scholarly journals Allocation of Ventilators in a Public Health Disaster

2008 ◽  
Vol 2 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Tia Powell ◽  
Kelly C. Christ ◽  
Guthrie S. Birkhead
Keyword(s):  
Public Health ◽  
New York ◽  
Clinical Guidelines ◽  
Task Force ◽  
New York State ◽  
Assessment System ◽  
Ethical Framework ◽  
Standards Of Care ◽  
York State Department ◽  
York State

ABSTRACTBackground: In a public health emergency, many more patients could require mechanical ventilators than can be accommodated.Methods: To plan for such a crisis, the New York State Department of Health and the New York State Task Force on Life and the Law convened a workgroup to develop ethical and clinical guidelines for ventilator triage.Results: The workgroup crafted an ethical framework including the following components: duty to care, duty to steward resources, duty to plan, distributive justice, and transparency. Incorporating the ethical framework, the clinical guidelines propose both withholding and withdrawing ventilators from patients with the highest probability of mortality to benefit patients with the highest likelihood of survival. Triage scores derive from the sepsis-related organ failure assessment system, which assigns points based on function in 6 basic medical domains. Triage may not be implemented by a facility without clear permission from public health authorities.Conclusions: New York State released the draft guidelines for public comment, allowing for revision to reflect both community values and medical innovation. This ventilator triage system represents a radical shift from ordinary standards of care, and may serve as a model for allocating other scarce resources in disasters. (Disaster Med Public Health Preparedness. 2008;2:20–26)

Window of Opportunity for New Disease Surveillance: Developing Keyword Lists for Monitoring Mental Health and Injury Through Syndromic Surveillance

2016 ◽  
Vol 11 (2) ◽  
pp. 173-178 ◽  
Author(s):  
Ursula Lauper ◽  
Jian-Hua Chen ◽  
Shao Lin
Keyword(s):  
Public Health ◽  
Mental Health ◽  
New York ◽  
Syndromic Surveillance ◽  
New York State ◽  
Hurricane Sandy ◽  
York State Department ◽  
Free Text ◽  
York State ◽  
The Impact

AbstractStudies have documented the impact that hurricanes have on mental health and injury rates before, during, and after the event. Since timely tracking of these disease patterns is crucial to disaster planning, response, and recovery, syndromic surveillance keyword filters were developed by the New York State Department of Health to study the short- and long-term impacts of Hurricane Sandy. Emergency department syndromic surveillance is recognized as a valuable tool for informing public health activities during and immediately following a disaster. Data typically consist of daily visit reports from hospital emergency departments (EDs) of basic patient data and free-text chief complaints. To develop keyword lists, comparisons were made with existing CDC categories and then integrated with lists from the New York City and New Jersey health departments in a collaborative effort. Two comprehensive lists were developed, each containing multiple subcategories and over 100 keywords for both mental health and injury. The data classifiers using these keywords were used to assess impacts of Sandy on mental health and injuries in New York State. The lists will be validated by comparing the ED chief complaint keyword with the final ICD diagnosis code. (Disaster Med Public Health Preparedness. 2017;11:173–178)

New York State Public Health System Response to Hurricane Sandy: An Analysis of Survey Feedback

2016 ◽  
Vol 10 (3) ◽  
pp. 454-462 ◽  
Author(s):  
Asante Shipp Hilts ◽  
Stephanie Mack ◽  
Yunshu Li ◽  
Millicent Eidson ◽  
Trang Nguyen ◽  
...  
Keyword(s):  
Public Health ◽  
New York ◽  
New York State ◽  
Hurricane Sandy ◽  
System Response ◽  
York State Department ◽  
Health Staff ◽  
Local Health ◽  
York State ◽  
Public Health Staff

AbstractObjectiveThe objective was to provide a broad spectrum of New York State and local public health staff the opportunity to contribute anonymous feedback on their own and their agencies’ preparedness and response to Hurricane Sandy, perceived challenges, and recommendations for preparedness improvement.MethodsIn 2015, 2 years after Hurricane Sandy, public health staff who worked on Hurricane Sandy response were identified and were provided a link to the anonymous survey. Quantitative analyses were used for survey ratings and qualitative content analyses were used for open-ended questions.ResultsSurveys were completed by 129 local health department (LHD) staff in 3 counties heavily impacted by Sandy (Nassau, Suffolk, and Westchester) and 69 staff in the New York State Department of Health who supported the LHDs. Staff agreed that their Hurricane Sandy responsibilities were clearly defined and that they had access to adequate information to perform their jobs. Challenges were reported in the operational, communication, service interruptions, and staff categories, with LHD staff also reporting challenges with shelters.ConclusionsNew York local and state public health staff indicated that they were prepared for Hurricane Sandy. However, their feedback identified specific challenges and recommendations that can be addressed to implement improved preparedness and response strategies. (Disaster Med Public Health Preparedness. 2016;10:454–462)

