The purpose of this study is to identify key risk factors that could negatively affect public health emergency responders’ health and wellbeing. We seek to use this information to provide recommendations and strategies to mitigate such risks.

A narrative review of the peer-reviewed literature on wellbeing of military personnel and other responders was conducted. Data was grouped and categorized according to overarching domains.

Factors associated with wellbeing were categorized into 5 domains: (1) demographics; (2) mental health concerns; (3) social networks; (4) work environment; and (5) postdeployment life. The strategies identified to promote wellbeing included mental health assessments, preparedness trainings, debriefs in the field, postdeployment debriefs, resources in the field, and further postdeployment decompression strategies.

This study provides a unique understanding of the risk factors associated with poor health and wellbeing outcomes in public health emergency response work by extending the body of knowledge that focuses on other types of emergency and military response.

In March 2020, the Louisiana Department of Health activated the Medical Monitoring Station (MMS) in downtown New Orleans. This alternative care site is designed to decompress hospitals and nursing homes overwhelmed by the coronavirus disease 2019 (COVID-19) pandemic. Given the city’s historic vulnerability to hurricanes, planning for possible tropical weather events has been a priority for MMS leadership.

The planning process incorporated input from all sectors/agencies working at the facility, to ensure consistency and cohesion. The MMS Shelter-in-Place Plan (MSIPP) was created, and a comprehensive tabletop exercise was conducted.

Six planning topics emerged as a result of the planning process and were used to create a comprehensive plan for sheltering-in-place. These topics address hurricane preparedness for patient care, interfacility coordination, wrap-around services, medical logistics, essential staffing, and incident command during a shelter-in-place scenario.

The MSIPP created by the MMS helped to maximize patient safety and continuity of operations during a real-world event. Select pieces of the plan were activated to meet the needs and threat level of Tropical Storm Cristobal. This experience reinforced the need for originality, scalability, and flexibility in building emergency operations plans in the midst of an unprecedented pandemic.

This research aimed to examine health-care workers’ grief counseling for bereaved families of coronavirus disease 2019 (COVID-19) victims in China. Our research may provide a new opportunity to stimulate development of grief counseling in China.

A cross-sectional survey was conducted with 724 health-care workers selected by convenience sampling from 7 hospitals in Wuhan. Data collection tools included a sociodemographic questionnaire, the skills of grief counseling scale (SGCS), and the attitudes of grief counseling scale (AGCS).

The average SGCS score was 18.96 ± 4.66, whose influencing factors consisted of sense of responsibility, frequency of contact with bereaved families, and relevant training (P < 0.05). The average AGCS score was 33.36 ± 8.70, whose influencing factors consisted of other grief counseling skills, communication skills, education background, and relevant training (P < 0.05).

The skills and attitudes toward grief counseling among health-care workers combating COVID-19 were at a lower level in Wuhan, China, indicating the need to build a comprehensive grief counseling system, establish a standardized training course, and strengthen the popularization of grief counseling services to the public.

The aim of this study was to compare primary care appointment disruptions around Hurricanes Ike (2008) and Harvey (2017) and identify patterns that indicate differing continuity of primary care or care systems across events.

Primary care appointment records covering 5 wk before and after each storm were identified for Veterans Health Affairs (VA) facilities in the greater Houston and surrounding areas and a comparison group of VA facilities located elsewhere. Appointment disposition percentages were compared within and across storm events to assess care disruptions.

For Hurricane Harvey, 14% of primary care appointments were completed during the week of landfall (vs 33% for Hurricane Ike and 69% in comparison clinics), and 49% were completed the following week (vs 58% for Hurricane Ike and 71% for comparison clinics). By the second week after Hurricane Ike and third week after Harvey, the scheduled appointment completion percentage returned to prestorm levels of approximately 60%.

There were greater and more persistent care disruptions for Hurricane Harvey relative to Hurricane Ike. As catastrophic emergencies including major natural disasters and infectious disease pandemics become a more recognized threat to primary and preventive care delivery, health-care systems should consider implementing strategies to monitor and ensure primary care appointment continuity.

