scholarly journals Supporting Wildfire Response During a Pandemic in the United States: the COVID-19 Incident Risk Assessment Tool

2021 ◽  
Vol 4 ◽  
Author(s):  
Matthew P. Thompson ◽  
Erin J. Belval ◽  
Jake Dilliott ◽  
Jude Bayham
Keyword(s):  
Public Health ◽  
United States ◽  
Risk Assessment ◽  
Assessment Tool ◽  
The United States ◽  
Risk Assessment Tool ◽  
Fire Season ◽  
Local Public Health ◽  
Epidemiological Modeling ◽  
Management Functions

The onset of the global pandemic in 2020 significantly increased the complexity and uncertainty of wildfire incident response in the United States, and there was a clear role for decision support to inform and enhance coordination and communication efforts. Epidemiological modeling suggested the risk of COVID-19 outbreak at a traditional large fire camp could be substantial and supported the broadscale implementation of mitigations, and management of COVID-19 required expanding the response network to interface with entities such as local public health agencies, hospitals, and emergency operations centers. Despite the early issuance of medical and public health guidance to support wildfire management functions under a COVID-19 modified operating posture, an identified gap was a scale- and scope-appropriate tool to support incident-level assessment of COVID-19 risk. Here we review the development and application of a COVID-19 Incident Risk Assessment Tool intended to fill that gap. After prototyping with fire managers and risk practitioners, including early-season use on several incidents, we built an online dashboard that was used operationally throughout the 2020 fire season. We summarize usage statistics, provide some examples of real use on wildfire incidents, and report feedback from users. The tool helped to fill a critical information gap and was intended to support risk-informed decision-making regarding incident logistics, operations, and COVID-19 mitigations.

A Cost-Benefit Analysis of a Potential Supervised Injection Facility in San Francisco, California, USA

2016 ◽  
Vol 47 (2) ◽  
pp. 164-184 ◽  
Author(s):  
Amos Irwin ◽  
Ehsan Jozaghi ◽  
Ricky N. Bluthenthal ◽  
Alex H. Kral
Keyword(s):  
Public Health ◽  
United States ◽  
San Francisco ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Cost Effective ◽  
The United States ◽  
Local Public Health ◽  
Supervised Injection ◽  
Overdose Deaths

Supervised injection facilities (SIFs) have been shown to reduce infection, prevent overdose deaths, and increase treatment uptake. The United States is in the midst of an opioid epidemic, yet no sanctioned SIF currently operates in the United States. We estimate the economic costs and benefits of establishing a potential SIF in San Francisco using mathematical models that combine local public health data with previous research on the effects of existing SIFs. We consider potential savings from five outcomes: averted HIV and hepatitis C virus (HCV) infections, reduced skin and soft tissue infection (SSTI), averted overdose deaths, and increased medication-assisted treatment (MAT) uptake. We find that each dollar spent on a SIF would generate US$2.33 in savings, for total annual net savings of US$3.5 million for a single 13-booth SIF. Our analysis suggests that a SIF in San Francisco would not only be a cost-effective intervention but also a significant boost to the public health system.

scholarly journals Glucose-6-Phosphate Dehydrogenase Deficiency and the Benefits of Early Screening

2020 ◽  
Vol 39 (5) ◽  
pp. 270-282
Author(s):  
Julie Jensen DelFavero ◽  
Amy J. Jnah ◽  
Desi Newberry
Keyword(s):  
United States ◽  
Risk Assessment ◽  
G6pd Deficiency ◽  
Dehydrogenase Deficiency ◽  
Assessment Tool ◽  
The United States ◽  
Assessment Tools ◽  
Early Screening ◽  
Intercultural Marriages ◽  
Glucose 6 Phosphate Dehydrogenase

Glucose-6-phosphate dehydrogenase (G6PD) deficiency, the most common enzymopathy worldwide, is an insufficient amount of the G6PD enzyme, which is vital to the protection of the erythrocyte. Deficient enzyme levels lead to oxidative damage, hemolysis, and resultant severe hyperbilirubinemia. If not promptly recognized and treated, G6PD deficiency can potentially lead to bilirubin-induced neurologic dysfunction, acute bilirubin encephalopathy, and kernicterus. Glucose-6-phosphate dehydrogenase deficiency is one of the three most common causes for pathologic hyperbilirubinemia. A change in migration patterns and intercultural marriages have created an increased incidence of G6PD deficiency in the United States. Currently, there is no universally mandated metabolic screening or clinical risk assessment tool for G6PD deficiency in the United States. Mandatory universal screening for G6PD deficiency, which includes surveillance and hospital-based risk assessment tools, can identify the at-risk infant and foster early identification, diagnosis, and treatment to eliminate neurotoxicity.

