Kuala Lumpur train collision during the COVID-19 pandemic

Background Two city trains collided in an underground tunnel on 24 May 2021 at the height of COVID-19 pandemic near the Petronas Towers, Kuala Lumpur, Malaysia, immediately after the evening rush hours. We aim to evaluate the management of this mass casualty incident highlighting the lessons learned to be used in preparedness for similar incidents that may occur in other major cities worldwide. Methods Information regarding incident site and hospital management response were analysed. Data on demography, triaging, injuries and hospital management of patients were collected according to a designed protocol. Challenges, difficulties and their solutions were reported. Results The train's emergency response team (ERT) has shut down train movements towards the incident site. Red zone (in the tunnel), yellow zone (the station platform) and green zone (outside the station entrance) were established. The fire and rescue team arrived and assisted the ERT in the red zone. Incident command system was established at the site. Medical base station was established at the yellow zone. Two hundred and fourteen passengers were in the trains. Sixty-four of them were injured. They had a median (range) ISS of 2 (1–43), and all were sent to Hospital Kuala Lumpur (HKL). Six (9.4%) patients were clinically triaged as red (critical), 19 (29.7%) as yellow (semi-critical) and 39 (60.9%) as green (non-critical). HKL's disaster plan was activated. All patients underwent temperature and epidemiology link assessment. Seven (10.9%) patients were admitted to the hospital (3 to the ICU, 3 to the ward and 1 to a private hospital as requested by the patient), while the rest 56 (87.5%) were discharged home. Six (9.4%) needed surgery. The COVID-19 tests were conducted on seven patients (10.9%) and were negative. There were no deaths. Conclusions The mass casualty incident was handled properly because of a clear standard operating procedure, smooth coordination between multi-agencies and the hospitals, presence of a 'binary' system for 'COVID-risk' and 'non-COVID-risk' areas, and the modifications of the existing disaster plan. Preparedness for MCIs is essential during pandemics.

Kuala Lumpur Train Collision During the COVID-19 Pandemic

Background: Two city trains collided in an underground tunnel on 24th May 2021 at the height of Covid-19 pandemic near the Petronas Towers, Kuala Lumpur, Malaysia immediately after the evening rush hours. We aim to evaluate the management of this mass casualty incident highlighting the lessons learned to be used in preparedness for similar incidents that may occur in other major cities worldwide. Methods: Information regarding incident site and hospital management response were analysed. Data on demography, triaging, injuries and hospital management of patients were collected according to a designed protocol. Challenges, difficulties and their solutions were reported. Results: The train's emergency response team (ERT) has shut down train movements towards the incident site. Red zone (in the tunnel), yellow zone (the station platform) and green zone (outside the station entrance) were established. The fire and rescue team arrived and assisted the ERT in the red zone. Incident command system was established at the site. Medical base station was established at the yellow zone. 214 passengers were in the trains. 64 of them were injured. They had a median (range) ISS of 2 (1-43) and all were sent to Hospital Kuala Lumpur (HKL). Six (9.4%) patients were clinically triaged as red (critical), 19 (29.7%) as yellow (semi-critical) and 39 (60.9%) as green (non-critical). HKL's disaster plan was activated. All patients underwent temperature and epidemiology link assessment. Seven (10.9 %) patients were admitted to the hospital (3 to the ICU, 3 to the ward, and 1 to a private hospital as requested by the patient), while the rest 56 (87.5%) (56) were discharged home. Six (9.4%) needed surgery. The Covid-19 tests were conducted on seven patients (10.9%) and was negative There were no deaths. Conclusions: The mass casualty incident was handled properly because of a clear standard operating procedure, smooth coordination between multi-agencies and the hospitals, presence of a'binary' system for 'Covid risk' and 'non-Covid risk' areas, and the modifications of the existing disaster plan. Preparedness for MCIs is essential during pandemics.

Beirut Explosion: The Largest Non-Nuclear Blast in History

A massive explosion have ripped Beirut on August 4, 2020, leaving behind more than 6000 casualties, 800 regular floor admissions, 130 intensive care unit admissions, and over 200 deaths. Buildings were destroyed, hospitals in Beirut were also destroyed, others became nonfunctional. A disaster code was initiated in all the hospitals. Victims were transported by the Lebanese Red Cross or by volunteers to the nearest hospital that was still functional. Hospitals were flooded in patients, the coordination between health care centers was missing. Each hospital was functioning to its maximum capacity. With the many challenges we had, a rapid response was initiated. An effective triage done outside the Emergency had the major role in saving lives. After the Beirut Explosion, an assessment of the disaster plan and a major evaluation of the hospitals’ coordination is needed.

