Healthcare workers (HCW) are at increased risk of infection during pandemics. HCW personal protective equipment (PPE) use has been shown to lower infection rates among HCW and patients. However, low compliance and misuse are frequent. Since future outbreaks are unavoidable, this issue needs to be addressed.

A validated questionnaire was distributed to 617 HCWs (nurses and physicians) in 21 hospitals and 40 primary care clinics in Israel at the peak of the A/H1N1 pandemic.

PPE confidence was higher among HCWs with higher tested and self-perceived knowledge. Confidence was also higher among nurses compared with physicians and among employees in hospitals compared with those in primary care clinics. Experience treating A/H1N1 patients was related to higher self-perceived knowledge and PPE confidence.

High levels of PPE knowledge were significantly correlated to HCWs’ confidence in PPE and may help increase PPE usage and reduce absenteeism. (Diaster Med Public Health Preparedness. 2014;0:1-8)

The present study examined the psychological effects and identify factors associated with worse outcomes, during the coronavirus disease 2019 (COVID-19) outbreak in Mexican nurses involved in fighting against COVID-19.

An anonymous online questionnaire was applied through an online survey, which collected information regarding basic information, traumatic distress response (IES-R scale), emotional exhaustion (MBI-EE), and psychological distress (K10 scale).

Results showed that 46.72% of nurses reported moderate-severe traumatic distress response, 42.40% of nurses evidenced a high level of emotional exhaustion, and 41.78% showed moderate-severe psychological distress. Nurses who have >2 children, an increase in working hours due to COVID-19, increase in tobacco and alcohol consumption, and presence of a confirmed and suspected case of COVID-19 in their workplace showed worse outcomes.

These findings demonstrate that a large portion of nurses in Mexico is suffering from psychological disturbances due to the COVID-19 outbreak. In the face of a health crisis, not seen in several years in Mexico, the proper psychological well-being of the nursing staff at this vulnerable time is essential.

This study aims to clarify the association between prosperity and the coronavirus disease (COVID-19) outcomes and its impact on the future management of pandemics.

This is an observational study using information from 2 online registries. The numbers of infected individuals and deaths and the prosperity rank of each country were obtained from worldometer.info and the Legatum Institute’s Prosperity Index, respectively.

There is a combination of countries with high and low prosperity on the list of COVID-19-infected countries. The risk of the virus pandemic seems to be more extensive in countries with high prosperity. A Spearman’s rho test confirmed a significant correlation between prosperity, the number of COVID-19 cases, and the number of deaths at the 99% level.

New emerging pandemics affect all nations. In order to increase the likelihood of successfully managing future events, it is important to consider preexisting health security, valid population-based management approaches, medical decision-making, communication, continuous assessment, triage, treatment, early and complete physical distancing strategies, and logistics. These elements cannot be taught on-site and on occasion. There is a need for innovative and regular educational activities for all stakeholders committed to safeguarding our future defense systems concerning diagnostic, protection, treatment, and rehabilitation in pandemics, as well as other emergencies.

To determine whether there were incremental mental health impacts, specifically on depression trajectories, as a result of the 2008 economic crisis (the Great Recession) and subsequent Hurricane Sandy.

Using latent growth mixture modeling and the ORANJ BOWL dataset, we examined prospective trajectories of depression among older adults (mean age, 60.67; SD, 6.86) who were exposed to the 2 events. We also collected community economic and criminal justice data to examine their impact upon depression trajectories. Participants (N=1172) were assessed at 3 times for affect, successful aging, and symptoms of depression. We additionally assessed posttraumatic stress disorder (PTSD) symptomology after Hurricane Sandy.

We identified 3 prospective trajectories of depression. The majority (83.6%) had no significant change in depression from before to after these events (resilience), while 7.2% of the sample increased in depression incrementally after each event (incremental depression). A third group (9.2%) went from high to low depression symptomology following the 2 events (depressive-improving). Only those in the incremental depression group had significant PTSD symptoms following Hurricane Sandy.

We identified a small group of individuals for whom the experience of multiple stressful events had an incremental negative effect on mental health outcomes. These results highlight the importance of understanding the perseveration of depression symptomology from one event to another. (Disaster Med Public Health Preparedness. 2019;13:173–182)

This study aimed to examine the effect of Hurricane Sandy on Long Island mental health emergency department (ED) visits and to determine whether these visits varied according to patient demographics or geographic area and intensity of the impact.

Individual-level de-identified data were extracted from the Statewide Planning and Research Cooperative System from New York State ED visits from October 1 to December 2012 for residents of Nassau and Suffolk counties in Long Island. The dates of the ED visits were grouped into 4 periods: (1) pre-Sandy, October 1–28; (2) during Sandy, October 29; (3) post-Sandy I, October 30 to November 1; and (4) post-Sandy II, November 2–30.

