Preparing for compounding crises: Staff shortages and cyber-attack vulnerability in the era of COVID-19 In 2020, while the USA was experiencing successive waves of COVID-19, Universal Health Services experienced a major cyber attack that crippled electronic systems in over 200 hospitals, including a major academic medical centre that was playing a key regional role in COVID-19 care and clinical trials. This paper discusses the impact of the attack on … Continue reading “Preparing for compounding crises: Staff shortages and cyber-attack vulnerability in the era of COVID-19” Learn More
Using analytics to support a utility's initial response to the COVID-19 pandemic amid an uncertain evidence base Energy utilities play a critical role in fostering disaster resilience. Much of the world is increasingly dependent on the availability and reliability of safe and efficient energy. In addition to its importance for industrial, commercial and household functionality, energy provision is increasingly significant in determining health and equity outcomes during a disaster. Amid the COVID-19 … Continue reading “Using analytics to support a utility’s initial response to the COVID-19 pandemic amid an uncertain evidence base” Learn More
Current Data Gaps in Modeling Essential Worker Absenteeism Due to COVID-19 With the uncertain physical and mental health implications of COVID-19 infection, companies have taken a myriad of actions that aim to reduce the risk of employees contracting the virus, with most grounded in reducing or eliminating in-person interactions. Our preliminary analysis indicates that while there is some data to support modelling absenteeism, there are gaps … Continue reading “Current Data Gaps in Modeling Essential Worker Absenteeism Due to COVID-19” Learn More
Do Shared Barriers When Reporting to Work During an Influenza Pandemic Influence Hospital Workers’ Willingness to Work? A Multilevel Framework Objective Characteristics associated with interventions and barriers that influence health care workers’ willingness to report for duty during an influenza pandemic were identified. Additionally, this study examined whether workers who live in proximal geographic regions shared the same barriers and would respond to the same interventions. Methods Hospital employees (n=2965) recorded changes in willingness to … Continue reading “Do Shared Barriers When Reporting to Work During an Influenza Pandemic Influence Hospital Workers’ Willingness to Work? A Multilevel Framework” Learn More
Surge Capacity Logistics Successful management of a pandemic or disaster requires implementation of preexisting plans to minimize loss of life and maintain control. Managing the expected surges in intensive care capacity requires strategic planning from a systems perspective and includes focused intensive care abilities and requirements as well as all individuals and organizations involved in hospital and regional … Continue reading “Surge Capacity Logistics” Learn More
Disaster Planning for Vulnerable Populations: Leveraging Community Human Service Organizations Direct Service Delivery Personnel Given the variability, complexities, and available resources for local vulnerable populations, it is clear that preparing effectively for catastrophic events cannot be accomplished with a single, simple template. Inclusion of Community Human Service Organizations’ (CHSO’s) direct service delivery personnel ensures that emergency disaster planning efforts for vulnerable populations are effective and responsive to unique needs … Continue reading “Disaster Planning for Vulnerable Populations: Leveraging Community Human Service Organizations Direct Service Delivery Personnel” Learn More
Lessons from Sandy — Preparing Health Systems for Future Disasters Within hours after Hurricane Sandy’s landfall, doctors and staff at one of New York City’s premier medical centers realized that something was going terribly wrong. Lights were flickering, critical devices essential to life support for more than 200 patients, many in intensive care units, were malfunctioning. A decision had to be made by hospital leaders, … Continue reading “Lessons from Sandy — Preparing Health Systems for Future Disasters” Learn More
The 2011 Tuscaloosa Tornado: Integration of Pediatric Disaster Services into Regional Systems of Care Objective: To empirically describe the integration of pediatric disaster services into regional systems of care after the April 27, 2011, tornado in Tuscaloosa, Alabama, a community with no pediatric emergency department or pediatric intensive care unit and few pediatric subspecialists. Study design: Data were obtained in interviews with key informants including professional staff and managers … Continue reading “The 2011 Tuscaloosa Tornado: Integration of Pediatric Disaster Services into Regional Systems of Care” Learn More
