The EMIRATES Framework: Emergency Management Integrated Roadmap Aimed Towards Every Healthcare System. A Conceptual Framework

Abstract. Disasters are frequent, ongoing and very likely to increase in the future with global climate change. Significant investments in hazard mitigation, policies and emergency management have so far failed to stop disasters. Their recurrences suggest that either there are some gaps in the current response or a different perspective is needed on the way hazards have been dealt with to date. This paper views disasters through the lens of hazardscape, which shows the context of both hazard occurrence and response. It finds that one major cause of response failure is inadequate consideration of the local hazardscape in planning. It notes that although globalization of hazard response practices is progressive, it has been less successful in dealing with local variations in vulnerability. This paper presents the conceptual framework of hazardscape, and illustrates various shortcomings of the current responses in relation to the local hazardscapes where they are adopted. It recommends a holistic approach that considers various aspect of the hazardscape in order to plan a response strategy.

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COVID-19 vaccine intentions and uptake in a tertiary care healthcare system: A longitudinal study

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.523 ◽

2021 ◽

pp. 1-19

Author(s):

Charlesnika T. Evans ◽

Benjamin J. DeYoung ◽

Elizabeth L. Gray ◽

Amisha Wallia ◽

Joyce Ho ◽

...

Keyword(s):

Healthcare System ◽

Tertiary Care ◽

The Public ◽

Factors Associated ◽

Chicago Area ◽

Clinical Procedures ◽

System A ◽

Serology Test ◽

Vaccine Mandates

Abstract Objective Healthcare workers (HCWs) are a high priority group for COVID-19 vaccination and serve as sources for information for the public. This analysis assessed vaccine intentions, factors associated with intentions, and change in uptake over time in HCWs. Methods A prospective cohort study of COVID-19 seroprevalence was conducted with HCWs in a large healthcare system in the Chicago area. Participants completed surveys (November 25, 2020-January 9, 2021 and April 24-July 12, 2021) on COVID-19 exposures, diagnosis and symptoms, demographics, and vaccination status. Results Of 4,180 HCWs who responded to a survey, 77.1% indicated they intended to get the vaccine; in this group, 23.2% had already received at least one dose of the vaccine (23.2%), 17.4% were unsure, and 5.5% reported that they would not get the vaccine. Factors associated with intention or vaccination were being exposed to clinical procedures (vs no procedures) and having a negative serology test for COVID-19 (vs no test) (adjusted odds ratio (AOR)=1.39, 95% Confidence Interval (CI) 1.16-1.65, AOR=1.46, 95% CI 1.24-1.73, respectively). Nurses (vs physicians, AOR=0.24 95% CI 0.17-0.33), non-Hispanic Black (vs Asians, AOR=0.35, 95% CI 0.21-0.59), and women (vs men, AOR=0.38, 95% CI 0.30-0.50) had lower odds of intention to get vaccinated. By 6-months follow-up, over 90% of those who had previously been unsure were vaccinated, while 59.7% of those who previously reported no intention of getting vaccinated, were vaccinated. Conclusions COVID-19 vaccination in HCWs was high, but variability in vaccination intention exists. Targeted messaging coupled with vaccine mandates can support uptake.

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