A total of 126,337 ED visits were recorded among 23 EDs. A significant drop in volume was observed on October 29; 399 more ED visits for physical health diagnoses were identified in the post-Sandy I period than in the pre-Sandy period. “Diseases of the respiratory system” was the only diagnosis group that showed a positive trend in the post-Sandy I period compared with the pre-Sandy period (increase of 4%). No significant changes in mental health visits were observed after Sandy landfall.

This analysis suggests that the critical temporal window during which ED resources should be increased is in the immediate aftermath of a hurricane. (Disaster Med Public Health Preparedness. 2016;10:344–350)

This study assessed disaster medicine knowledge and competence and perceived self-efficacy and motivation for disaster response among medical, nursing, and dental students.

Survey methodology was used to evaluate knowledge, comfort, perceived competency, and motivation. Also, a nonresponder survey was used to control for responder bias.

A total of 136 responses were received across all 3 schools. A nonresponder survey showed no statistical differences with regard to age, gender, previous presence at a disaster, and previous emergency response training. In spite of good performance on many knowledge items, respondent confidence was low in knowledge and in comfort to perform in disaster situations. Knowledge was strong in areas of infection control, decontamination, and biological and chemical terrorism but weak in areas of general emergency management, role of government agencies, and radiologic events. Variations in knowledge among the different health professions were slight, but overall the students believed that they required additional education. Finally, students were motivated not only to acquire more knowledge but to respond to disaster situations.

Health care students must be adequately educated to assume roles in disasters that are a required part of their professions. This education also is necessary for further disaster medicine education in either postgraduate or occupational education. As students’ performance on knowledge items was better than their perceived knowledge, it appears that a majority of this education can be achieved with the use of existing curricula, with minor modification, and the addition of a few focused subjects, which may be delivered through novel educational approaches. (Disaster Med Public Health Preparedness. 2013;7:499-506)

This study had 2 aims. First, we evaluated the current levels of disaster preparedness among university students in southern China. Second, we assessed students’ demands for future disaster education. In addition, we examined the influence of demographic factors on current disaster preparedness status and demand.

A cross-sectional design was used. The data were collected from 1893 students in 10 universities in the Guangzhou Higher Education Mega (GHEM) center. A self-administered questionnaire developed for this study was administered to assess the current status and demand for disaster education.

The results are based on 1764 valid questionnaires. Among the participants, 77.8% reported having had disaster education experiences before, 85.5% indicated their desire for a systematic disaster course, and 75.4% expressed their willingness to take such a course upon its availability. The total mean score for demand for disaster course content (5-point Likert scale) was 4.17±0.84, with items relating to rescue skills given the highest scores. These results suggested that students had high desires for disaster preparedness knowledge, especially knowledge concerning rescue skills. We observed significant differences in disaster education experiences between male and female students and across programs, school years, and home locations. Furthermore, we observed significant differences in demand for disaster course content between male and female students and across universities, student programs, years of school, and students’ majors.

A systematic disaster course focused on rescue skills is needed by all types of universities. To improve the disaster education system in universities, disaster drills should be performed on a semester basis as a refresher and to enhance disaster preparedness. The government and universities should support building a simulated disaster rescue center and recruit faculty from the emergency department, especially those who have had disaster relief experience. (Disaster Med Public Health Preparedness. 2017;11:310–317)

Community-level disaster readiness is a major component of community health promotion. However, many readiness programs are focused on the response of emergency and health care personnel and not on the preparedness levels of local citizens. This potentially leaves the public unready and unprepared for emergency event response.

A 20-item survey on general states of disaster preparedness was delivered to the residents of a midsized midwestern county. The residents were asked to share their knowledge of local hazards, emergency systems, and personal preparedness.

A convenience sample of 423 residents responded to the survey. Fifty-seven percent (n=241) reported limited personal preparedness. Seventy-six percent (n=321) acknowledged little to no familiarity with residential emergency systems, and 52% (n=220) reported that they did not know how to gain information on public health emergencies, such as pandemic flu and evacuation response.

Local citizens should become educated on the methods to support personal disaster and emergency readiness. Health care and emergency management organizations are encouraged to include these concepts in routine community health promotion activities and to pay special attention to known areas of community vulnerability. Failure to do so creates a population unable to support themselves in the provision of basic health and safety measures. (Disaster Med Public Health Preparedness. 2015;9:239-244)

The purpose of this study was to explore the level of coronavirus disease 2019 (COVID-19) vaccine hesitancy among medical students in Wuhan, China, and to identify the factors and barriers associated with their vaccination decision.

A cross-sectional survey was launched with 612 medical students recruited by convenience sampling from 6 universities. Data collection measures mainly included a demographic questionnaire, COVID-19 vaccine knowledge questionnaire, and the vaccine hesitancy scale.