Injuries may occur when putting up and taking down hurricane (storm) shutters. This study described hurricane shutter-related injuries managed at emergency departments (EDs).

Hurricane shutter-related injuries were identified through the National Electronic Injury Surveillance System (NEISS), a database of consumer product-related injuries collected from the EDs of approximately 100 United States hospitals.

There were 329 hurricane shutter-related injuries during 2001-2017. Thirty-six injuries were reported during October 2005 (Hurricane Wilma), 30 during August 2008 (Tropical Storm Fay), and 103 during September 2017 (Hurricane Irma). Patients were 20 years or older in 90.6% of the cases; 76.3% of the patients were male. The most frequently reported injuries were laceration (48.9%), sprain or strain (15.2%), and fracture (9.4%). Lower extremities (34.0%) were the most commonly affected body part followed by upper extremities (29.5%) and head or neck (17.0%). The patient was treated or examined at the ED and released in 86.6% of the cases.

Over half of the hurricane shutter-related injuries appeared to occur in association with hurricanes and tropical storms. The most frequently reported injuries were laceration followed by sprain or strain and fracture. The majority of patients were treated or examined at the ED and released.

Three years after the 2013 Yolanda Typhoon, this study sought to determine the factors associated with the stress of the affected mothers and the health of the children on Leyte island, and the preparedness of the community to mitigate future potential disasters.

Three hundred mothers with children from 0 to 7 years old were selected through convenience sampling, structured interviews conducted using the Hurricane-Related Traumatic Experiences questionnaire and the PTSD (post-traumatic stress disorder) Checklist 5 (PCL5), and the children’s weights and heights were measured.

The provisional PTSD prevalence was found to be 53.3% 3 y after Yolanda. The multiple regression analysis with multiple imputation for the missing values found that housing and childcare attitudes were significantly associated with preparedness.

This study concluded that living in multistoried houses was useful for disaster mitigation and that the caregiving responsibility for their children could be a disaster preparedness motivation for mothers.

The objective of this study was to determine whether coordination of prehospital emergency health services and Disaster and Emergency Management Presidency (DEMP) and being prepared for disasters, such as building collapses, allow quick evaluation and fast intervention.

The information flow, hierarchy, treatment, and rehabilitation processes, and rescue organization and planning during the rescue attempt for 35 people who needed help due to this building collapse were reviewed.

Of the 43 people who lived in this 8-story building, 35 were inside the building during the collapse; 40% of them were assessed as injured and 60% as exitus. Almost two-thirds (64.3%) of the injured individuals who were rescued were women. The mean duration until rescue was 330 (57.0-512.0) min.

Leading and important factors that can increase the success rate in search and rescue interventions are informing official authorities as first early warning by individuals who can clearly define the situation, early security measures by security forces arriving before the health and search-rescue teams, accurate identification of estimated numbers of injured victims, and identifying and informing appropriate hospitals which victims rescued from the debris will be transferred to there.

This study was conducted to test the ability of the St Louis County Department of Health to efficiently dispense medication to individuals with functional needs during a public health emergency and develop new guidelines for future emergency planning. Historically, people with functional needs have been vulnerable in emergency situations, and emergency planners are responsible for creating equal access for mass prophylaxis events.

Measures to create access for individuals with functional needs were tested in a countywide exercise in which 40 volunteers with functional needs walked through an open point of dispensing location to collect medication as if it were a real emergency. Actions were informed by representatives from the functional needs community in the St Louis area.

During the exercise, medications were successfully dispensed to all participants. Many participants offered feedback for future program design.