Health care system planning for and response to a nuclear detonation The hallmark of a successful response to a nuclear detonation will be the resilience of the community, region, and nation. An incident of this magnitude will rapidly become a national incident; however, the initial critical steps to reduce lives lost, save the lives that can be saved with the resources available, and understand and apply … Continue reading “Health care system planning for and response to a nuclear detonation” Learn More
Utilizing paramedics for in-patient critical care surge capacity INTRODUCTION: While many hospitals have developed preliminary emergency department and in-patient surge plans, the ability to surge is often limited by critical resources. The resource which is often the most limited is usually the human resource and within this category the limiting factor is almost universally nursing. As a result, nursing shortages can result in … Continue reading “Utilizing paramedics for in-patient critical care surge capacity” Learn More
Emergency Response and Public Health in Hurricane Katrina: What Does it Mean to Be a Public Health Emergency Responder? Since 9/11, federal funds directed toward public health departments for training in disaster preparedness have dramatically increased, resulting in changing expectations of public health workers’ roles in emergency response. This article explores the public health emergency responder role through data collected as part of an oral history conducted with the 3 health departments that responded … Continue reading “Emergency Response and Public Health in Hurricane Katrina: What Does it Mean to Be a Public Health Emergency Responder?” Learn More
Regional Health and Public Health Preparedness for Nuclear Terrorism: Optimizing Survival in a Low Probability/High Consequence Disaster The United States remains unprepared to cope with the possibility of an attack on a major city by terrorists capable of acquiring and detonating an improvised nuclear device. Long-held anxieties about the non-survivability of nuclear war promulgated during the intense U.S.—Soviet arms race from the late 1940s through the 1980s, and reluctance to consider low … Continue reading “Regional Health and Public Health Preparedness for Nuclear Terrorism: Optimizing Survival in a Low Probability/High Consequence Disaster” Learn More
Hospital Referral Patterns: How Emergency Medical Care is Accessed in a Disaster BACKGROUND: A prevalent assumption in hospital emergency preparedness planning is that patient arrival from a disaster scene will occur through a coordinated system of patient distribution based on the number of victims, capabilities of the receiving hospitals, and the nature and severity of illness or injury. In spite of the strength of the emergency medical … Continue reading “Hospital Referral Patterns: How Emergency Medical Care is Accessed in a Disaster” Learn More
Mitigating absenteeism in hospital workers during a pandemic Objectives: An influenza pandemic, as with any disaster involving contagion or contamination, has the potential to influence the number of health care employees who will report for duty. Our project assessed the uptake of proposed interventions to mitigate absenteeism in hospital workers during a pandemic. Methods: Focus groups were followed by an Internet-based survey of … Continue reading “Mitigating absenteeism in hospital workers during a pandemic” Learn More
The Future of Pediatric Preparedness This article is part of a collaborative effort by experts in the field of emergency preparedness to complete an overview begun by the late Michael Shannon, MD, MPH, on the current challenges and future directions in pediatric disaster readiness. This particular article, “The Future of Pediatric Preparedness,” will offer a perspective on future directions in … Continue reading “The Future of Pediatric Preparedness” Learn More
Education and Training of Hospital Workers: Who Are Essential Personnel during a Disaster? Hospital plans often vary when it comes to the specific functional roles that are included in emergency and incident management positions. Bioterrorism coordinators and emergency managers for 31 hospitals in a seven-county region outside of a major metropolitan area, with urban, suburban, and rural demographics were surveyed to determine which specific functional roles were considered … Continue reading “Education and Training of Hospital Workers: Who Are Essential Personnel during a Disaster?” Learn More