KESIAP SIAGAAN RUMAH SAKIT DALAM PENANGGULANGAN BENCANA STUDI KASUS DI RSU ELPI AL AZIZ RANTAUPRAPAT, 2020

Penelitian ini bertujuan untuk mengetahui kesiapsiagaan RSU Elpi Al Azis Rantauprapat dalam penanggulangan bencana, dengan subfokus mengetahui pelaksanaan Hospital Disaster Plan, Emergency Operation Plan, Specific Operation Plan dan Pedoman Penanggulangan Bencana di RSU itu. Jenis penelitian yang digunakan adalah penelitian kualitatif dengan menggunakan rancangan Studi Kasus. Informan penelitian ini adalah 7 orang, yaitu Direktur RS, Tim K3 RS, Kepala Perawat IGD, Manajer Keperawatan, Kepala Farmasi Kepala Kamar Operasi dan Kepala Sarpras RS. Penelitian ini dilaksanakan dalam periode Oktober 2019 hingga September 2020 (12 bulan). Pemeriksaan keabsahan data dengan cara credibility, dependability, confirmability, dan transferability. Pengumpulan data dilakukan dengan wawancara mendalam dan observasi dengan menggunakan alat perekam dan kamera. Analisis data dilakukan dengan metode Miles & Hubberman. Pelaksanaan Hospital Disaster Plan di RSU Elpi Al Aziz Rantauprapat sudah cukup baik karena RS ini telah memiliki organisasi pencegahan dan penanggulangan bencana rumah sakit yang di dalamnya melibatkan beberapa instalasi rumah sakit. Emergency Operation Plan yang ada sudah mengikuti standar pelayanan minimal rumah sakit kelas B, namun kuantitas sarana dan prasarana masih harus lebih ditingkatkan lagi karena Specific Operation Plan belum memenuhi standar yang ada. Pedoman Penanggulangan Bencana di RSU Elpi Al Aziz sudah ada namun masih ada beberapa staff di RS Elpi Al Aziz yang belum mengerti dan paham mengenai kesiapsiagaan dalam menghadapi bencana.

Disaster Planning

As disasters become more frequent and severe worldwide, disaster planning as a human endeavor is more important than ever, with the potential to save millions of lives globally. In this important new book, the author offers a practical, step-by-step guide for writing, implementing, and measuring the quality of your own disaster plan to address any threat with an approach that has been tested in public health and medical settings worldwide. Filling a significant gap in the existing literature, this book offers a comprehensive reference for both the principles and the practice of disaster planning. Access to a 25-lecture training course provides ancillary teaching materials for college level courses, offering added value for academic readers. An essential resource for public health graduates and anyone responsible for the management of disasters, primarily public health professionals, emergency physicians, first responders, and emergency managers.

When usage matters: time-of-use analysis of Cape Town's Day Zero drought response

Poor resource management and infrastructure limitations make the effects of drought worse for cities in developing countries. One way to alleviate the impact without large investments is targeted demand management. This has worked well in studies that focused on some of the recent droughts, including Cape Town's ‘Day Zero’ drought of 2016–2018. Many studies have measured demand response to a drought at a coarse time resolution, but few have measured it at an hourly resolution or compared weekday with weekend use. In this study we evaluated households' hourly time-of-use behaviour in response to the Cape Town drought at two prominent inflection points identified by previous studies: the announcement of the Critical Water Shortages Disaster Plan in October 2017 and the introduction of Level 6B restrictions in February 2018. The first major reduction was caused by residents reducing their usage by about a third in the early morning and evening hours on weekdays, and the second, even larger, reduction was achieved in the mid-morning hours on weekdays when home owners were not at home but ensured that domestic workers used water sparingly.