Outcomes indicated the importance of working closely with the community organizations that serve people with functional needs in designing appropriate response measures, providing sensitivity training to staff members, employing useful technology, and using visual and verbal cues. The lessons learned from this exercise apply to emergency planning nationwide, as planning efforts for persons with functional needs still lag significantly.(Disaster Med Public Health Preparedness. 2014;0:1–9)

In times of repeated disaster events, including natural disasters and pandemics, public health workers must recover rapidly to respond to subsequent events. Understanding predictors of time to recovery and developing predictive models of time to recovery can aid planning and management.

We examined 681 public health workers (21-72 y, M(standard deviation [SD]) = 48.25(10.15); 79% female) 1 mo before (T1) and 9 mo after (T2) the 2005 hurricane season. Demographics, trauma history, social support, time to recover from previous hurricane season, and predisaster work productivity were assessed at T1. T2 assessed previous disaster work, initial emotional response, and personal hurricane injury/damage. The primary outcome was time to recover from the most recent hurricane event.

Multivariate analyses found that less support (T1; odds ratio [OR] = .74[95% confidence interval [CI] = .60-.92]), longer previous recovery time (T1; OR = 5.22[95%CI = 3.01-9.08]), lower predisaster work productivity (T1; OR = 1.98[95%CI = 1.08-3.61]), disaster-related personal injury/damage (T2; OR = 3.08[95%CI = 1.70-5.58]), and initial emotional response (T2; OR = 1.71[95%CI = 1.34-2.19]) were associated with longer recovery time (T2).

Recovery time was adversely affected in disaster responders with a history of longer recovery time, personal injury/damage, lower work productivity following prior hurricanes, and initial emotional response, whereas responders with social support had shorter recovery time. Predictors of recovery time should be a focus for disaster preparedness planners.

This study examined the differential impact of Hurricane Harvey on adolescent standardized Body Mass Index (zBMI), physical activity, diet, and perceived stress.

Prior to Hurricane Harvey, 175 ethnic minority adolescents were recruited from an independent school district in Houston. Height and weight were directly measured. The School Physical Activity and Nutrition Questionnaire assessed diet and physical activity. Stress was assessed with the Perceived Stress Scale. High hurricane impact was classified as at least 1 affirmative response to house damage, rescue, displacement, or going without food, water, or medicine. Repeated measures such as ANCOVA models were developed to assess differences in zBMI, physical activity, diet, and stress between the hurricane impact groups. Regression models were used to assess stress as a mediator of the hurricane impact and zBMI change relationship.

Students who were highly impacted by the hurricane had a greater decrease in zBMI than those less impacted from pre-hurricane to 15 weeks post-hurricane (95% CI 0.02 to 0.25, p<0.05). Physical activity and diet did not differ by impact. Perceived stress at 3 weeks post-hurricane mediated the impact and zBMI change relationship (β=-0.04 95% CI -0.12 to -0.002).

The decrease in zBMI among highly impacted students warrants further monitoring. Perceived stress, immediately following the hurricane, impacted student growth months later.

Several aspects of the coronavirus disease 2019 (COVID-19) pandemic remain ambiguous, including its transmission, severity, geographic, and racial differences in mortality. These variations merit elaboration of local patterns to inform wider national policies.

In a retrospective analysis, data of patients treated at a dedicated COVID hospital with moderate and severe illness during 8 wk of the pandemic were reviewed with attention to mortality in a competing risks framework.

A total of 1147 patients were hospitalized, and 312 (27.2%) died in hospital. Those who died were older (56.5 vs 47.6 y; P < 0.0001). Of these, 885 (77.2%) had tested positive on reverse transcriptase polymerase chain reaction (RT-PCR), with 219 (24.2%) deaths (incidence rate, 1.9 per 100 person-days). Median time from onset of symptoms to death was 11 days. A competing risks analysis for in-hospital death revealed an adjusted cause-specific hazard ratio of 1.4 for each decade increase in age.

This retrospective analysis provides broad patterns of disease presentation and mortality. Even COVID test-negative patients will receive treatment at dedicated facilities, and 33% presenting cases may die within the first 72 h, most with comorbid illness. This should be considered while planning distribution of services for effective health-care delivery