The COVID-19 vaccination campaign in Bhutan: strategy and enablers

Bhutan has reported a total of 2596 COVID-19 cases and three deaths as of September 15, 2021. With support from India, the United States, Denmark, the People’s Republic of China, Croatia and other countries, Bhutan was able to conduct two rounds of nationwide vaccination campaign. While many countries struggle to overcome vaccine refusal or hesitancy due to complacency, a lack of trust, inconvenience and fear, escalated in some countries by anti-vaccine groups, Bhutan managed to inoculate more than 95% of its eligible populations in two rounds of vaccination campaign. Enabling factors of this successful vaccination campaign were strong national leadership, a well-coordinated national preparedness plan, and high acceptability of vaccine due to effective mass communication and social engagement led by religious figures, volunteers and local leaders. In this short report, we described the national strategic plan and enabling factors that led to the success of this historical vaccination campaign.

Rethinking preparedness planning in disaster emergency care: lessons from a beyond-surge-capacity event

Background Large-scale burn disasters can produce casualties that threaten medical care systems. This study proposes a new approach for developing hospital readiness and preparedness plan for these challenging beyond-surge-capacity events. Methods The Formosa Fun Coast Dust Explosion (FFCDE) was studied. Data collection consisted of in-depth interviews with clinicians from four initial receiving hospitals and their relevant hospital records. A detailed timeline of patient flow and emergency department (ED) workload changes of individual hospitals were examined to build the EDs' overload patterns. Data analysis of the multiple hospitals' responses involved chronological process-tracing analysis, synthesis, and comparison analysis in developing an integrated adaptations framework. Results A four-level ED overload pattern was constructed. It provided a synthesis of specifics on patient load changes and the process by which hospitals' surge capacity was overwhelmed over time. Correspondingly, an integrated 19 adaptations framework presenting holistic interrelations between adaptations was developed. Hospitals can utilize the overload patterns and overload metrics to design new scenarios with diverse demands for surge capacity. The framework can serve as an auxiliary tool for directive planning and cross-check to address the insufficiencies of preparedness plans. Conclusions The study examined a wide-range spectrum of emergency care responses to the FFCDE. It indicated that solely depending on policies or guidelines for preparedness plans did not contribute real readiness to MCIs. Hospitals can use the study's findings and proposal to rethink preparedness planning for the future beyond surge capacity events.

Perceived Change in Tobacco Use and Its Associated Factors among Older Adults Residing in Rohingya Refugee Camps during the COVID-19 Pandemic in Bangladesh

This study explored the perceived change in tobacco use during the COVID-19 pandemic and its associated factors among older adults residing in Rohingya refugee camps, also referred to as Forcibly Displaced Myanmar Nationals in Bangladesh. The study followed a cross-sectional design and was conducted in October 2020 among 416 older adults aged 60 years and above. A purposive sampling technique was applied to identify eligible participants, and face-to-face interviews were conducted using a pre-tested semi-structured questionnaire to collect the data. Participants were asked if they noted any change in their tobacco use patterns (smoking or smokeless tobacco) during the COVID-19 pandemic compared to pre-pandemic. Binary logistic regression models determined the factors associated with the perceived change in tobacco use. More than one in five participants (22.4%) were current tobacco users, of whom 40.8% reported a perceived increase in tobacco use during the COVID-19 pandemic. Adjusted analysis revealed that participants who were concerned about COVID-19 had significantly (p < 0.05) lower odds of perceived increase in tobacco use (aOR = 0.22, 95% CI: 0.06–0.73), while older adults who were overwhelmed by COVID-19 (aOR = 0.26, 95% CI: 0.06–1.18) and communicated less frequently with others during the pandemic than before (aOR = 0.19, 95% CI: 0.03–1.20) had marginally significantly (p < 0.1) lower odds of perceived increase in tobacco use during this pandemic. Relevant stakeholders, policymakers, and practitioners need to focus on strengthening awareness-raising initiatives as part of an emergency preparedness plan to control tobacco use during such a crisis period.

