Schools' Flood Emergency Preparedness in Khyber Pakhtunkhwa Province, Pakistan

Pakistan is highly exposed to climate-induced disasters, especially floods. Flooding history shows that educational establishments have been disproportionately hard-hit by flooding events. In Pakistan, school safety and preparedness is still a choice, rather than a mandatory requirement for all schools. But schools in Pakistan do have a responsibility to keep safe the students in their care,especially during and after the catastrophic events. This implies the need to maintain the environment in and around school property, so as to minimize the impacts of floods and to have the mechanisms in place to maximize a school's resilience. This study examined the emergency preparedness activities of 20 schools in four districts of Khyber Pakhtunkhwa Province that had recently been severely affected by floods. Through face to face interviews and a structured questionnaire(n = 100) we collected data on the four pillars of emergency preparedness:emergency planning, preparation measures, safe school facilities, and hazard education and training. The study revealed that the majority of the sample schools hadexperienced more than one natural hazard-induced disaster,predominantly flooding, yet despite this had not undertaken adequate emergency preparedness activities. There are particular gaps with regard to plans for students with disabilities, the continuity of school operations after a disaster,the presence of maps to identify evacuation routes, the availability of emergency equipment and resources, disaster preparedness guidelines, and psychological first aid and crisis counseling. The strengths, weaknesses, opportunities,and threats analysis that our researchers carried out indicates that, although schools in the survey have taken many steps towards flood preparedness, many weaknesses still exist and there remain significant opportunities to strengthen the preparedness level of many schools. The goal of this study is to inform policy decisions that improve school safety in Pakistan and to suggest the priority areas for future school disaster preparedness and management efforts.

Preparedness training programs improved the emergency response and crucial outcomes among nursing students:a scoping review

Objective:The study aims to review and discuss the outcomes of emergency preparedness training programs among nursing students.Methods:A scoping review was conducted based on the guidelines of Arskey and O’Malley.Databases through PubMed,Science Direct,and Google Scholar were used to obtain the relevant articles within the scoping review.Results:The researchers found 1175 articles.After manual review,28 articles were identified and assessed.The review reported that the emergency preparedness training program significantly affects preparedness,knowledge,performance,self-efficacy,learning motivation,self-confidence,satisfaction,critical decision-making,and problem-solving.Conclusions:Emergency training effectively increases knowledge,skills,confidence,satisfaction,and team performance.

Diversity of Emergency Codes in Hospitals

Background: Hospitals must be prepared to deal efficiently and effectively with different emergencies. To accomplish this, several countries have standardized their hospital emergency codes to improve their response capability. This is particularly important in Puerto Rico given that many health professionals, particularly physicians and nurses, provide services in more than one hospital. This study examined the emergency codes and alerts utilized in Puerto Rican hospitals. Objective: To assess hospitals’ level of emergency preparedness and response capability related to the variability of emergency codes and alerts utilized to respond to a situation in Puerto Rico. Method: A survey was conducted to characterize hospital emergency department level of preparedness and response to a mass fatality incident. A total of 39 out of a sample of 44 hospitals participated in the study. Semi-structured questionnaires were administered by the research team to members of each hospital’s administrative staff to explore the following: general hospital characteristics, emergency plans, emergency department capacity, collaborative agreements, personnel training, emergency communications, laboratory facilities, treatment protocols, security, epidemiologic surveillance, equipment and infrastructure. Results: Some hospitals in Puerto Rico use color coded emergency alerts, while others use key words or codes. Single color emergency codes can have different meanings in different hospitals. Conclusions: The findings clearly show that there is a lack of uniformity and clarity in the emergency codes utilized by hospitals in Puerto Rico. Single color codes have diverse meanings in different hospitals. This could adversely affect hospitals’ efficient and effective emergency response.

