According to the Centers for Disease Control and Prevention (2012), “…it is important to conduct surveillance to determine the extent and scope of the health effects on the affected populations…Public health surveillance during a disaster allows for the detection of potential disease outbreaks and track disease and injury trends.” In public health emergencies, decisions need to be made in a very short period, which is very different than a standard epidemiological investigation.
Please answer the following:
- Discuss a scenario (your experience if possible) when an attempt to control health problems was implemented. Be sure to focus on the health of a community, rather than the individual patients.
- How are rapid needs assessments used during disasters and emergencies?
EXAMPLES BELOW
- Discuss a scenario (your experience if possible) when an attempt to control health problems was implemented. Be sure to focus on the health of a community, rather than the individual patients.
In my last position as a phlebotomist, prior to covid, when a worker tested positive for influenza A or B, they were to stay home for 5 days from the positive test date. This was to prevent the illness spreading amongst the staff and/or patients. The area the employee worked within was sanitized to hopefully kill any lingering germs as well. If any others who worked closely with that employee displayed symptoms or just wanted to be tested, they were tested as well to try to prevent a major outbreak amongst staff, and the resulting short-staffing issue that would follow.
Precautions to prevent the spread of influenza during the peak season were that we had to mask and glove up before interacting with patients suspected of having the illness. They were quarantined in their clinic room as much as possible (to limit interaction with staff and other patients) so we would draw their blood there and take them to the nearest restroom for urine specimens. After the patient left the clinic, the room was disinfected with a spray including the blood pressure cuffs, and then the spray was left to dry naturally for the recommended timeframe. If a patient did make it down to the lab even though they were positive, we would try to take them back to their room if we caught it in time or shut that waiting room down and disinfect the seats, and then disinfect the phlebotomy chair they were drawn in as well. Hand washing as well as using hand sanitizer between patients while always encouraged was more thoroughly supervised.
How are rapid needs assessments used during disasters and emergencies?
According to the Community Assessment for Public Health Emergency Response (CASPER) rapid needs assessments (RNAs) provide reliable and actionable data during epidemics (Schnall et al., 2020). CASPER can be used by public health leaders and emergency managers to help them gather household-based information on a community to determine things like health status and basic needs (Schnall et al., 2020). CASPERs are useful for the following:
- Upholding petitions for financing or projects in the middle of restoration efforts.
- Appropriating limited supplies.
- Adapting crisis readiness strategy.
- Answering the communities’ particular needs like additional oxygen or medications.
- Directing information and instruction correspondence to the community.
- Supplying accurate facts to elected officials, news media, and other leadership to validate or eliminate gossip, or corroborate questions.
“Disaster surveillance helps to identify disaster related health problems; provides information to prevent or reduce injury, illness, or death; and helps guide prevention strategies for future disasters.” (Nakata et al., 2016)
References:
Nakata, N., Schnall, A., Wolkin, A., Noe, R., Burrer, S., & Bayleyegn, T. (2016). A Primer for Understanding the Principles and Practices of Disaster Surveillance in the United States: First edition. Centers for Disease Control and Prevention Division of Environmental Hazards and Health Effects National Center for Environmental Health Health Studies Branch. https://www.cdc.gov/nceh/hsb/disaster/Disaster_Surveillance_508.pdf
National Center for Environmental Health. (2020, August 20). Community Assessment for Public Health Emergency Response (CASPER). Centers for Disease Control and Prevention. https://www.cdc.gov/nceh/casper/default.htm
Schnall, A. H., Nakata, N., & Bayleyegn, T. (2020, August 20). Community Assessment for Public Health Emergency Response (CASPER) Toolkit Third Edition 3.2. Centers for Disease Control and Prevention | National Center for Environmental Health. https://www.cdc.gov/nceh/casper/default.htm
1) A recent experience of trying to control health problems was the shelter operations from the flooding in Pajaro, CA. We assisted both Santa Cruz and Monterey in opening the Santa Cruz County fairgrounds as a shelter operation for both the 1st and 2nd round of flooding/winter storms, in January and again in March. During the shelter operations, our peak shelter population was approx 500 survivors, located in 3 separate buildings at the Fairgrounds. We had plenty of illnesses going around including: Foot Rot/Trench Foot (Due to survivors wearing wet socks/shoes), Athlete’s foot due to shared shower stalls, COVID, common colds, flu, and Respiratory Syncytial Virus (RSV), which I learned is a common cold for most people but can become very dangerous and serious for infants and older adults.