Preparing for COVID-19: Household food insecurity and vulnerability to shocks in Nairobi, Kenya

An understanding of the types of shocks that disrupt and negatively impact urban household food security is of critical importance to develop relevant and targeted food security emergency preparedness policies and responses, a fact magnified by the current COVID-19 pandemic. This gap is addressed by the current study which draws from the Hungry Cities Partnership (HCP) city-wide household food insecurity survey of Nairobi city in Kenya. It uses both descriptive statistics and multilevel modelling using General Linear Mixed Models (GLMM) to examine the relationship between household food security and 16 different shocks experienced in the six months prior to the administration of the survey. The findings showed that only 29% of surveyed households were completely food secure. Of those experiencing some level of food insecurity, more experienced economic (55%) than sociopolitical (16%) and biophysical (10%) shocks. Economic shocks such as food price increases, loss of employment, and reduced income were all associated with increased food insecurity. Coupled with the lack of functioning social safety nets in Nairobi, households experiencing shocks and emergencies experience serious food insecurity and related health effects. In this context, the COVID-19 pandemic is likely to have a major negative economic impact on many vulnerable urban households. As such, there is need for new policies on urban food emergencies with a clear emergency preparedness plan for responding to major economic and other shocks that target the most vulnerable.

Disaster Preparedness and Planning for Service Sustainability: Case of Egerton University Digital Library, Main Campus

Preparing and planning for disaster remains the most crucial component of libraries. It also happens to be one that is least understood. Since the existence of libraries and information science, there has been a history of disasters happening from time to time. Disasters are events in which no library would like to experience but the still do. Egerton University library being the study area, has experienced disasters in the form of rioting students causing service disruption and incidences of fire. This study sought to evaluate the disaster preparedness and planning of digital libraries in relation to service sustainability. It considered the following objectives: To establish the level of disaster preparedness and planning; To find out the training the library staff have undergone; To determine the disaster preparedness and planning equipment in place; and to establish the challenges faced in preparing and planning for disasters at Egerton University digital library in service delivery. It was anchored on the Theory of Planned Behavior. The study made use of descriptive research design and considered census method to arrive at 68 library staff as its respondents. Primary data was collected using self-administered questionnaire with a five-point Likert scale. The quantitative data collected was inferentially analyzed as per the objectives of this study. A statistical software SPSS was used in analyzing this data. Findings were presented in the form of tables as frequencies and percentages for easy understanding. The validity of the instruments was determined using specialists who assisted in properly framing questions in the questionnaire. They also assisted in realigning it according to the objectives of the study. The study established that the level of disaster preparedness and planning at the digital library in Egerton University was low hence the digital library was at risk of disasters; not all the library staff had not adequately undergone training on disaster preparedness and planning; the library was not adequately supplied with disaster preparedness and planning equipment’s; the digital library was experiencing challenges in regards to disaster preparedness and planning; and the digital library services will be affected in the event of a disaster happening. The study concluded that the digital library could experience disasters because they were not exempted from disasters like any other organization or section within the University; the library was not so keen on training its staff on disaster preparedness and planning; the digital library had inadequate disaster preparedness and planning equipment’s; implementing a disaster preparedness plan was hindered by lack of adequate funds which were needed for purchasing suitable equipment’s, servicing these equipment as well as training all the library staff. The study recommended that the management of the university and library should provide the needed support and influence staff training in regards to disaster preparedness and planning; the library should develop a well-documented disaster preparedness policy of its own and incorporate it with the overall disaster preparedness policy for the university; and a structured, systematic and regular mechanism of training staff on disaster preparedness should be developed, supported and implemented within the library.