Environmental perspectives of COVID-19 outbreaks:A review

The coronavirus disease 2019(COVID-19)pandemic,caused by the novel virus severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),began in December 2019 in China and has led to a global public health emergency.Previously,it was known as 2019-nCoV and caused disease mainly through respiratory pathways.The COVID-19 outbreak is ranked third globally as the most highly pathogenic disease of the twenty-first century,after the outbreak of SARS-CoV and Middle East respiratory syndrome in 2002 and 2012,respectively.Clinical,laboratory,and diagnostic methodology have been demonstrated in some observational studies.No systematic reviews on COVID-19 have been published regarding the integration of COVID-19 outbreaks(monitoring,fate and treatment)with environmental and human health perspectives.Accordingly,this review systematically addresses environmental aspects of COVID-19 outbreak such as the origin of SARS-CoV-2,epidemiological characteristics,diagnostic methodology,treatment options and technological advancement for the prevention of COVID-19 outbreaks.Finally,we integrate COVID-19 outbreaks(monitoring,fate and treatment)with environmental and human health perspectives.We believe that this review will help to understand the SARS-CoV-2 outbreak as a multipurpose document,not only for the scientific community but also for global citizens.Countries should adopt emergency preparedness such as prepare human resources,infrastructure and facilities to treat severe COVID-19 as the virus spreads rapidly globally.

Sustainable strategies for Ebola virus disease outbreak preparedness in Africa:a case study on lessons learnt in countries neighbouring the Democratic Republic of the Congo

Background: From May 2018 to September 2022, the Democratic Republic of Congo (DRC) experienced seven Ebola virus disease (EVD) outbreaks within its borders. During the 10th EVD outbreak (2018–2020), the largest experienced in the DRC and the second largest and most prolonged EVD outbreak recorded globally, a WHO risk assessment identified nine countries bordering the DRC as moderate to high risk from cross border importation. These countries implemented varying levels of Ebola virus disease preparedness interventions. This case study highlights the gains and shortfalls with the Ebola virus disease preparedness interventions within the various contexts of these countries against the background of a renewed and growing commitment for global epidemic preparedness highlighted during recent World Health Assembly events.Main text: Several positive impacts from preparedness support to countries bordering the affected provinces in the DRC were identified, including development of sustained capacities which were leveraged upon to respond to the subsequent coronavirus disease 2019 (COVID-19) pandemic. Shortfalls such as lost opportunities for operationalizing cross-border regional preparedness collaboration and better integration of multidisciplinary perspectives, vertical approaches to response pillars such as surveillance, over dependence on external support and duplication of efforts especially in areas of capacity building were also identified. A recurrent theme that emerged from this case study is the propensity towards implementing short-term interventions during active Ebola virus disease outbreaks for preparedness rather than sustainable investment into strengthening systems for improved health security in alignment with IHR obligations, the Sustainable Development Goals and advocating global policy for addressing the larger structural determinants underscoring these outbreaks.Conclusions: Despite several international frameworks established at the global level for emergency preparedness, a shortfall exists between global policy and practice in countries at high risk of cross border transmission from persistent Ebola virus disease outbreaks in the Democratic Republic of Congo. With renewed global health commitment for country emergency preparedness resulting from the COVID-19 pandemic and cumulating in a resolution for a pandemic preparedness treaty, the time to review and address these gaps and provide recommendations for more sustainable and integrative approaches to emergency preparedness towards achieving global health security is now.

A close look at the biology of SARS-CoV-2,and the potential influence of weather conditions and seasons on COVID-19 case spread

Background:There is sufficient epidemiological and biological evidence of increased human susceptibility to viral pathogens such as Middle East respiratory syndrome coronavirus,respiratory syncytial virus,human metapneumovirus and influenza virus,in cold weather.The pattern of outbreak of the coronavirus disease 2019(COVID-19)in China during the flu season is further proof that meteorological conditions may potentially influence the susceptibility of human populations to coronaviruses,a situation that may become increasingly evident as the current global pandemic of COVID-19 unfolds.Main body:A very rapid spread and high mortality rates have characterized the COVID-19 pandemic in countries north of the equator where air temperatures have been seasonally low.It is unclear if the currently high rates of COVID-19 infections in countries of the northern hemisphere will wane during the summer months,or if fewer people overall will become infected with COVID-19 in countries south of the equator where warmer weather conditions prevail through most of the year.However,apart from the influence of seasons,evidence based on the structural biology and biochemical properties of many enveloped viruses similar to the novel severe acute respiratory syndrome coronavirus 2 or SARS-CoV-2(aetiology of COVID-19),support the higher likelihood of the latter of the two outcomes.Other factors that may potentially impact the rate of virus spread include the effectiveness of infection control practices,individual and herd immunity,and emergency preparedness levels of countries.Conclusion:This report highlights the potential influence of weather conditions,seasons and non-climatological factors on the geographical spread of cases of COVID-19 across the globe.