Evaluation of High-Occupancy-Vehicle Lanes on Long Island Expressway

1996 ◽  
Vol 1554 (1) ◽  
pp. 110-120
Author(s):  
Wayne Ugolik ◽  
Nancy O'Connell ◽  
Jerome S. Gluck ◽  
Atma Sookram
Keyword(s):  
New York ◽  
Task Force ◽  
Long Island ◽  
New York State ◽  
Monitoring Program ◽  
State Department ◽  
York State Department ◽  
Department Of Transportation ◽  
York State ◽  
Hov Lanes

New York State's first suburban high-occupancy-vehicle (HOV) lanes were opened in May 1994 along a 19.3-km (12-mi) stretch of the Long Island Expressway (LIE), I-495 in western Suffolk County, a major suburb of metropolitan New York City. As with some other HOV facilities across the country, the implementation of HOV lanes on Long Island remains controversial. Nevertheless, HOV lanes continue to have an important role in subsequent plans to manage congestion on the LIE. In May 1991 the New York State Department of Transportation formed the LIE/HOV task force to provide advisory opinions on key HOV issues. The task force, comprising private-sector and government representatives, recommended among its numerous findings that the New York State Department of Transportation establish a comprehensive HOV monitoring program to provide up-to-date information to the media and concerned citizens, as well as help fine-tune operational and marketing elements associated with HOV lane usage and to provide firsthand information and guidance for the subsequent development of HOV lanes on the LIE and in the region. The department, in conjunction with consultant services, instituted a monitoring program that involved surveys and focus groups and periodic compilation of relevant HOV data. The first stage of that ongoing evaluation process is reported. A finding of note is that the HOV lanes have encouraged new ridesharing. Also, both HOV users and nonusers support extending the HOV lanes on the LIE.

scholarly journals Improvements to the Success of Outbreak Investigations of Legionnaires' Disease: 40 Years of Testing and Investigation in New York State

2021 ◽  
Author(s):  
Dianna Schoonmaker-Bopp ◽  
Elizabeth Nazarian ◽  
David Dziewulski ◽  
Ernest Clement ◽  
Deborah J. Baker ◽  
...  
Keyword(s):  
Public Health ◽  
New York ◽  
Environmental Samples ◽  
New York State ◽  
The United States ◽  
York State Department ◽  
Environmental Isolates ◽  
York State ◽  
Outbreak Investigations ◽  
Legionnaires Disease

Since 1978, the New York State Department of Health’s public health laboratory, Wadsworth Center (WC), in collaboration with epidemiology and environmental partners, has been committed to providing comprehensive public health testing for Legionella in New York. Statewide, clinical case counts have been increasing over time, with the highest numbers identified in 2017 and 2018 (1022 and 1426, respectively). Over the course of more than 40 years, the WC Legionella testing program has continuously implemented improved testing methods. The methods utilized have transitioning from solely culture-based methods for organism recovery to development of a suite of reference testing services including identification and characterization by PCR and pulsed-field gel electrophoresis (PFGE). In the last decade, whole-genome sequencing (WGS) has further refined the ability to link outbreak strains between clinical specimens and environmental samples. Here we review Legionnaires' disease outbreak investigations during this time period including comprehensive testing of both clinical and environmental samples. Between 1978 and 2017, 60 outbreaks involving clinical and environmental isolates with matching PFGE patterns were detected in 49 facilities from the 157 investigations at 146 facilities. However, 97 investigations were not solved due to the lack of clinical or environmental isolates or PFGE matches. We found 69% of patient specimens from New York State (NYS) were outbreak-associated, a much higher rate than other published reports. The consistent application of new cutting-edge technologies and environmental regulations have resulted in successful investigations resulting in remediation efforts. Importance Legionella , the causative agent of Legionnaires’ disease (LD) can cause severe respiratory illness. In 2018, there were nearly 10,000 cases of LD reported in the United States (1), with actual incidence believed to be much higher. About 10% of patients with LD will die and as high as 90% of patients diagnosed will be hospitalized. As Legionella are spread predominantly through engineered building water systems, identifying sources of outbreaks by assessing environmental sources is key to preventing further cases LD.

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