scholarly journals A Survey of Tick Surveillance and Control Practices in the United States

2020 ◽  
Author(s):  
Emily M Mader ◽  
Claudia Ganser ◽  
Annie Geiger ◽  
Laura C Harrington ◽  
Janet Foley ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Data Communication ◽  
The United States ◽  
Tick Control ◽  
Accurate Information ◽  
Surveillance Program ◽  
Local Public Health ◽  
Pathogen Testing ◽  
And Control

Abstract Tickborne diseases are an increasing public health threat in the United States. Prevention and diagnosis of tickborne diseases are improved by access to current and accurate information on where medically important ticks and their associated human and veterinary pathogens are present, their local abundance or prevalence, and when ticks are actively seeking hosts. The true extent of tick and tickborne pathogen expansion is poorly defined, in part because of a lack of nationally standardized tick surveillance. We surveyed 140 vector-borne disease professionals working in state, county, and local public health and vector control agencies to assess their 1) tick surveillance program objectives, 2) pathogen testing methods, 3) tick control practices, 4) data communication strategies, and 5) barriers to program development and operation. Fewer than half of respondents reported that their jurisdiction was engaged in routine, active tick surveillance, but nearly two-thirds reported engaging in passive tick surveillance. Detection of tick presence was the most commonly stated current surveillance objective (76.2%). Most of the programs currently supporting tick pathogen testing were in the Northeast (70.8%), Upper and Central Midwest (64.3%), and the West (71.4%) regions. The most common pathogens screened for were Rickettsia spp. (Rickettsiales: Rickettsiaceae) and bacterial and viral agents transmitted by Ixodes (Acari: Ixodidae) ticks. Only 12% of respondents indicated their jurisdiction directly conducts or otherwise financially supports tick control. Responses indicated that their ability to expand the capacity of tick surveillance and control programs was impeded by inconsistent funding, limited infrastructure, guidance on best practices, and institutional capacity to perform these functions.

scholarly journals The United States: A system built on fragmentation

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
H. Jarman
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
Health Care System ◽  
The United States ◽  
Universal Health Care ◽  
Local Public Health ◽  
The Us ◽  
Universal Health ◽  
Care System

Abstract Background The United States is effectively a laboratory for ways to produce public goods, such as public health, on the cheap. Its c. 90,000 governments compete for residents, businesses, taxes, development, and jobs while also trying to compensate for the lack of universal health care coverage. They all have structural incentives to provide services as cheaply as possible. The effects are diverse and poorly mapped. They can mean innovation in organizational forms, a different and typically less expensive skill mix among the workers, poor quality, or simple under provision. The exact mix can often be hard to identify. It can also mean extreme responsiveness to funding from higher levels of government such as the states or federal government. Methods A comparative historical analysis (CHA) based on government documents, law, and secondary sources. Results The distinctively expansive scope of US public health actions is largely due to the country’s failure to establish a universal health care system, and the diversity of US public health tasks reflects local adaptation of tens of thousands of governments. This means that public health in the United States retains much of the activity it had in, for example, the UK before the establishment of the US. In particular, and even in states that accepted the Medicaid expansion in the Affordable Care Act (ACA), local public health departments provide a substantial amount of direct care and fill in for gaps in health care provision. Conclusions The US public health system is highly fragmented like the governments that run it, and therefore diverse. Reflecting the failures of the US health care system, it carries out many more tasks that in other countries are seen as health, especially primary, care.

scholarly journals Public Health and Mass Gathering Events: Assessing Need for Surveillance in Wales, UK

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Priyanka Parmar ◽  
Daniel RH Thomas
Keyword(s):  
Public Health ◽  
Risk Assessment ◽  
Surveillance System ◽  
Assessment Tool ◽  
Risk Assessment Tool ◽  
Risk Level ◽  
Mass Gathering ◽  
Evidenced Based ◽  
International Events

The study investigates the need of surveillance during mass gathering events in Wales, UK. An evidenced based risk assessment tool is designed to identify the risk level of an event by grading risk variables present during the occurrence of event. This tool was observed consistent when compared with the international events. The need for a continuous surveillance is associated to the risk level of the mass gathering event. Enhancing the current surveillance system to establish a collaborated department would require less resources to monitor events and for training in emergency conditions.

scholarly journals Risk Assessment tool for Religious Mass Gathering Events of India

