All levels of government are authorized to apply coronavirus disease 2019 (COVID-19) protection measures; however, they must consider how and when to ease lockdown restrictions to limit long-term societal harm and societal instability. Leaders that use a well-considered framework with an incremental approach will be able to gradually restart society while simultaneously maintaining the public health benefits achieved through lockdown measures. Economically vulnerable populations cannot endure long-term lockdown, and most countries lack the ability to maintain a full nationwide relief operation. Decision-makers need to understand this risk and how the Maslow hierarchy of needs and the social determinants of health can guide whole of society policies. Aligning decisions with societal needs will help ensure all segments of society are catered to and met while managing the crisis. This must inform the process of incremental easing of lockdowns to facilitate the resumption of community foundations, such as commerce, education, and employment in a manner that protects those most vulnerable to COVID-19. This study proposes a framework for identifying a path forward. It reflects on baseline requirements, regulations and recommendations, triggers, and implementation. Those desiring a successful recovery from the COVID-19 pandemic need to adopt an evidence-based framework now to ensure community stabilization and sustainability.
Introduction: Over the last quarter of a century the frequency of natural disasters and the burden of non-communicable diseases (NCD) across the globe have been increasing. For individuals susceptible to, or chronically experiencing, NCDs this has become a significant risk. Disasters jeopardize access to essential treatment, care, equipment, water and food, which can result in an exacerbation of existing conditions or even preventable death. Consequently, there is a need to expand the public health focus of disaster management to include NCDs. To provide a platform for this to occur, this article presents the results from a systematic review that identifies and describes the impact of cyclone, flood and storm related disasters on those susceptible to, or experiencing, NCDs. The NCDs researched were: cardiovascular diseases; cancers; chronic respiratory diseases; and diabetes. Methods: Four electronic publication databases were searched with a date limit of 31 December 2014. The data was analyzed through an aggregation of individual papers to create an overall data description. The data was then grouped by disease to describe the impact of a disaster on treatment management, exacerbation, and health care of people with NCDs. The PRISMA checklist was used to guide presentation of the research. Results: The review identified 48 relevant articles. All studies represented developed country data. Disasters interrupt treatment management and overall care for people with NCDs, which results in an increased risk of exacerbation of their illness or even death. The interruption may be caused by a range of factors, such as damaged transport routes, reduced health services, loss of power and evacuations. The health impact varied according to the NCD. For people with chronic respiratory diseases, a disaster increases the risk of acute exacerbation. Meanwhile, for people with cancer, cardiovascular diseases and diabetes there is an increased risk of their illness exacerbating, which can result in death. Conclusion: Cyclone, flood and storm related disasters impact on treatment management and care for people with NCDs. Possible consequences include exacerbation of illness, complications or even death. There is now a need to expand traditional disaster approaches by public health to incorporate NCDs. This must be guided by the major NCDs identified by the World Health Organization and implemented in-line with the Sendai Framework for Disaster Risk Reduction: 2015-2030. This includes understanding all the factors that influence both direct and indirect (preventable) morbidity and mortality related to NCDs during and after disasters. Once achieved, disaster planners and public health professionals will be in a position to develop and implement effective mitigation strategies.
This two-part article examines the global public health (GPH) information system deficits emerging in the coronavirus disease 2019 (COVID-19) pandemic. It surveys past, missed opportunities for public health (PH) information system and operational improvements, examines current megatrend changes to information management, and describes a new multi-disciplinary model for population-based management (PBM) supported by a GPH Database applicable to pandemics and GPH crises.
Background: The exposure of people and infrastructure to flood and storm related disasters across the world is increasing faster than vulnerability is decreasing. For people with non-communicable diseases this presents a significant risk as traditionally the focus of disaster management systems has been on immediate trauma and communicable diseases. This focus must now be expanded to include the management of non-communicable diseases because these conditions are generating the bulk of ill health, disability and premature death around the globe. When public health service infrastructure is destroyed or damaged access to treatment and care is severely jeopardised, resulting in an increased risk of non-communicable disease exacerbation or even death. This research proposes disaster responders, coordinators and government officials are vital assets to mitigate and eventually prevent these problems from being exacerbated during a disaster. This is due to their role in supporting the public health service infrastructure required to maximise treatment and care for people with non-communicable diseases. By focusing on the disaster cycle as a template, and on mitigation and prevention phases in particular, these actions and activities performed by disaster service responders will lead to overall improved preparedness, response, recovery and rehabilitation phases.Methods: Data were collected via 32 interviews and one focus group (eight participants) between March 2014 and August 2015 (total of 40 participants). The research was conducted in the State of Queensland, Australia, with disaster service providers. The analysis included the phases of: organizing data; data description; data classification; and interpretation.Results: The research found a relationship between the impact of a disaster on public health service infrastructure, and increased health risks for people with non-communicable diseases. Mitigation strategies were described for all phases of the disaster cycle impacting public health service infrastructure. Specific measures include: increasing the use of telemedicine; preplanning with medical suppliers; effective town planning; health professionals visiting evacuation centers; evacuation centers having power for medical equipment; hubs for treatment and care after a disaster; evacuation of high risk people prior to disaster; mapping people at risk by non-communicable disease; and a mechanism for sharing information between agencies. A common theme from the participants was that having accurate and easily accessible data on people with non-communicable diseases would allow disaster service providers to adequately prepare for and respond to a disaster.Conclusions: Disaster service providers can play a vital role in reducing the risk of disaster exacerbated non-communicable diseases through public health service infrastructure resilience. They are often employed in communities where disasters occur and are therefore best-placed to lead implementation of the mitigation strategies identified in this research. To...
This research demonstrated that a negative trend pattern existed between the impact of STC Yasi and other similar world cyclone events on PHI and the management of NCDs. This research provides an insight for disaster planners to address concerns of people with NCDs. While further research is needed, this study provides an understanding of areas for improvement, specifically enhancing protective PHI and the development of strategies for maintaining treatment and alternative care options, such as maintaining safe water for dialysis patients.
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