Teaching emergency preparedness to public health workers: use of blended learning in web-based training This article presents the development of a program and results of a study to evaluate an online distancebased learning (DBL) program for competency-based, basic emergency preparedness training for employees of local health departments nationwide. The program was developed and implemented beginning in May 2003 by Columbia University’s Center for Public Health Preparedness (CU-CPHP), and was … Continue reading “Teaching emergency preparedness to public health workers: use of blended learning in web-based training” Learn More
The 2008 American Preparedness Project: Why Parents May Not Heed Evacuation Orders and What Emergency Planners, Families and Schools Need to Know Since 2002, the National Center for Disaster Preparedness (NCDP) at Columbia University’s Mailman School of Public Health, and The Children’s Health Fund (CHF), have conducted annual surveys of public attitudes and personal preparedness in the aftermath of the terror attacks of September 11, 2001. Produced in collaboration with the Marist College Institute for Public Opinion … Continue reading “The 2008 American Preparedness Project: Why Parents May Not Heed Evacuation Orders and What Emergency Planners, Families and Schools Need to Know” Learn More
Interventions to Mitigate the Reduced Ability and Willingness to Work of Health Care Workers During a Pandemic Influenza Public Health Emergency Several widely publicized articles were released in the past two years which suggest that health care and public health employees may be unable or unwilling to report to work during a public health emergency involving contagion or contamination such as pandemic influenza, SARS, smallpox, or a terrorist attack using disease or radiation: A 2006 study … Continue reading “Interventions to Mitigate the Reduced Ability and Willingness to Work of Health Care Workers During a Pandemic Influenza Public Health Emergency” Learn More
Comfort level of emergency medical service providers in responding to weapons of mass destruction events: impact of training and equipment Background: Numerous studies have suggested that emergency medical services (EMS) providers are ill-prepared in the areas of training and equipment for response to events due to weapons of mass destruction (WMD) and other public health emergencies (epidemics, etc.). Methods: A nationally representative sample of basic and paramedic EMS providers in the United States was surveyed … Continue reading “Comfort level of emergency medical service providers in responding to weapons of mass destruction events: impact of training and equipment” Learn More
Critical Concepts for Children in Disasters Identified by Hands-on Professionals: Summary of Issues Demanding Solutions Before the Next One This supplement contains many hands-on experiences of pediatricians and others who cared for children during the Hurricane Katrina disaster. They have all offered significant insightful suggestions to help planners better prepare for care of children during the next disaster. Pediatricians and other providers need to educate families on many aspects of disaster planning. Families should … Continue reading “Critical Concepts for Children in Disasters Identified by Hands-on Professionals: Summary of Issues Demanding Solutions Before the Next One” Learn More
The Pediatrician and Disaster Preparedness Recent natural disasters and events of terrorism and war have heightened society’s recognition of the need for emergency preparedness. In addition to the unique pediatric issues involved in general emergency preparedness, several additional issues related to terrorism preparedness must be considered, including the unique vulnerabilities of children to various agents as well as the limited … Continue reading “The Pediatrician and Disaster Preparedness” Learn More
Accuracy of a Priority Medical Dispatch System in Dispatching Cardiac Emergencies in a Suburban Community Introduction: Over-triage of patients by emergency medical services (EMS) dispatch is thought to be an acceptable alternative to under-triage, which may delay how quickly life-saving care reaches a patient. Previous studies have looked at advanced life support (ALS) misutilization in urban- and county-based EMS systems and have attempted to analyze how dispatch methods either contribute … Continue reading “Accuracy of a Priority Medical Dispatch System in Dispatching Cardiac Emergencies in a Suburban Community” Learn More
A Critical Concern: Pediatrician Self-care After Disasters As of this writing, health care in the areas impacted by Hurricane Katrina has shifted from emergency to primary care mode. Disasters take a heavy toll not only on victims but also on professionals and volunteers who experience the immediate, short-term, and long- term impact through their patients. The impact may occur because of the … Continue reading “A Critical Concern: Pediatrician Self-care After Disasters” Learn More
