The COVID-19 pandemic has caused clinicians at the frontlines to confront difficult decisions regarding resource allocation, treatment options, and ultimately the life-saving measures that must be taken at the point of care. This article addresses the importance of enacting Crisis Standards of Care (CSC) as a policy mechanism to facilitate the shift to population-based medicine. In times of emergencies and crises such as this pandemic, the enactment of CSC enables concrete decisions to be made by governments relating to supply chains, resource allocation, and provision of care to maximize societal benefit. This shift from an individual to a population-based societal focus has profound consequences on how clinical decisions are made at the point of care. Failing to enact CSC may have psychological impacts for healthcare providers particularly related to moral distress, through an inability to fully enact individual beliefs (individually-focused clinical decisions) which form their moral compass.
Objectives: Biological weapons are one of the oldest weapons of mass destruction used by man. Their use has not only determined the outcome of battles, but also influenced the fate of entire civilizations. Although the use of biological weapons agents in a terrorist attack is currently unlikely, all services responsible for the surveillance and removal of epidemiological threats must have clear guidelines and emergency response plans.
Methods: In the face of the numerous threats appearing in the world, it has become necessary to put the main emphasis on modernizing, securing, and maintaining structures in the field of medicine which are prepared for unforeseen crises and situations related to the use of biological agents.
Results: This article presents Poland’s current preparation to take action in the event of a bioterrorist threat. The study presents both the military aspect and procedures for dealing with contamination.
Conclusions: In Poland, as in other European Union countries fighting terrorism, preparations should be made to defend against biological attacks, improve the flow of information on the European security system, strengthen research centers, train staff, create observation units and vaccination centers, as well as prepare hospitals for the hospitalization of patients—potential victims of bioterrorist attacks.
Time is of the essence to continue the pandemic disaster cycle with a comprehensive post-COVID-19 health care delivery system RECOVERY analysis, plan and operation at the local, regional and state level. The second wave of COVID-19 pandemic response are not the ripples of acute COVID-19 patient clusters that will persist until a vaccine strategy is designed and implemented to effect herd immunity. The COVID-19 second wave are the patients that have had their primary and specialty care delayed. This exponential wave of patients requires prompt health care delivery system planning and response.
The unpredictable emergence of Coronavirus 2019 has proven to be challenging for many countries and their preparedness systems. In the heat of the current pandemic, initial interventions have been directed to the medical component of pandemic management, while other parameters such as tracing, retaining, and controlling the infection have been dismantled. It must be remembered that a defective water management system for drinking or personal use cannot only worsen the medical management of an emergency but can also contribute to spreading the disease or other water-borne conditions. This report highlights the significant use of water as a necessity for life and for controlling the pandemic.
Female Sex Workers are among those women who are significantly more vulnerable to violence. Apart from the human rights perspective, assessing the frequency of violence among sex workers is especially important because of its relation to the spread of HIV and other sexually-transmitted infections. This cross-sectional, observational study was conducted among 263 female sex workers in southern parts of Tehran and their suburban regions in 2017 where the population is considered more socially and economically vulnerable. To evaluate univariate analysis between sexual violence and physical violence as dependent variables and the assumed exposures as well as confounders, the models were built distinctly. The models included exposures of the questionnaire as independent variables. The exposure factors with a p value of less than 0.2 were moved into the multiple logistic regression models. The rates of sexual violence and physical violence were reported as 72.2% and 82.3% respectively. According to our results, sexual violence is associated with higher education, working in streets, drug usage, having the experience of forced unprotected sex and feeling of discrimination. Physical violence is associated with low education, drug usage and feeling of discrimination in multiple analyses. Addressing the violence against female sex workers is a complex multifactorial issue in Iran. It requires structural changes in some social, legal, economic and health infrastructure programs.
The review of the article, “Developing a Public Health Monitoring System in a War-torn Region: A Field Report from Iraqi Kurdistan,” prompted the writing of this commentary. Decisions to implement health data systems within Iraq require exploration of many otherwise undisclosed or unknown historical facts that led to the politicization of and ultimate demise of the pre-2003 Iraq war systematic health data monitoring system designed to mitigate both direct and indirect mortality and morbidity. Absent from the field report’s otherwise accurate history leading up to and following the war is the politically led process by which the original surveillance system planned for the war and its aftermath was destroyed. The successful politicization of the otherwise extensively planned for public health monitoring in 2003 and its legacy harmed any future attempts to implement similar monitoring systems in succeeding wars and conflicts. Warring factions only collect military casualty data. The field report outlines current attempts to begin again in building a systematic health monitoring system emphasizing it is the “only way to manage the complex post-war events that continue to lead to disproportionate preventable mortality and morbidity.”