A total of 58.2% of medical students reported vaccine hesitancy. The most common reasons for this were worrying about the side effects of vaccines (44.4%), uncertainty about vaccine safety (40.4%), and underestimating the risk of exposure to COVID-19 (27.9%). The main factors associated with COVID-19 vaccine hesitancy among participants were their knowledge about COVID-19 vaccine, training related to COVID-19 vaccines, family address, and education level (P < 0.05).

The government, health department and universities in China need to work together and actively communicate with vaccine-hesitant students, establish a standardized COVID-19 vaccine course, and provide on-campus vaccination services.

This study describes findings of the impacts of Hurricane Sandy on environmental factors including power outages, air quality, water quality, and weather factors and how these affected mental health during the hurricane.

An ecological study was conducted at the county level to describe changes in environmental factors—especially power outages—and their relationships to emergency department (ED) visits for mental health problems by use of a Poisson regression model.

We found that many environmental hazards occurred as co-exposures during Hurricane Sandy in addition to flooding. Mental health ED visits corresponded with the peak of maximum daily power blackouts, with a 3-day lag, and were positively associated with power blackouts in Bronx (prevalence ratio [PR]: 8.82, 95% confidence interval [CI]: 1.27–61.42) and Queens (PR: 2.47, 95% CI: 1.05–5.82) counties. A possible dose-response relationship was found between the quantile of maximum blackout percentage and the risk of mental health in the Bronx.

We found that multiple co-environmental hazards occurred during Hurricane Sandy, especially power blackouts that mediated this disaster’s impacts. The effects of power outage on mental health had large geographic variations and were substantial, especially in communities with low sociodemographic status. These findings may provide new insights for future disaster response and preparedness efforts. (Disaster Med Public Health Preparedness. 2016;10:314–319)

Numerous practice reports recommend roles pharmacists may adopt during disasters. This study examines the peer-reviewed literature for factors that explain the roles pharmacists assume in disasters and the differences in roles and disasters when stratified by time.

Quantitative content analysis was used to gather data consisting of words and phrases from peer-reviewed pharmacy literature regarding pharmacists’ roles in disasters. Negative binomial regression and Kruskal-Wallis nonparametric models were applied to the data.

Pharmacists’ roles in disasters have not changed significantly since the 1960s. Pharmaceutical supply remains their preferred role, while patient management and response integration roles decrease in context of common, geographically widespread disasters. Policy coordination roles, however, significantly increase in nuclear terrorism planning.

Pharmacists’ adoption of nonpharmaceutical supply roles may represent a problem of accepting a paradigm shift in nontraditional roles. Possible shortages of personnel in future disasters may change the pharmacists’ approach to disaster management. (Disaster Med Public Health Preparedness. 2013;7:563–572)

The aim of this study was to assess the risks in confronting the coronavirus disease 2019 (COVID-19) pandemic and the ongoing lockdown effectiveness in each of Italy, Germany, Spain, France, and the United States using China’s lockdown model simulation, and cases forecast until the plateau phase.

Quantitative and qualitative historical data analysis. Total Risk Assessment (TRA) evaluation tool was used to assess the pre-pandemic stage risks, pandemic threshold fast responsiveness, and the ongoing performance until plateau. The Infected Patient Ratio (IPR) tool was developed to measure the number of patients resulting from 1 infector during the incubation period. Both IPR and TRA were used together to forecast inflection points, plateau phases, intensive care units’ and ventilators’ breakpoints, and the Total Fatality Ratio.

In Italy, Spain, France, Germany, and the United States, an inflection point is predicted within the first 15 d of April, to arrive at a plateau after another 30 to 80 d. Variations in IPR drop are expected due to variations in lockdown timing by each country, the extent of adherence to it, and the number of performed tests in each.

Both qualitative (TRA) and quantitative (IPR) tools can be used together for assessing and minimizing the pandemic risks and for more precise forecasting.

The Syrian civil war since 2011 has led to one of the most complex humanitarian emergencies in history. The objective of this study was to document the impact of the conflict on the familial, educational, and public health state of Syrian children.

A cross-sectional observational study was conducted in May 2015. Health care workers visited families with a prospectively designed data sheet in 4 Northern Syrian governorates.

The 1001 children included in this study originated from Aleppo (41%), Idleb (36%), Hamah (15%), and Lattakia (8%). The children’s median age was 6 years (range, 0-15 years; interquartile range, 3-11 years), and 61% were boys. Almost 20% of the children were internally displaced, and 5% had deceased or missing parents. Children lacked access to safe drinking water (15%), appropriate sanitation (23%), healthy nutrition (16%), and pediatric health care providers (64%). Vaccination was inadequate in 72%. More than half of school-aged children had no access to education. Children in Idleb and Lattakia were at greater risk of having unmet public health needs. Younger children were at greater risk of having an incomplete vaccination state.

After 4 years of civil war in Syria, children have lost parents, live in substandard life quality circumstances, and are at risk for outbreaks because of worsening vaccination states and insufficient availability of health care providers. (Disaster Med Public Health Preparedness. 2016;10:874–882)