Terrorism and preparedness: What September 11 and its aftermath mean for physicians In the aftermath of September 11, the people and government of the United States confronted a new reality–so too did the health care community. The attacks revealed a number of vulnerabilities with respect to the health care system’s infrastructure and ability to respond to terrorism. Although September 11 represents an unprecedented disaster in the United … Continue reading “Terrorism and preparedness: What September 11 and its aftermath mean for physicians” Learn More
The Willingness of U.S. Emergency Medical Technicians to Respond to Terrorist Incidents A nationally representative sample of basic and paramedic emergency medical service providers in the United States was surveyed to assess their willingness to respond to terrorist incidents. EMTs were appreciably (9-13%) less willing than able to respond to such potential terrorist-related incidents as smallpox outbreaks, chemical attacks, or radioactive dirty bombs (p < 0.0001). EMTs … Continue reading “The Willingness of U.S. Emergency Medical Technicians to Respond to Terrorist Incidents” Learn More
Psychosocial Implications of Disaster or Terrorism on Children: A Guide for the Pediatrician During and after disasters, pediatricians can assist parents and community leaders not only by accommodating the unique needs of children but also by being cognizant of the psychological responses of children to reduce the possibility of long-term psychological morbidity. The effects of disaster on children are mediated by many factors including personal experience, parental reaction, … Continue reading “Psychosocial Implications of Disaster or Terrorism on Children: A Guide for the Pediatrician” Learn More
Uncommon Sense, Uncommon Courage: How the New York City School System, Its Teachers, Leadership and Students Responded to the Terror of September 11 Eight public schools are situated within a quarter mile of Ground Zero with 9,000 students ranging in ages from three to eighteen years – grammar, middle and high schools. On Tuesday, September 11, 2001 in the midst of chaos and a relentless unfolding of tragedy, professionals of the Board of Education safely evacuated all 9,000 … Continue reading “Uncommon Sense, Uncommon Courage: How the New York City School System, Its Teachers, Leadership and Students Responded to the Terror of September 11” Learn More
Pediatric Preparedness for Disasters and Terrorism: A National Consensus Conference: Executive Summary In a time of crisis, it is essential to ensure the needs of children are being met in planning and preparing for disasters and terrorist events. The current adult models and guidelines cannot be applied to the care of children. We convened experts from the multiple areas of expertise and disciplines involved in the planning … Continue reading “Pediatric Preparedness for Disasters and Terrorism: A National Consensus Conference: Executive Summary” Learn More
Disaster and Terrorism Preparedness: What Pediatricians Need To Know This chapter is designed to provide an overview of key issues for the pediatrician with respect to terrorism and disaster preparedness. It is not intended to be a complete compendium of didactic content, but it does represent an approach to understanding what needs to be learned by the pediatrician on this difficult topic and how … Continue reading “Disaster and Terrorism Preparedness: What Pediatricians Need To Know” Learn More
The Vigilance Defense: Proven Systems and Well-Prepared People Are Our Best Protection Against Bioterror Last fall, when physicians diagnosed anthrax in a Florida man named Robert Stevens, they initially suspected that they were seeing a rare, natural case of the disease. The infection of a co-worker of Stevens, however, put the country on alert. Five people eventually died, but the quick recognition that the earliest anthrax infections resulted from … Continue reading “The Vigilance Defense: Proven Systems and Well-Prepared People Are Our Best Protection Against Bioterror” Learn More
First Steps: A Pilot Preparedness Program for Public Health Nurses Public health will face major challenges in the coming decades. The 1999 West Nile outbreak in New York City and other recent incidents demonstrate how important public health is as a frontline defense against emerging infections, bioterrorism, and other unexpected emergencies. A well-prepared public health workforce is more critical than ever. The challenges are particularly … Continue reading “First Steps: A Pilot Preparedness Program for Public Health Nurses” Learn More
