The health system response to long COVID in England — at a critical juncture

AbstractObjectiveAnalyzing Hurricane Sandy emergency reports to assess the New York State (NYS) public health system response will help inform and improve future disaster preparedness and response.MethodsQualitative analysis of NYS Department of Health (NYSDOH) and Nassau and Suffolk County local health department (LHD) emergency reports was conducted. Three after-action reports and 48 situation reports were reviewed, grouped by key words and sorted into 16 Public Health Preparedness Capabilities. Within each capability, key words were labeled as strengths, challenges, or recommendations.ResultsThe NYSDOH capability most cited as a strength was successful emergency operations coordination, eg, interagency conference calls (27.4% of 1681 strengths). The most cited challenge was environmental health protection, eg, mold and oil spills (28% of 706 challenges). The LHD capability most cited both as a strength (46.7% of 30 strengths) and as a challenge (32.5% of 123 challenges) was emergency operations coordination. Strengths were exemplified by sharing local resources and challenges by insufficient memorandums of understanding for coordination.ConclusionsPost-disaster emergency reports should be systematically reviewed to highlight both successes and areas for improvement. Future studies should prioritize collecting feedback from a wider spectrum of public health and service provider staff for planning of preparedness and response activities. (Disaster Med Public Health Preparedness. 2015;10:308–313)

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Health System Response and Adaptation to the Largest Sandstorm in the Middle East

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2016.111 ◽

2016 ◽

Vol 11 (2) ◽

pp. 227-238 ◽

Cited By ~ 1

Author(s):

Furqan B. Irfan ◽

Sameer A. Pathan ◽

Zain A. Bhutta ◽

Mohamed E. Abbasy ◽

Amr Elmoheen ◽

...

Keyword(s):

Public Health ◽

Emergency Department ◽

Particulate Matter ◽

Middle East ◽

Respiratory Distress ◽

Health System ◽

Disaster Management ◽

Peak Load ◽

Tertiary Hospital ◽

System Response

AbstractThe State of Qatar experienced a sandstorm on the night of April 1, 2015, lasting approximately 12 hours, with winds of more than 100 km/h and average particulate matter of approximately 10 μm in diameter. The emergency department (ED) of the main tertiary hospital in Qatar managed 62% of the total emergency calls and those of higher triage order. The peak load of patients during the event manifested approximately 6 hours after the onset. The Major Emergency Command Centre of the hospital ensured the department was maximally organized in terms of disaster management, and established protocols were brought into action. Multiple timely meetings were convened in efforts to effectively execute plans that included rapid emergency medical services handover time, resourcing staff, maximizing bed space, preventing dust entry in the ED, bypassing certain administrative processes, canceling day-surgeries that did not affect inpatient morbidity, and procuring additional respiratory equipment. Patients arrived mainly with exacerbations of asthma and respiratory distress, ophthalmic emergencies, and vehicular trauma; surprisingly, the incidence of pedestrian injuries did not vary. (Disaster Med Public Health Preparedness. 2017;11:227–238)

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Lessons About the State and Local Public Health System Response to the 2009 H1N1 Pandemic

Journal of Public Health Management and Practice ◽

10.1097/phh.0b013e3182751d3e ◽

2013 ◽

Vol 19 (5) ◽

pp. 428-435 ◽

Cited By ~ 13

Author(s):

Michael A. Stoto ◽

Christopher Nelson ◽

Melissa A. Higdon ◽

John Kraemer ◽

Lisle Hites ◽

...

Keyword(s):

Public Health ◽

Health System ◽

Public Health System ◽

The State ◽

System Response ◽

H1n1 Pandemic ◽

Local Public Health ◽

2009 H1n1 ◽

State And Local

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Regional Health System Response to the Virginia Tech Mass Casualty Incident

Disaster Medicine and Public Health Preparedness ◽

10.1097/dmp.0b013e318149f5a2 ◽

2007 ◽

Vol 1 (S1) ◽

pp. S9-S13 ◽

Cited By ~ 12

Author(s):

Lisa Kaplowitz ◽

Morris Reece ◽

Jody Henry Hershey ◽

Carol M. Gilbert ◽

Italo Subbarao

Keyword(s):

