COVID-19 and the water sector: understanding impact, preparedness and resilience in the UK through a sector-wide survey.
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ABSTRACT:
SUBMITTER: Cotterill S
PROVIDER: S-EPMC7675279 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:OBJECTIVES:To present Emergency Preparedness, Resilience and Response (EPRR) guidance for Hospital Transfusion Teams on behalf of the National Blood Transfusion Committee emergency planning working group. BACKGROUND:The Civil Contingencies Act 2004 requires healthcare organisations to demonstrate that they can deal with major incidents while maintaining critical services. Recent mass casualty events and the use of transfusion-based resuscitation have highlighted the evolving role of the Hospital Transfusion Team. METHODS:This multi-disciplinary advice is informed by recent global and national experience, the 2018 NHS England clinical guidelines for Major Incidents, and stakeholder workshops. GUIDANCE:Transfusion staff should be familiar with local EPRR plans including casualty type and numbers. Staff should be exercised as part of wider Trust preparation, with documented roles and responsibilities. Transfusion support should be proactive and include blood issue, regulatory compliance and sample handling. Robust LIMS-compatible emergency identification systems are essential to minimise errors. Emergency stock management requires rapid assessment of existing stock and estimated demand before re-ordering. Initial demand should be based on 2 to 4 red blood cells (RBC) per patient admitted. Patients with significant haemorrhage may require further red cells and early haemostatic support. Where "universal" components are demanded, they should be gender appropriate. Senior staff should lead the response, log and communicate key decisions, and prepare for post-incident recovery. CONCLUSIONS:Transfusion teams have an important role in ensuring continuity of transfusion support. Teams should develop their EPRR plans based on local plans and national guidance. Emergency preparedness should include post-incident debriefing for ongoing staff support and future service improvement.
| S-EPMC7317494 | biostudies-literature
Project description:The COVID-19 pandemic required a wide range of adaptations to the way that water sector operated globally. This paper looks into the impact of the COVID-19 pandemic on Brazilian water sector and evaluates the water sector's organisational resilience from the lens of water professionals. This study uses British Standard (BS 65000:2014)'s Resilience Maturity Scale method to evaluate organisational resilience in water sector under two defined scenarios of before and during the pandemic. For this purpose, the self-assessment framework developed by Southern Water in the United Kingdom (based on BS 65000:2014), comprising of the core resilience elements of Direction, Awareness, Alignment, Learning, Strengthening, and Assurance, are used for evaluations. A qualitative-quantitative surveying method is used for data collection. A total of 14 responses to the whole questionnaire were received from May 2021 to August 2021, each representing one water company in Brazil (four local companies and ten state-owned ones). The analyses identified COVID-19 as a threat multiplier particularly to already existing financial challenges due to the pre-existing threats in water sector. Bad debt and the COVID-19 emergency measures are recognised as the main challenges by 21 % and 14 % of the survey respondents. The state-owned and local companies scored an almost similar maturity level 3, 35 % and 34 % respectively, while the local companies scored much lower at maturity level 4 i.e., 26 % as opposed to 47 % in state-owned sector. This indicates that COVID-19 has a greater impact on local companies and the needs to increase preparedness. This study replicates an international experience to raise awareness on water sector's resiliency in Brazil and how it can be improved to withstand future external shocks. It sheds light on how and what existing challenges can be exacerbated facing a global shock and proposes opportunities for improvement of resilience maturity in water sector in Brazil.
| S-EPMC9361783 | biostudies-literature
Project description:Although COVID-19 has impacted water and wastewater utilities in new and profound ways, they must still provide their vital services despite the disruptions. The pandemic brings into focus their need for proactive emergency preparedness. In the United States, professional associations have long advocated in this area and have already developed considerable policy guidance and resources to help water and wastewater utilities prepare for and respond to emergencies. In the midst of the crisis, several U.S. policies are reviewed here. Utilities should reflect on their COVID-19 experience, learn from it, and apply their newfound perspective to strengthen future emergency preparedness.
| S-EPMC7218402 | biostudies-literature
Project description:The outbreak of COVID-19 led to restrictions on movements and activities, which presented a serious challenge to the resilience of the water sector. It is essential to understand how successfully water companies responded to this unprecedented event so effective plans can be built for future disruptive events. This study aimed to evaluate how the water sectors in the UK and Ireland were affected from a holistic sustainability and resilience-based perspective. Using pre-COVID data for 18 indicators of company performance and comparing them to the first year of the pandemic, the direction and magnitudes of change varied across companies. Financial indicators were significantly negatively affected, with interest cover ratio, post-tax return on regulated equity, and operating profit, exhibiting the greatest average declines of 21%, 21%, and 18%, respectively, a trend that would be dangerous to provisions and company operations if continued. Despite this, service and environmental indicators improved during the first year of the pandemic, exemplified by unplanned outage, risk of sewer storm flooding, and water quality compliance risk decreasing by a mean average of 37%, 32%, and 27%, respectively. Analysis using the Hicks-Moorsteen Productivity Index concluded that average productivity increased by 35%. The results suggest that the water sector was relatively resilient to the COVID-19 pandemic in terms of services, but adverse effects may have manifested in a deteriorated financial position that could exacerbate future challenges arising from exogenous pressures such as climate change. Specific advice for the UK water sector is to scrutinize non-critical spending, such as shareholder payments, during periods of economic downturn to ensure essential capital projects can be carried out. Although results are temporal and indicator selection sensitive, we recommend that policy, regulation, and corporate culture embrace frameworks that support long-term resilience to since the relative success in response to COVID-19 does not guarantee future success against differing challenges. This study generates a timely yet tentative insight into the diverse performance of the water sector during the pandemic, pertinent to the water industry, regulators, academia, and the public.
