Emerging and re-emerging infections

Emerging infections are newly identified infections in humans—and are most often zoonotic—caused by infectious organisms that breach the species barrier between animals and humans. Re-emerging infections are known organisms that infect humans, but are identified after a period of absence from human populations. Re-emerging infections also often result from breaches in the species barrier. In addition to direct health outcomes of sickness and death, they also affect the economy, and may spread globally. This chapter discusses factors that influence the emergence of infectious diseases including weak public health infrastructure; failure of safety procedures and regulations; population shifts including rapid population increases and uncontrolled urbanization; anthropogenic activities and climate change; civil disturbance, human displacement, and natural disasters; human behaviours; and deliberate use to cause fear and harm. To address these threats, national public health systems must be strengthened to detect and respond to infectious diseases when and where they emerge, or re-emerge; and a safety net of global networks is required if and when the countries in which they emerge or re-emerge are unable to stop their international spread.

Here Comes the Flood, but Not Failure? Lessons to Learn after the Heavy Rain and Pluvial Floods in Germany 2021

Floods are a known natural hazard in Germany, but the amount of precipitation and ensuing high death toll and damages after the events especially from 14 to 15 July 2021 came as a surprise. Almost immediately questions about failure in the early warning chains and the effectiveness of the German response emerged, also internationally. This article presents lessons to learn and argues against a blame culture. The findings are based on comparisons with findings from previous research projects carried out in the Rhein-Erft Kreis and the city of Cologne, as well as on discussions with operational relief forces after the 2021 events. The main disaster aspects of the 2021 flood are related to issuing and understanding warnings, a lack of information and data exchange, unfolding upon a situation of an ongoing pandemic and aggravated further by critical infrastructure failure. Increasing frequencies of flash floods and other extremes due to climate change are just one side of the transformation and challenge, Germany and neighbouring countries are facing. The vulnerability paradox also heavily contributes to it; German society became increasingly vulnerable to failure due to an increased dependency on its infrastructure and emergency system, and the ensuing expectations of the public for a perfect system.

Water Infrastructure Development in Nigeria: Trend, Size, and Purpose

Water infrastructure development is key to attaining sustainable development, especially for water supply, sanitation and health, agricultural development, and energy production. However, sub-Saharan African countries face specific challenges around infrastructure financing, systemic and repeated malfunctioning, and decentralised infrastructure types. Using Nigeria as a case, this article aims to analyse historical water infrastructure development in Nigeria with a specific focus on dams and standpipes. Seven themes are discussed: infrastructure divisions; deprioritising water supply; political infrastructures; infrastructure failure and sustainability; infrastructure classification and typologies; optimal use of water resources and infrastructure; and a commentary on the future of water infrastructure development. The article concludes with policy and research suggestions for policymakers and other relevant stakeholders.

The Considerations and Controversies in Using High-Flow Nasal Oxygen with Self-Prone Positioning in SARS-CoV-2 COVID-19 Disease

Evidence exists for the use of high-flow nasal oxygen (HFNO) in the general critical care population for acute hypoxemic respiratory failure. There is discord between guidelines for hypoxemia management in COVID-19. Both noninvasive management and intubation present risk to patients and staff and potentially overwhelm hospital mechanical ventilator capacity. The use of HFNO has been particularly controversial in the UK, with oxygen infrastructure failure. We discuss our experience of managing COVID-19 with HFNO and awake self-prone positioning. We focus upon the less-usual case of an eighteen-year-old female to illustrate the type of patient where HFNO may be used when perhaps earlier intubation once was. It is important to consider the wider implications of intubation. We have used HFNO as a bridge to intubation or as definitive management. As we await clinical trial evidence, HFNO with self-prone positioning has a role in COVID-19 for certain patients. Response parameters must be set and reviewed, oxygen infrastructure considered, and potential staff droplet exposure minimised.

An Evaluation Framework and Algorithms for Train Rescheduling

In railway traffic systems, whenever disturbances occur, it is important to effectively reschedule trains while optimizing the goals of various stakeholders. Algorithms can provide significant benefits to support the traffic controllers in train rescheduling, if well integrated into the overall traffic management process. In the railway research literature, many algorithms are proposed to tackle different versions of the train rescheduling problem. However, limited research has been performed to assess the capabilities and performance of alternative approaches, with the purpose of identifying their main strengths and weaknesses. Evaluation of train rescheduling algorithms enables practitioners and decision support systems to select a suitable algorithm based on the properties of the type of disturbance scenario in focus. It also guides researchers and algorithm designers in improving the algorithms. In this paper, we (1) propose an evaluation framework for train rescheduling algorithms, (2) present two train rescheduling algorithms: a heuristic and a MILP-based exact algorithm, and (3) conduct an experiment to compare the two multi-objective algorithms using the proposed framework (a proof-of-concept). It is found that the heuristic algorithm is suitable for solving simpler disturbance scenarios since it is quick in producing decent solutions. For complex disturbances wherein multiple trains experience a primary delay due to an infrastructure failure, the exact algorithm is found to be more appropriate.

Compounding Impacts of Lifeline Infrastructure Failure During Natural Hazard Events

Critical infrastructures, such as transportation systems, communication networks, power and water utilities, have become so integrated into our modern and globalised world that they are commonly taken for granted. That is, until their services are disrupted. The failure of these lifeline services during natural hazard events has the potential to impact populations by exacerbating the hazard itself and/or hindering their ability to respond to or recover from the event. The failure of lifeline infrastructure can also propagate outside the reach of the hazard footprint, causing disruption in regions not directly impacted by the event. Understanding the potential flow-on effects from lifeline failure during natural hazard events is vital for future disaster mitigation, response and recovery. The 2009 South-Eastern Australia heatwave and the 2010 Eyjafjallajökull eruption in Iceland are drawn on to highlight and discuss the vulnerability of lifelines to disruption from natural hazard shocks and the compounding impacts of lifeline failure during natural hazard events.