Hospital Disaster Plan Dalam Perencanaan Kesiapsiagaan Bencana

Kota Bukittinggi merupakan daerah yang rawan bencana alam seperti gempa bumi, banjir, dan tanah longsor, dan baru – baru ini banjir juga menggenangi beberapa daerah di kota Bukittinggi, tampa terkecuali juga mengenai Rumah Sakit. Rumah sakit sebagai sarana pelayanan kesehatan rujukan khususnya bagi kasus-kasus emergensi, lebih siap dalam menghadapi dampak bencana baik bencana di dalam atau di luar rumah sakit. Tujuan penelitian ini Untuk Menganalisis Kesiapan Manajemen Rumah Sakit Ibnusina Yarsi Bukittinggi Dalam Perencanaan Penyiagaan Bencana (Hospital Disaster Plan) Tahun 2020. Metode Penelitian ini menggunakan metode desain deskriptif kualitatif dengan strategi fenomenalogi dengan metode wawancara mendalam, observasi dan telaah dokumen. Penelitian dilakukan di rumah sakit Ibnusina Yarsi Bukittinggi bulan Februari sampai November 2020. Teknik penentuan informan menggunakan metode purposive sampling. Pengolahan data menggunakan reduksi data, penyajian data, penarikan kesimpulan dan verifikasi. Analisis data menggunakan triangulasi teknik dan triangulasi sumber. Hasil penelitian menunjukkan bahwa rumah sakit Ibnusina Yarsi sudah memiliki struktur organisasi tim penanggulangan bencana dan tupoksi masing - masing, namun perlu adanya perbaharuan/update dari struktur tim, kesiapan sumber daya manusia sudah memiliki Tim kebencanaan dan tim Bantuan Kesehatan, namun sarana dan prasarana rumah sakit belum mencukupi untuk penanganan korban massal. Sedangkan sistem komunikasi rumah sakit sudah memiliki alat komunikasi untuk penyampaian informasi. Kesimpulan Tim penanggulangan bencana kurang siap menghadapi bencana karena struktur organisasi beserta tugas dan fungsinya belum optimal diperbaharui, masih kurangnya sarana dan prasarana dalam penanggulangan korban massal dan sudah memiliki alat komunikasi. Diharapkan rumah sakit mengupdate struktur organisasi, dan melengkapi sarana dan prasarana dalam penanggulangan bencana.

COVID-19 Pandemic; Anxiety and Depression among frontline healthcare workers: Rising from the Ashes

This chapter gives an insight into the psychological journey of the essential healthcare workers (HCWs) during the COVID-19 pandemic. The catastrophe which started off with uncertainty, provoked fear-related behaviors among the frontline doctors, nurses and paramedical staff. With meager resources and lack of a disaster plan, fire-fighting was a reflex response of healthcare institutions. Though the whole world seemed to be unprepared for the calamity, developing countries with fragile healthcare systems were more vulnerable to collapse. The negative aura was complicated by mistrust among the general population, regarding healthcare workers, institutions and government. Furthermore, with economic downfall; balancing work and protecting the family was a challenge for HCWs, especially during the pandemic peak. The psychological distress translated to rising incidence of depression and anxiety among them. As institutions gained insight into psychosocial issues of HCWs; support and therapies were offered to them. Positive messages labelling HCWs as “Heroes of the Pandemic” were circulated and structured programs developed to address their needs. With the advent of COVID-19 vaccine, a ray of hope emerged, although there are still apprehensions about its efficacy and side-effects. The whole world now eagerly awaits the calamity to perish while normality can rise from ashes.

Hospitals Disaster Preparedness and Management in the Eastern Province of the Kingdom of Saudi Arabia: A Cross-sectional study

Objective: The current study was conducted to assess disaster preparedness of hospitals in the Eastern region of Saudi Arabia. Methods: A descriptive cross-sectional study of all hospitals in the Eastern Region of KSA was conducted between July 2017 and July 2018. The included hospitals were selected using convenience sampling. The questionnaire was distributed together with an official letter providing information about the aim and objectives of the study as well as ethical issues guiding their participation in the exercise. Results: All the included hospitals had a disaster plan that was completely accessible by all staff members. About 70% of the included hospitals established an educational program on disaster preparedness once per year. Assessment of hospital disaster preparedness was conducted using disaster drills in 62 (n= 98%) of the hospitals. However, only 9.5% of the hospitals had post-disaster recovery assistance programs like counseling and support services. Conclusion: Most hospitals involved in this study had sufficient resources for disaster management; however, the overall effectiveness of hospitals’ disaster preparedness was slight to moderate. Some recommendations to improve hospitals’ disaster preparedness should be proposed, including improved staff training and testing, better communications and safety procedures, and adoption of a holistic approach for disaster management.

Community Preparedness to Reduce Risk Disaster of Tsunami

Introduction: Kebumen is one of the districts that has a high level of disaster vulnerability in Central Java. Most of area is lowland and village located in a coastal area and close to the beach so that it has a tsunami disaster. This research is to describe level of knowledge, attitude, disaster plan, emergency disaster, early warning system, mobilization of resources in a tsunami disaster. Methods: This study is a descriptive study with 98 respondents were all members of the community. The sampling technique used purposed sampling with 50 questionnaires, and analysis determine the proportion based on the categories of good, adequate and insufficient. Results: The level of knowledge and attitudes of the disaster community is in the bad category (51%), level of family policies is in the moderate category (52%), level of emergency response plans is in the moderate category (72.4%), and level of the warning system bad category (56.1%). Meanwhile, the level of resource mobility was in the bad category (71.4%). Conclusion: The results of community preparedness in Kebumen in the face of tsunami disaster based on 5 parameters were found that the community wasn’t ready.