , Transporte de Pacientes/organização & administração , Centros de Traumatologia/organização & administração , Feminino , Bombeiros/estatística & dados numéricos , Humanos , Comunicação Interdisciplinar , Masculino , Incidentes com Feridos em Massa/prevenção & controle , Inovação Organizacional , Controle de Qualidade , Triagem , Estados Unidos
18.
Prehosp Disaster Med ; 34(4): 393-400, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31389323

RESUMO

INTRODUCTION: Hospital evacuations of patients with special needs are extremely challenging, and it is difficult to train hospital workers for this rare event.Hypothesis/Problem:Researchers developed an in-situ simulation study investigating the effect of standardized checklists on the evacuation of a patient under general anesthesia from the operating room (OR) and hypothesized that checklists would improve the completion rate of critical actions and decrease evacuation time. METHODS: A vertical evacuation of the high-fidelity manikin (SimMan3G; Laerdal Inc.; Norway) was performed and participants were asked to lead the team and evacuate the manikin to the ground floor after a mock fire alarm. Participants were randomized to two groups: one was given an evacuation checklist (checklist group [CG]) and the other was not (non-checklist group [NCG]). A total of 19 scenarios were run with 28 participants. RESULTS: Mean scenario time, preparation phase of evacuation, and time to transport the manikin down the stairs did not differ significantly between groups (P = .369, .462, and .935, respectively). The CG group showed significantly better performance of critical actions, including securing the airway, taking additional drug supplies, and taking additional equipment supplies (P = .047, .001, and .001, respectively). In the post-evacuation surveys, 27 out of 28 participants agreed that checklists would improve the evacuation process in a real event. CONCLUSION: Standardized checklists increase the completion rate of pre-defined critical actions in evacuations out of the OR, which likely improves patient safety. Checklist use did not have a significant effect on total evacuation time.


Assuntos
Lista de Checagem/normas , Defesa Civil/organização & administração , Emergências , Salas Cirúrgicas/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Treinamento por Simulação , Feminino , Humanos , Masculino , Desastres Naturais , Segurança do Paciente/estatística & dados numéricos , Fatores de Tempo , Estados Unidos
19.
Prehosp Disaster Med ; 34(4): 385-392, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31280729

RESUMO

BACKGROUND: The Global Terrorism Database (GTD) is an open-source database on terrorist incidents around the world since 1970, and it is maintained by the National Consortium for the Study of Terrorism and Responses to Terrorism (START; College Park, Maryland USA), a US Department of Homeland Security Center of Excellence. The consortium reviews media reports to determine if an event meets eligibility to be categorized as a terrorism incident for entry into the database. OBJECTIVE: The objective of this study was to characterize chemical terrorism incidents reported to the GTD and understand more about the kinds of chemical agents used, the associated morbidity and mortality, the geography of incidents, and the intended targets. METHODS: Chemical terrorism incidents from 1970 through 2015 were analyzed by chemical agent category, injury and fatality, geographic region, and target. RESULTS: During the study period, 156,772 terrorism incidents were reported to the GTD, of which 292 (0.19%) met the inclusion criteria for analysis as a chemical terrorism incident. The reported chemical agent categories were: unknown chemical (30.5%); corrosives (23.3%); tear gas/mace (12.3%); unspecified gas (11.6%); cyanide (8.2%); pesticides (5.5%); metals (6.5%); and nerve gas (2.1%). On average, chemical terrorism incidents resulted in 51 injuries (mean range across agents: 2.5-1,622.0) and seven deaths (mean range across agents: 0.0-224.3) per incident. Nerve gas incidents (2.1%) had the highest mean number of injuries (n = 1,622) and fatalities (n = 224) per incident. The highest number of chemical terrorism incidents occurred in South Asia (29.5%), Western Europe (16.8%), and Middle East/North Africa (13.0%). The most common targets were private citizens (19.5%), of which groups of women (22.8%) were often the specific target. Incidents targeting educational institutions often specifically targeted female students or teachers (58.1%). CONCLUSIONS: Chemical terrorism incidents rarely occur; however, the use of certain chemical terrorism agents, for example nerve gas, can cause large mass-causality events that can kill or injure thousands with a single use. Certain regions of the world had higher frequency of chemical terrorism events overall, and also varied in their frequencies of the specific chemical terrorism agent used. Data suggest that morbidity and mortality vary by chemical category and by region. Results may be helpful in developing and optimizing regional chemical terrorism preparedness activities.


Assuntos
Causas de Morte , Terrorismo Químico/estatística & dados numéricos , Defesa Civil/organização & administração , Planejamento em Desastres/organização & administração , Ferimentos e Lesões/terapia , Vazamento de Resíduos Químicos/estatística & dados numéricos , Gerenciamento de Dados , Bases de Dados Factuais , Feminino , Saúde Global , Humanos , Incidência , Masculino , Medição de Risco , Análise de Sobrevida , Ferimentos e Lesões/diagnóstico , Ferimentos e Lesões/mortalidade
20.
Aust N Z J Public Health ; 43(4): 395-400, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31091364

RESUMO

OBJECTIVE: Public preparedness for natural hazard events is low. With worsening severe weather events due to climate change, public health policy and practices must evolve to more effectively engage communities. This study's findings identify and suggest new strategic public health policies to shift the practice of all-hazards preparedness into routine, everyday life. METHODS: Semi-structured interviews, focus groups and Thematic Analysis were used to investigate the interactions between participant groups: emergency responders and animal owners. RESULTS: Three policies designed to improve human safety and well-being are proposed and discussed. These are (i) a new system of workplace leave, (ii) an innovative regime of financial incentives for fire-ready properties, and (iii) review of the use of firebreaks on farms and rural blocks. CONCLUSION: Policies proposed in this research aim to proactively narrow the awareness-preparedness gap and build adaptive capacity to minimise risk to human health in all-hazards contexts. Further research could evaluate the efficacy of trialled public policy. Implications for public health: These new policies seek to contribute to establishing and maintaining a culture of preparedness as a routine aspect of everyday life, and thus promote and protect public health in the short, medium and long terms.


Assuntos
Defesa Civil/organização & administração , Planejamento em Desastres/organização & administração , Saúde Pública , Política Pública , Incêndios Florestais , Animais , Austrália , Desastres , Grupos Focais , Humanos , Entrevistas como Assunto
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