Hantavirus: Emergency department respsonse to a disaster from an emerging pathogen

Brillman, Judith C.; Sklar, David P.; Davis, Kathleen; Beamsely, Alan

doi:10.1016/s0196-0644(94)70179-2

Cited by 12 publications

(8 citation statements)

References 13 publications

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“…2 Similarly, visits initially doubled during the Hantavirus outbreak in 1993, although this may have been related to a media campaign urging people to seek medical attention if they had flu-like symptoms. 1 We believe that, during the initial stage of the SARS outbreak, fear of contracting the illness in the ED led to a reduction in visits, and that this trend was exacerbated after media coverage intensified. Media coverage of the Washington E. coli 0157:H7 outbreak did not have a negative effect on ED visits, possibly because spread requires direct contact, because it is a well described illness, and because the outbreak was linked to having eaten at a specific restaurant chain.…”

Section: Discussionmentioning

confidence: 97%

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Effect of the SARS outbreak on visits to a community hospital emergency department

Heiber

Lou

2006

CJEM

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, 18%-24%) over the 4-week study period. The greatest reduction was for combined infant and toddler visits (69%; 95% CI, 58%-79%); these did not recover the following year. However, during the SARS outbreak there was a large increase in the number of visits for respiratory illnesses in adults (61%; 95% CI, 46%-75%) and in teenagers (132%; 95% CI, 82%-182%). Conclusions: During the SARS outbreak, total ED visits fell. The relative decline was most notable for infants and toddlers. By contrast, there was an increase in respiratory illness-related visits for adults and teenagers. In 2004, the year following the SARS outbreak, visit patterns shifted toward baseline levels, but ED visits by infants and toddlers remained depressed.

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Section: Discussionmentioning

confidence: 97%

“…In May 1993, a Hantavirus outbreak in the southwestern United States led to a 2-fold increase in ED visits, 1 and a 1993 Escherichia coli 0157:H7 outbreak in Washington state increased ED visits by 17%. 2 More recent articles have documented how SARS outbreaks in Hong Kong, 3 Taiwan, 4,5 and Toronto 6 reduced tertiary care ED visits.…”

Section: Introductionmentioning

confidence: 99%

Effect of the SARS outbreak on visits to a community hospital emergency department

Heiber

Lou

2006

CJEM

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“…Research increased. 30,31 The reason for this variation is unclear, but it seems likely that widespread dissemination of information about the contagiousness and potential severity of COVID-19 and SARS to the public may have played a role in the public's perception of these diseases. 32 We found that the largest reduction in ED CT examinations occurred for patients with CT examinations without critical test results and that CT examination yield for critical test results increased during the COVID-19 pandemic.…”

Section: Openmentioning

confidence: 99%

Effect of COVID-19 on computed tomography usage and critical test results in the emergency department: an observational study

Agarwal

Udare

Patlas

et al. 2020

cmajo

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(COVID-19) has had a major impact on the delivery of health care worldwide. 1 To prepare for a potential surge of patients with COVID-19 and to reduce the risk of COVID-19 transmission, many medical societies recommended that nonurgent medical procedures such as colonoscopy, Papanicolaou smears and mammography for cancer screening be delayed or rescheduled. 2-4 Preliminary data suggest that the volume of nonurgent procedures markedly decreased during the initial phase of the COVID-19 pandemic in North America. 5,6 Many governments issued policies for the provision of care; for example, the Ontario provincial government issued Directive 2 on Mar. 19, 2020, stating that all nonessential and elective health care services be stopped or reduced to minimal levels. 7 In addition to the COVID-19 pandemic's effects on the delivery of elective and nonurgent health care, there is evidence of a reduction in delivery of care for diseases requiring urgent management. Garcia and colleagues found a 38% reduction in cardiac catheterizations for ST-elevation myocardial infarction at the beginning of the pandemic in the United States. 8 They hypothesized that this may have been Effect of COVID-19 on computed tomography usage and critical test results in the emergency department: an observational study

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“…15 Yet, when a new illness (ultimately found to be the previously unknown Hantavirus) began killing people on New Mexico's Navaho reservation, emergency physicians, among others, continued to treat patients despite the risks. 16 And when SARS struck Asia and Canada in the early 2000s, most physicians and other health care professionals stayed to treat their patients. 17…”

Section: Will They Stay? Historical Precedentsmentioning

confidence: 99%

Fight or Flight: The Ethics of Emergency Physician Disaster Response

Iserson

Heine

Larkin

et al. 2008

Annals of Emergency Medicine

108

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Most disaster plans depend on using emergency physicians, nurses, emergency department support staff, and out-of-hospital personnel to maintain the health care system's front line during crises that involve personal risk to themselves or their families. Planners automatically assume that emergency health care workers will respond. However, we need to ask: Should they, and will they, work rather than flee? The answer involves basic moral and personal issues. This article identifies and examines the factors that influence health care workers' decisions in these situations. After reviewing physicians' response to past disasters and epidemics, we evaluate how much danger they actually faced. Next, we examine guidelines from medical professional organizations about physicians' duty to provide care despite personal risks, although we acknowledge that individuals will interpret and apply professional expectations and norms according to their own situation and values. The article goes on to articulate moral arguments for a duty to treat during disasters and social crises, as well as moral reasons that may limit or override such a duty. How fear influences behavior is examined, as are the institutional and social measures that can be taken to control fear and to encourage health professionals to provide treatment in crisis situations. Finally, the article emphasizes the importance of effective risk communication in enabling health care professionals and the public to make informed and defensible decisions during disasters. We conclude that the decision to stay or leave will ultimately depend on individuals' risk assessment and their value systems. Preparations for the next pandemic or disaster should include policies that encourage emergency physicians, who are inevitably among those at highest risk, to "stay and fight."

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Hantavirus: Emergency department respsonse to a disaster from an emerging pathogen

Cited by 12 publications

References 13 publications

Effect of the SARS outbreak on visits to a community hospital emergency department

Effect of the SARS outbreak on visits to a community hospital emergency department

Effect of COVID-19 on computed tomography usage and critical test results in the emergency department: an observational study

Fight or Flight: The Ethics of Emergency Physician Disaster Response

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