Public Health ◽

Mortality Rate ◽

Health System ◽

Trauma Center ◽

Virginia Tech ◽

Mass Casualty Incident ◽

Mass Casualty ◽

System Response ◽

Regional Health ◽

Severity Scores

ABSTRACTBackground: On April 16, 2007 a mass shooting occurred on the campus of Virginia Polytechnic Institute and State University (Virginia Tech). Due to both distance and weather, air transport of the injured directly to a level 1 trauma center was not possible. The injured received all of their care or were initially stabilized at 3 primary hospitals that either had a level 3 trauma center designation or no trauma center designation.Methods: This article is a retrospective analysis of the regional health system (prehospital, hospital, regional hospital emergency operations center, and public health local and state) response. Data records from all of the regional responding emergency medical services, hospitals, and coordinating services were reviewed and analyzed. Records for all 26 patients were reviewed and analyzed using triage designations, injury severity scores (ISS), and critical mortality.Results: Twenty-five of the 26 patients were triaged in the field. Excluding 1 patient (asthma), the average ISS for victims presenting was 8.2. Twelve patients had an ISS of ≥9, and 5 had an ISS score of ≥15. Ten of the 26 patients (38%) required urgent intervention and surgery in the first 24 hours. The overall regional health system mortality of victims received was 3.8% (1 death [excluding 1 dead on arrival {DOA}]/ 26 victims from scene). The regional health system critical mortality rate (excluding 1 victim who was DOA) was 20% (1/5).Discussion: The outcomes of the Virginia Tech mass casualty incident, as evidenced by the low overall regional health system mortality of victims received at 3.8% (1/26) and low critical mortality rate (excluding 1 victim who was DOA) of 20%, coupled with a need to treat a significant amount of moderately injured victims 46% (12/26 with ISS ≥9) gives credence to the successful response. The successful response occurred as a consequence of regional collaborative planning, training, and exercising, which resulted not only in increased expertise and improved communications but also in essential relationships and a sense of trust forged among all of the responders. (Disaster Med Public Health Preparedness. 2007;1(Suppl 1):S9–S13)

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Mapping the health systems response to violence against women: key learnings from five LMIC settings (2015–2020)

BMC Women s Health ◽

10.1186/s12905-021-01499-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Shegufta Shefa Sikder ◽

Rakhi Ghoshal ◽

Padma Bhate-Deosthali ◽

Chandni Jaishwal ◽

Nobhojit Roy

Keyword(s):

Health System ◽

Health Systems ◽

Violence Against Women ◽

Health Facilities ◽

System Response ◽

Provider Attitudes ◽

Middle Income ◽

Middle Income Countries ◽

One Stop ◽

Low And Middle Income

Abstract Background Violence against women (VAW) is a global challenge, and the health sector is a key entry point for survivors to receive care. The World Health Organization adopted an earlier framework for health systems response to survivors. However, documentation on the programmatic rollout of health system response to violence against women is lacking in low and middle-income countries. This paper studies the programmatic roll out of the health systems response across select five low- and middle-income countries (LMIC) and identifies key learnings. Methods We selected five LMIC settings with recent or active programming on national-level health system response to VAW from 2015 to 2020. We synthesized publicly available data and program reports according to the components of the WHO Health Systems Framework. The countries selected are Bangladesh, Brazil, Nepal, Rwanda, and Sri Lanka. Results One-stop centers were found to be the dominant model of care located in hospitals in four countries. Each setting has implemented in-service training as key to addressing provider knowledge, attitudes and practice; however, significant gaps remain in addressing frequent staff turnover, provision of training at scale, and documentation of the impact of training. The health system protocols for VAW address sexual violence but do not uniformly include clinical and health policy responses for emotional or economic violence. Providing privacy to survivors within health facilities was a universal challenge. Conclusion Significant efforts have been made to address provider attitudes towards provision of care and to protocolize delivery of care to survivors, primarily through one-stop centers. Further improvements can be made in data collection on training impact on provider attitudes and practices, in provider identification of VAW survivors, and in prioritization of VAW within health system budgeting, staffing, and political priorities. Primary health facilities need to provide first-line support for survivors to avoid delays in response to all forms of VAW as well as for secondary prevention.

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