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Upasana Sharma ◽  
Sankara Sarma
Keyword(s):  
Public Health ◽  
Risk Assessment ◽  
Content Validity ◽  
Tamil Nadu ◽  
Assessment Tool ◽  
Risk Assessment Tool ◽  
Mass Gathering ◽  
Planning Stage ◽  
Mass Gatherings ◽  
Special Events

ObjectiveTo develop a risk assessment tool to assess the public health and environmental risks associated with religious mass gathering events of Tamil Nadu, a state in the southern part of IndiaIntroductionIn spite of the fact that mass gatherings are an undeniably regular element of our society attended by huge crowds yet such occasions are not very well understood. Even though such gatherings are accumulations of "well people", vast number of people associated with mass gatherings can put a serious strain on the entire health care system1.The public health implications of mass gathering events include a potential increased risk for disease transmission because of the variability and mobility of those attending the event and increased media attention. Risk assessment for mass gathering events is crucial to identify the potential health hazards which aids in planning and response activities specific to the event2. Preparing for mass gatherings offer an opportunity to improve health service delivery, enhance health promotion and strengthen public health systems3.In India, many of the religious festivals are observed with mass gatherings and prayers. Large crowd participate in such festivals as participants to observe the unique rituals and also as spectators. Literature indicates that in India, we might be well equipped for response activities but the scientific concept of risk assessment i.e., to understand the existing risks, identify the risks, characterize the risks and plan for risk reduction strategies accordingly are at an infant stage .The little that has been done in the field of mass gatherings has generally focused on description of preparedness activities of single event, crowd control, prevention of stampedes with little attention to public health preparedness. The present project is an attempt to systemize the process of risk assessment by developing a risk assessment tool consisting of characteristics peculiar to planned religious mass gatherings of Indian context.MethodsQualitative approach was followed to identify the risks associated with mass gathering events and to identify the domains and items to be included in the risk assessment tool. Firstly, an extensive review of literature about the risks associated with the mass gathering events was done. Secondly, Key Informants (n=20) involved in planning and management of religious mass gathering events in the State of Tamil Nadu, India were purposively identified and interviewed using a semi structured interview guide. Principle of redundancy was followed. Content/Thematic analysis was done using Atlas.ti software. Currently, the project is in the phase of obtaining content validity of the developed tool. Followed by this, a mobile application based upon the validated tool will be developed which will be further field tested for feasibility in a selected mass gathering event in Tamil Nadu. Using a self administered content validity questionnaire, the experts will be asked to assess the relevance of the items of the tool. Agreement proportions between the experts will be calculated. S-CVI (Scale Content Validity Index), index for inter-rater agreement (agreement proportion) and Kappa agreement coefficient will be calculated.ResultsA sum total of 48 unique health risks have been identified. Stampedes, fire accidents, structural collapse, drowning, outbreak of communicable diseases, exacerbation of existing medical illnesses (like cardiac diseases, asthma etc) etc are the some of the health risks identified. Six domains (characteristics related to event, participant, environment, disaster preparedness, medical service preparedness and pre event planning activities) and 21 items have been generated from the content analysis of key informant interviews and literature review.ConclusionsSome special events and unforeseen events occur in places of mass gatherings besides fixed places of worshipping .Such events cause more damage to human beings and property. Special events like idol procession, chariot pulling, fire walking, animal sacrificing happen pulling larger crowds within the mass gatherings. In order to inform all planning and delivery activities it is essential to understand the mass gathering context and risk assessments. This tool can be used by public health managers to identify key public health and environmental risks at the planning stage before the event takes off. At the planning stage, use of this tool will help in putting the required measures in place in order to address the potential risks identified. The tool can be used as a guiding instrument during and after the event as well. The investigators further plan to develop a mobile based app from this risk assessment tool and test it out in a selected mass gathering event of the state of Tamil Nadu located in southern part of India. Feedback from public health managers about the mobile based risk assessment tool can be instrumental in further modifying the tool. By contributing to public health preparedness activities during mass gathering events in a country with poor resources like India, this research activity is an initiative that is expected to lead to health systems strengthening.References1. Arbon P. The development of conceptual models for mass-gathering health. Prehospital and Disaster Medicine. 2004 Sep;19(3):208-12.2. World Health Organization. Public health for mass gatherings: Key considerations. Geneva: WHO; 2015.3. Tam JS, Barbeschi M, Shapovalova N, Briand S, Memish ZA, Kieny MP. Research agenda for mass gatherings: a call to action. The Lancet infectious diseases. 2012 Mar 31; 12(3):231-9.

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