Unfortunately, I even caught COVID while working these shelter operations and was sent home for 10 days to get better. The County emergency services and public health decided to make the smaller of the 3 buildings into a “quarantine” area for Survivors who were experiencing illness, the American Red Cross and local non-government organizations (NGOs) offered temporary hotel vouchers to families that tested positive for COVID, and once they were no longer positive, they would return to the congregate sheltering setting at the Fairgrounds. The health of the community was extremely important and continued to be the number one priority, including Survivors and personnel from all levels of government: Red Cross, County, State, and Federal workers and volunteers. However, Survivors were not forced to take COVID tests, nor was anyone required to show proof of vaccination, and wearing masks or PPE was optional within the shelter setting for workers and Survivors.
2) Rapid needs assessments are critical to gather essential information about the immediate needs of the affected population, which then assists in allocating resources in a quick and efficient manner. Of course, food, water, shelter, are the immediate need along with healthcare and safety. Data collected helps responders form an idea of the number of personnel, supplies, and equipment needed to serve the affected population and what unmet needs are left to focus on, and what strategies can be implemented to solve the unmet needs. By identifying these gaps, emergency managers are then able to plan and coordinate with other stakeholders who may offer those services. By understanding the population we are serving, we then understand the unique needs of the targeted audience, for example, vulnerable groups which can be children, elderly seniors, or people with disabilities that require specialized care and support.
In shelter settings, oftentimes there are great needs for Durable Medical Equipment (DME) which includes wheelchairs, walkers, oxygen tanks, AFN cots, etc. and if the County does not have the items, they can reach out to other partners for assistance. The data from the rapid needs assessment can also be used in an After Action Report (AAR) to raise awareness and advocate for increased resources and perhaps funding for the next response phase of a disaster. It’s a way to improve for future operations and we must understand that not all communities will have the same rapid needs during assessment.
References
Centers for Disease Control and Prevention. (2022, October 28). RSV (respiratory syncytial virus). Centers for Disease Control and Prevention. https://www.cdc.gov/rsv/index.html#:~:text=Respiratory%20Syncytial%20Virus%20(RSV)%20Infection&text=Respiratory%20syncytial%20(sin%2DSISH%2D,for%20infants%20and%20older%20adults.
G0557: Rapid Needs Assessment . Student Manual – FEMA. (n.d.). https://training.fema.gov/gstate/xcr3wnlp/g0557%20-%20rapid%20needs%20assessment/03%20sm/g0557%20sm.pdf
As a paramedic amidst the COVID-19 pandemic, a key aim was to manage the transmission of the virus and alleviate its consequences on the wider populace. The emphasis was not solely on providing medical care to individual patients, but also on executing public health interventions aimed at hindering additional transmission. Amidst the pandemic, a crucial responsibility entailed the execution of public health surveillance to oversee the magnitude and range of the virus’s influence on the populace. The task at hand encompassed the monitoring of disease patterns, detection of plausible epidemics, and collection of information to assess the efficacy of interventions. In my capacity as a paramedic, I fulfilled a crucial function in addressing emergency situations associated with COVID-19 by promptly evaluating and administering medical care to individuals in need. This entailed guaranteeing adherence to appropriate protocols aimed at averting transmission and safeguarding the well-being of both healthcare providers and patients. Disseminating information to the public regarding the prevention of transmission was a crucial component of the paramedic’s role amidst the pandemic. This entailed conveying the significance of measures such as donning masks, observing social distancing, and limiting non-essential outings.
Rapid needs assessments are a crucial instrument for expeditiously evaluating the requirements of populations impacted by calamities and crises. Population identification is a crucial aspect of disaster response efforts. It enables the determination of affected populations and their basic needs, including food, water, shelter, and medical care. Additionally, it facilitates the assessment of the immediate risk of disease outbreaks or injuries. Rapid needs assessments are customarily executed in the immediate aftermath of a calamity or crisis, with the aim of furnishing an initial appraisal of the prevailing circumstances. These can serve as a means to direct emergency response endeavors and facilitate the process of determining the optimal allocation of resources. Furthermore, they can aid in the identification of susceptible groups that may necessitate supplementary assistance, such as the elderly, individuals with medical ailments, or those who are homeless or experiencing poverty.
Sources:
Glenister, D., & Dowling, R. (2021). Paramedic practice during COVID‐19: Challenges and opportunities. The Australian Journal of Emergency Management, 36(2), 52-58. https://doi.org/10.26464/emanage.36.2.52
Santos, A., & Kutzin, J. (2018). Rapid needs assessment in disaster settings: what does it mean and what are the benefits? International Journal of Public Health, 63(8), 961-963. https://doi.org/10.1007/s00038-018-1134-2