| S-EPMC10080165 | biostudies-literature
Project description:ObjectiveTo assess the state of community disaster preparedness of Hong Kong residents and to identify factors associated with adequate preparedness behaviors.DesignA cross-sectional survey using random Global Positioning System (GPS) spatial sampling conducted from the 8 August 2015 to 6 September 2015.ParticipantsHong Kong residents aged 18 years or more.MethodA 19-item questionnaire was developed to assess respondents' preparedness information acquisition, communication plan, evacuation strategies, first-aid and disaster knowledge, financial resilience, and preparedness behaviors. In total, 1023 residents were interviewed at 516 GPS locations. Multiple logistic regression was used to identify factors associated with preparedness behaviors, defined as having an evacuation kit in our study.ResultsTelevision remains the key information source, both before and during disaster, with young respondents also favoring social media and the internet and elder residents preferring television and radio. Many respondents did not have adequate first-aid knowledge and few showed correct responses to a typhoon warning signal. Only 39.4% had an evacuation kit. In logistic regression, correct responses to first aid questions and a typhoon warning signal were significantly associated with kit preparation (OR 2.023, 95% CI 1.233-3.318, p=0.005). Residents with elderly household member(s) were significantly less likely to do so (OR 0.554, 95% CI 0.333-0.922, p=0.023).ConclusionsCommunity resilience-building programs should tailor information provision to different age groups with a focus on the family caregivers of elderly residents. There is a need to promulgate first-aid training and disaster education in the community.
| S-EPMC7103946 | biostudies-literature
Project description:The COVID-19 pandemic put dents on every sector of the affected countries, and the informal sector was no exception. This study is based on the quantitative analyses of the primary data of 1,867 informal workers of Bangladesh to shed light on the impact of the pandemic-induced economic crisis on this working class. The survey was conducted between 8 July and 13 August 2020 across the eight administrative divisions of the country. Analysis points out that about ninety percent of these workers faced an income and food expenditure drop during the lockdown. The effect was higher in males, particularly among the urban-centric and educated males engaged in services and sales. The findings suggest that policy support is needed for the informal workers to face such a crisis.
| S-EPMC8970377 | biostudies-literature
Project description:ObjectiveIn 2010, the European Society of Gastrointestinal Endoscopy delivered guidelines on the prophylaxis of postendoscopic retrograde cholangiopancreatography (post-ERCP) pancreatitis (PEP). These included Grade A recommendations advising the use of prophylactic pancreatic stent (PPS) and non-steroidal anti-inflammatory drugs (NSAIDs) in high-risk cases. Our study aim was to capture the current practice of UK biliary endoscopists in the prevention of PEP.DesignIn summer 2012, an anonymous online 15-item survey was emailed to 373 UK consultant gastroenterologists, gastrointestinal surgeons and radiologists identified to perform ERCP.ResultsThe response rate was 59.5% (222/373). Of the respondents, 52.5% considered ever using PPS for the prevention of PEP. PPS users always attempted insertion for the following procedural risk factors: pancreatic sphincterotomy (48.9%), suspected sphincter of Oddi dysfunction (46.5%), pancreatic duct instrumentation (35.9%), previous PEP (25.2%), precut sphincterotomy (8.5%) and pancreatic duct injection (7.8%). Prophylactic NSAID use was significantly associated with attempts at PPS placement (p<0.001). 64.1% of non-PPS users cited a lack of conviction in their benefit as the main reason for their decision. Self-reported pharmacological use rates for PEP prevention were: NSAIDs (34.6%), antibiotics (20.6%), rapid intravenous fluids (13.2%) and octreotide (1.6%). 6% routinely measured amylase post-ERCP.ConclusionsDespite strong evidence-based guidelines for prevention of PEP, less than 53% of ERCP practitioners use pancreatic stenting or NSAIDs. This suggests a need for the development of British Society of Gastroenterology guidelines to increase awareness in the UK. Even among stent users, PPS are being underused for most high-risk cases. Prophylactic pharmacological measures were rarely used as was routine post-ERCP serum amylase measurement.
