Today's health emergencies are increasingly complex due to factors such as globalization, urbanization and increased connectivity where people, goods and potential vectors of disease are constantly on the move. These factors amplify the threats to our health from infectious hazards, natural disasters, armed conflicts and other emergencies wherever they may occur. The current CoVID-19 pandemic has provided a clear demonstration of the fact that our ability to detect and predict the initial emergence of a novel human pathogen (for example, the spill-over of a virus from its animal reservoir to a human host), and our capacity to forecast the spread and transmission of the pathogen in human society remains limited. Improving ways in which we prepare will enable a more rapid and effective response and enable proactive preparations (including exercising) to respond to any novel emerging infectious disease outbreaks. This study aims to explore the current state of pandemic preparedness exercising and provides an assessment of a number of case study exercises for health hazards against the key components of the WHO's Exercises for Pandemic Preparedness Plans (EPPP) framework in order to gauge their usefulness in preparation for pandemics. The paper also examines past crises involving large-scale epidemics and pandemics and whether simulations took place to test health security capacities either in advance of the crisis based on risk assessments, strategy and plans or after the crisis in order to be better prepared should a similar scenario arise in the future. Exercises for animal and human diseases have been included to provide a “one health” perspective [1,2]. This article then goes on to examine approaches to simulation exercises relevant to prepare for a health crisis involving a novel emergent pathogen like CoVID-19. This article demonstrates that while simulations are useful as part of a preparedness strategy, the key is to ensure that lessons from these simulations are learned and the associated changes made as soon as possible following any simulation in order to ensure that simulations are effective in bringing about changes in practice that will improve pandemic preparedness. Furthermore, Artificial Intelligence (AI) technologies could also be applied in preparing communities for outbreak detection, surveillance and containment, and be a useful tool for providing immersive environments for simulation exercises for pandemic preparedness and associated interventions which may be particularly useful at the strategic level. This article contributes to the limited literature in pandemic preparedness simulation exercising to deal with novel health crises, like CoVID-19. The analysis has also identified potential areas for further research or work on pandemic preparedness exercising.
Background Nurses have a rich history in performing their duty both domestically and internationally in response to a disaster. Comprising the largest proportion of the healthcare workforce, nurses possess a unique opportunity to inform disaster planning and management. With the ongoing threat from COVID-19 and continuing conflict, humanitarian aid needs, epidemics and natural disasters; the capacity of nurses to continue to respond in times of global need is unparalleled. Aims The aim of this paper is to explore the developments in the field of disaster nursing. Mapping key changes in policy, practice and outcomes. Methods A qualitative interpretive historical review was conducted to examine core developments in the history of disaster nursing, examining key organisations (e.g. World Health Organization, International Council of Nurses), national and international policies and historical accounts. Results 29 articles were analysed, and politics, strategic perspectives and nursing identity (‘sense of duty’ and roles) emerged from the literature. The influence of professionalisation and public health/health promotion emerged next. A total of 10 articles refer to disaster nursing specifically, of which 4 of these are reports/policy. Conclusions Nurses have spent centuries building the trust and legitimacy of the profession. Disaster nursing goes beyond the expectations of a registered nurse. The responsibilities of a disaster nurse encompass wider community health promotion, critical decision-making beyond the individual patient, resilience and ethical challenges. Whilst significant advancements have emerged in the last 30 years, further research, and representation of the profession at a strategic and political level could enhance the effectiveness of nurses’ roles in the 4 phases of disaster response: mitigation, preparation, response and recovery.
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PurposeThe SARS epidemic in 2003 and the COVID-19 pandemic had a disruptive impact on countries around the world and highlight the importance of using scientific evidence to inform policy decisions and priorities during crises. The purpose of this article is to reflect upon the term “following the science” and examines the differences between SARS in 2003 and COVID-19.Design/methodology/approachThis study is exploratory, adopts a qualitative approach and reflects on the synthesis of scientific evidence into advice informing government decisions on health interventions. Random sampling of the literature was used to avoid bias and was guided by the keywords.FindingsIt considers preparedness activities and the need for these to be integral in the design of future planning. It argues that simulation exercises be intrinsically linked to all aspects of crisis management and provide the opportunity to use the scientific evidence base as part of preparedness planning. The article concludes that more transparency in the use of scientific advice in strategic decision-making would support building more resilience into health emergency preparedness through an integrated systems approach.Originality/valueThis article contributes to the literature on the evaluation of the “following the science” approach and its implementation. It also contributes to the limited literature on simulation exercising to deal with health crises, like pandemics and identifies potential areas for further research or work on developing an integrated systems approach to pandemic preparedness.
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