Principles of public health emergency response for acute environmental, chemical, and radiation incidents

In recent years there have been many environmental, chemical, and radiation disasters that have challenged the emergency preparedness of countries around the globe. This chapter on the principles of public health emergency response for acute environmental, chemical, and radiation incidents summarizes the stages of response to emergencies using a generic ‘all hazards’ framework and a ‘source–pathway–receptor’ risk assessment model which is adaptable to any situation and conforms with international obligations. The stages identified address incident management arrangements for emergency response including international obligations; public health risk assessment; public health risk management techniques and countermeasures; public reassurance in emergencies and incidents and finally the need to identify and publish the lessons from incidents Remembering that before any response can be mounted, the event has to be detected and identified as requiring special action. Detection requires early warning and forecasting to clinical awareness, timely surveillance, and intelligence. A significant number of evidence gaps remain and so detailed documentation and follow-up of future incidents will continue to be needed to fill those gaps and improve emergency preparedness and response in the future. By the use of case studies of some significant environmental, chemical, and radiological incidents and processes the stages of the emergency response are illustrated to facilitate an all hazards approach.

State of public health emergency response leadership training: A multitiered organizational perspective

Objective: To capture organizational level information on the current state of public health emergency response leadership training.Design: A web-based questionnaire.Participants: This multitiered assessment of health departments included two distinct respondent groups: (1) Public Health Emergency Preparedness (PHEP) Cooperative Agreement recipients (n = 34) and (2) local health departments (LHDs) (n = 169) representative of different agency sizes and populations served.Results: Overall, PHEP and LHD respondents expressed a clear preference for participatory learning with practical drills/exercises and participatory workshops as the preferred training delivery modes. Compared with technical and role-specific training, leadership training was less available. For both PHEP and LHD respondents, staff availability for training is most notably limited due to lack of time. For PHEP respondents, a common factor limiting agency ability to offer training is lack of mentors/instructors, whereas for LHD respondents, it is limited funding.Conclusions: Efforts should focus on increasing accessibility and the continued development of rigorous and effective training based on practical experience in all aspects of multitiered public health emergency response leadership.

Developing Public Health Emergency Response Leaders in Incident Management: A Scoping Review of Educational Interventions

During emergency responses, public health leaders frequently serve in incident management roles that differ from their routine job functions. Leaders’ familiarity with incident management principles and functions can influence response outcomes. Therefore, training and exercises in incident management are often required for public health leaders. To describe existing methods of incident management training and exercises in the literature, we queried 6 English language databases and found 786 relevant articles. Five themes emerged: (1) experiential learning as an established approach to foster engaging and interactive learning environments and optimize training design; (2) technology-aided decision support tools are increasingly common for crisis decision-making; (3) integration of leadership training in the education continuum is needed for developing public health response leaders; (4) equal emphasis on competency and character is needed for developing capable and adaptable leaders; and (5) consistent evaluation methodologies and metrics are needed to assess the effectiveness of educational interventions. These findings offer important strategic and practical considerations for improving the design and delivery of educational interventions to develop public health emergency response leaders. This review and ongoing real-world events could facilitate further exploration of current practices, emerging trends, and challenges for continuous improvements in developing public health emergency response leaders.

Analysis of the COVID-19 Pandemic: Lessons for a Contextualized and Effective Response to Public Health Emergencies

Background: The pandemic of Coronavirus Disease 2019 (COVID-19) is a timely reminder of the nature and impact of Public Health Emergencies of International Concern. As of 27 May 2021, there were over 169 million cases and over 3.5 million deaths notified since the start of the pandemic. The COVID-19 pandemic takes variable shapes and forms in different regions and countries of the world. The objective of this study is to analyse the COVID-19 pandemic so that lessons can be learned towards an effective public health emergency response. Methods: We conducted a mixed-methods study to understand the heterogeneity of the COVID-19 pandemic. Correlation analysis and scatter plot were employed for the quantitative data. We used Spearman’s correlation analysis. Thematic analysis was conducted on the qualitative data to explain the findings from the quantitative data.Results: We have found that regions and countries with high human development index are most affected by COVID-19 due to international connectedness and mobility of their population related to trade and tourism, and their vulnerability related to older populations and higher rates of non-communicable diseases. The pattern of the pandemic is also variable among high- and middle-income countries due to differences in the governance of the pandemic, fragmentation of health systems, and socio-economic inequities. Conclusion: The aspiration towards a healthier and safer society requires that countries develop and implement a coherent and context-specific national strategy, improve governance of public health emergencies, build the capacity of their (public) health systems, minimize fragmentation, and tackle upstream structural issues, including socio-economic inequities. This is possible through a primary health care approach, which ensures provision of universal and equitable promotive, preventive and curative services, through whole-of-government and whole-of-society approaches.

Study on the Formation Mechanism of Medical and Health Organization Staff’s Emergency Preparedness Behavioral Intention: From the Perspective of Psychological Capital

Medical and Health Organization (MHO) staff’s emergency preparedness awareness and behaviors are essential variables that affect public health emergency response effectiveness. Based on the theory of psychological capital and the theory of planned behavior (TPB), this study discusses the mechanism of the psychological characteristics of MHO staff on their emergency preparedness behavioral intention (EPBI). To verify the research model, we conducted a web-based questionnaire survey among 243 MHO staff from China and analyzed the data using the structural equation modeling software, AMOS 24.0 (IBM, New York, United States). The empirical results reveal that psychological capital significantly affected cognitive processes theorized by TPB. This study suggests that the positive psychological capital of MHO staff should be developed and managed to improve their EPBI.

Developing an instrument to measure household radiological emergency preparedness using the Community Assessment for Public Health Emergency Response (CASPER) methodology: An evidence-informed approach

Introduction: Community assessments to measure emergency preparedness can inform policies, planning, and communication to the public to improve readiness and response if an emergency was to occur. Public health and emergency management officials need an effective assessment tool to measure community preparedness for a radiological emergency. Methods: The authors created a survey instrument to collect data on household radiological emergency preparedness that could be implemented using the Community Assessment for Public Health Emergency Response (CASPER) methodology, developed by the US Centers for Disease Control and Prevention. To inform the development of the tool, the authors examined existing CASPER surveys, focusing on identifying best practices for creating a survey instrument, as well as analyzing the results of a survey of radiation preparedness experts and state/local health and emergency management officials. Results: The developed survey tool includes 32 questions covering four domains: communication in an emergency, preparedness planning, physical/behavioral health, and demographics. The instrument captures information related to identified barriers in communicating in a radiological emergency as well as self-reported behaviors that could potentially be influenced through awareness and education.Discussion: Using the proposed survey instrument and following the existing rapid assessment methodology provided by CASPER, public health and emergency management agencies can collect valuable information on the radiation preparedness needs of their communities, which can then be used to improve household readiness for an emergency.