| S-EPMC3977499 | biostudies-literature
Project description:BackgroundEmergencies and disasters impact population health. Despite the importance of upstream readiness, a persistent challenge for public health practitioners is defining what it means to be prepared. There is a knowledge gap in that existing frameworks lack consideration for complexity relevant to health systems and the emergency context. The objective of this study is to describe the essential elements of a resilient public health system and how the elements interact as a complex adaptive system.MethodsThis study used a qualitative design employing the Structured Interview Matrix facilitation technique in six focus groups across Canada. Focus group participants were practitioners from public health and related sectors. Data collection generated qualitative data on the essential elements, and interactions between elements, for a resilient public health system. Data analysis employed qualitative content analysis and the lens of complexity theory to account for the complex nature of public health emergency preparedness (PHEP). The unit of study was the local/regional public health agency. Ethics and values were considered in the development of the framework.ResultsA total of 130 participants attended the six focus groups. Urban, urban-rural and rural regions from across Canada participated and focus group size ranged from 15 to 33 across the six sites. Eleven elements emerged from the data; these included one cross-cutting element (Governance and leadership) and 10 distinct but interlinked elements. The essential elements define a conceptual framework for PHEP. The framework was refined to ensure practice and policy relevance for local/regional public health agencies; the framework has ethics and values at its core.ConclusionsThis framework describes the complexity of the system yet moves beyond description to use tenets of complexity to support building resilience. This applied public health framework for local/regional public health agencies is empirically-derived and theoretically-informed and represents a complex adaptive systems approach to upstream readiness for PHEP.
| S-EPMC6280369 | biostudies-literature
Project description:Resilience as a concept and resilience assessment as a practice are being explored across a range of social, ecological and technical systems. In this paper, we propose a new method and visualisation approach for interrogating the communication of resilience within organisational networks, using participatory social network analysis and message passing. Through an examination of the UK water sector organisational network, represented by multiple co-produced network graphs, we identify organisations having a key role in the communication of resilience regulatory and evidence messages, as well as highlighting the potential role of complexity tools in strategy formulation. Animations are presented showing the dynamics of resilience communication, which is discussed. Reflections on the use of participatory social network analysis are explored, as the method opens new doors to potentially examine how network changes could alter communication. Key insights highlight that perceived responsibilities for resilience in the UK water sector rest with a small core of organisations; water customers play a limited role in the two-way communication of resilience and water sector organisations do not communicate widely on resilience with other sectors (such as energy). Additionally, who an organisations' neighbours are and what catalyses a message to be passed are important in determining how quickly messages spread. Results lead to a recommendation that high level governmental and policy organisations should engage to a greater extent with new resilience knowledge and consider the use of complexity tools in policy making. Policy in relation to resilience is not keeping pace with such knowledge, limiting the communication and learning of organisations who ardently follow policy and regulation. For inter-organisational cooperation to make a difference to water governance, such organisations need to be encouraged to communicate and embed the latest approaches in relation to resilience and complexity thinking and practice.
| S-EPMC7533369 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic is a significant public health emergency that impacts all sectors of healthcare. The negative health outcomes for the COVID-19 infection have been most severe in the frail elderly dwelling in Canadian long-term care (LTC) homes.MethodsAn online cross-sectional survey of Ontario LTC Clinicians working in LTC homes in Ontario Canada was conducted to provide the clinician perspective on the preparedness and engagement of the LTC sector during the COVID-19 pandemic. The survey questionnaire was developed in collaboration with the Ontario Long-Term Care Clinicians organization (OLTCC) and was distributed between March 30, 2020 to May 25, 2020. All registered members of the OLTCC and Nurse-led LTC Outreach Teams were invited to participate. The primary outcomes were: 1) the descriptive report of the screening measures implemented, communication and information received, and the preparation of the respondent's LTC home to a potential COVID-19 outbreak; and 2) the level of agreement, as reported using a five-point Likert scale), to COVID-19 preparedness statements for the respondent's LTC home was also assessed.ResultsThe overall response rate was 54% (160/294). LTC homes implemented a wide range of important interventions (e.g. instituting established respiratory isolation protocols, active screening of new LTC admissions, increasing education on infection control processes, encouraging sick staff to take time off, etc). Ample communications pertinent to the pandemic were received from provincial LTC organizations, the government and public health officials. However, the feasibility of implementing public health recommendations, as well as the engagement of the LTC sector in pandemic planning were identified as areas of concern. Medical director status was associated with an increased knowledge of local implementation of interventions to mitigate COVID-19, as well as endorsing increased access to reliable COVID-19 information and resources to manage a potential COVID-19 outbreak in their LTC home.ConclusionsThis study highlights the communication and implementation of recommendations in the Ontario LTC sector, despite some concerns regarding feasibility. Importantly, LTC clinician respondents clearly indicated that better engagement with LTC leaders is needed to plan a coordinated pandemic response.
| S-EPMC7578587 | biostudies-literature