Preparedness Plan for the Water Supply Infrastructure during Water Terrorism—A Case Study from Irbid, Jordan

Terrorism is a crucial danger to the world, especially the Middle East. As Jordan is amidst countries with armed conflicts, its natural resources (in particularly, water resources) are vulnerable to terrorist attacks. In this paper, possible biological and chemical weapons that can be used as intimidation, along with their threats, vulnerabilities, and inactivation methods, concerning water treatment processes in the municipality of Irbid, are studied. Irbid is the second largest city in terms of population in Jordan, after the capital city of Amman, and it is the nearest governorate to Syria borders that is considered a war zone. After conducting risk assessment that takes into consideration criticality, threats, and vulnerability, it appears that only one of the eight units, which is the Makhraba pumping station, along with the Bushra water tank, were identified as medium risk. The other units have treatment processes and proper precautions that are able to inactivate or prevent any possible contamination. A response plan should be set by developing a telemetry system with specific sensors that can detect any sudden and unacceptable threats to the water quality and that has the ability to shut down the concerned units automatically.

A Scoping Review on Category A Agents as Bioweapons

Category A agents are biological pathogens that could pose a threat to health and human safety if used as bioweapons. The exploration and possibility of these threats must be comprehensively reviewed to create a preparedness plan to recognize outbreaks, to educate the public, and to offer vaccinations and/or treatment options, if available. A scoping review using PRISMA guidelines was performed to categorize current information on Category A biological agents as well as understand their potential for future threats. The results used 34 articles and found that while botulin neurotoxins were the most lethal, anthrax posed the most likely threat for use as a bioweapon. Most research was conducted on plague, though it is not the most likely threat. Smallpox is the most likely agent to vaccinate against as there is already a working vaccine that has proven effective and the issue at hand is the need for a larger stockpile. Ultimately, preparedness efforts should include vaccinations and continued research and development of them. Category A agents are a serious public health concern; updated and reformed bioterrorism preparedness plans could greatly minimize panic and mortality.

Assessing Veterinary Practice and Practitioner Preparedness for Natural and Man-Made Disasters, Including COVID-19

Natural and man-made disasters lead to hundreds of millions of dollars in economic losses annually worldwide. Veterinarians are most qualified to support local, state, national, and international efforts in emergency management. However, they may lack the knowledge and advanced training to most effectively plan, prepare, and respond. Currently, only two colleges offer training embedded in their core veterinary curriculum. In this study, a survey was conducted to gain an understanding of veterinary practice and practitioner preparedness for natural and man-made disasters in the United States and Canada, with questions assessing pandemic preparedness. The participants graduated from 28 American Veterinary Medical Association (AVMA)–accredited veterinary colleges globally and 2 non-accredited veterinary colleges, represent a diverse set of veterinary practice types, and have an average of 26 years’ practice experience. Overall, 63.5% of veterinary respondents had experienced a natural disaster, while only 9.6% had experienced a man-made disaster. Approximately 66% report having a practice disaster preparedness plan, while less than 20% of those actively maintain and update the plan. Furthermore, less than 50% of the practices and practitioners were ready to face the challenges of a global pandemic. Approximately 68% reported using some form of communication to educate clients about family and pet disaster readiness. Many felt that some advanced disaster readiness training would have been helpful in their veterinary curriculum. Our findings indicate that additional training in the veterinary curriculum, as well as continuing education, would help veterinarians and practices be better prepared for natural and man-made disasters.

Hospice Emergency Planning and COVID-19

Objectives: Centers for Medicare and Medicaid Services requirements for Emergency Preparedness Planning (EPP) by hospice organizations significantly increased in 2017. This study seeks to assess the involvement of various hospice personnel in EPP before and since the onset of the novel coronavirus disease COVID-19 pandemic. Methods: A link to an anonymous online survey was sent to members of the American Academy of Hospice and Palliative Medicine and the Hospice and Palliative Nurses Association, targeting members involved in hospice care in the United States. A descriptive analysis of the data was performed. Results: Prior to the pandemic, 39.8% of respondents were “moderately” or “very” involved with the development and revisions of the Emergency Preparedness Plan. Since the beginning of the pandemic, this increased to 59%, which largely occurred among physicians. Clinical Nurse and Nurse Practitioner involvement in development/revisions remained low. Approximately 30% of respondents desired more involvement across the areas of EPP. Conclusion: The involvement of personnel of various disciplines is varied and the involvement of physicians appears to have increased with the onset of the COVID-19 pandemic. A notable portion of personnel desired more involvement across all aspects of EPP. More research is needed in this important but little-understood area.