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Contains fulltext : 238976.pdf (Publisher’s version ) (Open Access) On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.

Objective:Operation based exercises represent simulation activities, which are of great importance for emergency preparedness, as they simulate real experiences in a guided manner. Whereas their primary purpose is to address the organizational emergency preparedness, little is known about the personal benefits of involved participants and whether these positive changes endure over time.Methods:Immediate and medium term assessment of the effectiveness on individual preparedness and benefits of participants, based on self-perception, after participating in a set of 4 interdisciplinary field exercises organized as part of the MSc in Global Health-Disaster Medicine of the Medical School of the National and Kapodistrian University of Athens, Greece. The field exercises were carried out yearly, from 2016 to 2019. Data were collected via questionnaires pre- and post-exercise (1 week and 10 months after participation). The sample size was 228 trainees, with a response rate of 88%.Results:The majority (95%) stated that Mass Casualty Incident (MCI) exercises are appropriate for disaster management training in terms of comprehending theory, and for team-building training. In the case of a real MCI, 22% of the participants declared themselves to be ready to respond prior to MCI exercises. Upon completion, the overall perception of readiness among the participants increased to 77%. Trainee feedback indicated enhancement of both technical and non-technical skills (87%), which were persistent over time, and revealed a high level of satisfaction with the training.Conclusion:This study shows a positive immediate and medium-term impact of operation-based exercises on technical, non-technical skills, and self-perception of participants.

Αbstract During the ongoing COVID-19 pandemic there is emerging evidence, from several European countries, suggesting drastic decline in emergency room (ER) visits. Two diametrically opposite hypotheses can be formulated: a) The altered lifestyle due to the lock-down measures as well as vast application of telemedicine has a beneficial effect on the health status of the majority of the adult population, reducing thus demand for emergency health services. b) Despite increased health needs, people choose to avoid interactions with the health system and the ER out of fear of getting infected with COVID-19 resulting in a health services underusage. ER and HS indicators can be useful in monitoring and interpreting the underlying causes of reduced hospital ER services demand. Investigating the causes of the decline in ER visits is of outmost public health relevance as it might shed light in the indirect health effects of COVID-19 pandemic.

Since December 2019, the world is potentially facing one of the most difficult infectious situations of the last decades. COVID-19 epidemic warrants consideration as a mass casualty incident (MCI) of the highest nature. An optimal MCI/disaster management should consider all four phases of the so-called disaster cycle: mitigation, planning, response, and recovery. COVID-19 outbreak has demonstrated the worldwide unpreparedness to face a global MCI.This present paper thus represents a call for action to solicitate governments and the Global Community to actively start effective plans to promote and improve MCI management preparedness in general, and with an obvious current focus on COVID-19.

Background In 2015-2016, more than a million refugees entered Greece. Along with other organizations, PRAKSIS, a local non-governmental organization, deployed mobile medical units on three islands and in temporary settlements in Athens. Methods This is a descriptive cross-sectional study aimed at analysing the demographic and clinical characteristics of the population (n=6688) that received services from PRAKSIS between October 2015 and June 2016 in different locations (islands of Samos, Kos and Leros in the southeastern Aegean Sea and on the mainland at Athens-Piraeus Port Gate E) before and after the closure of European borders in March 2016. Results The majority (88%) of the population came from Syria, Afghanistan and Iraq. Among them, 53% were women and children. Infectious diseases decreased as the population moved from the islands to the Athens-Piraeus Port, while all other disease categories increased in relative frequency, the difference being statistically significant (p

In the last three years, the European Union (EU) is being confronted with the most significant influx of migrants and refugees since World War II. Although the dimensions of this influx—taking the global scale into account—might be regarded as modest, the institutional response to that phenomenon so far has been suboptimal, including the health sector. While inherent challenges of refugee and migrant (R&M) health are well established, it seems that the EU health response oversees, to a large extend, these aspects. A whole range of emergency-driven health measures have been implemented throughout Europe, yet they are failing to address adequately the changing health needs and specific vulnerabilities of the target population. With the gradual containment of the migratory and refugee waves, three years after the outbreak of the so-called ‘refugee crisis’, we are, more than ever, in need of a sustainable and comprehensive health approach that is aimed at the integration of all of migrants and refugees—that is, both the new and old population groups that are already residing in Europe—in the respective national health systems.

Doctors in Greece face the possibility of encountering a person that has suffered torture, especially since the high rates of refugees’ and migrants’ inflows that took place over the last years. In order to assess the awareness and the knowledge of doctors and senior medical students in Greece regarding a manual on effective investigation and documentation of torture such as Istanbul Protocol (official United Nation document since 1999), a cross-sectional study was conducted using a structured anonymous questionnaire. The sample was doctors practicing in public hospitals in Greece, doctors volunteering at a non-governmental organization (NGO) and undergraduate medical students in their final year of studies in the Medical School of National and Kapodistrian University of Athens. The data were analyzed using IBM SPSS version 23, using descriptive statistics and statistical significance tests. In a total of 289 participants, the mean total score of Istanbul Protocol knowledge was 4.43 ± 1.104 (the maximum possible score was 10) and the mean total score of Istanbul Protocol awareness was 2.04 ± 1.521 (the maximum possible score was 10). The most important conclusion was that among doctors and senior medical students, there seem to be knowledge, awareness, and information deficit about Istanbul Protocol and several issues relating to torture. The overall research outcome highlights the need for the development of a relevant informative/educational program, in order to cover the corresponding existing needs of the population of doctors in Greece.

By its statute, the National and Kapodistrian University of Athens (NKUoA)—the oldest and more prestigious Institution of Higher Education in Greece-supports education at the highest level and promotes social cohesion (1). During this refugee crisis of enormous magnitude (2), NKUoA actively supports these vulnerable populations with a variety of immediate actions including healthcare services and integration actions ( Figure 1 ). Moreover, it supports collaborations among Institutional volunteer programs, local authorities, private non-profit foundations, NGOs, social partners and General State Administration (Ministry of Health). To ensure the transparency of the actions and inform public opinion about refugee crisis, a bulletin including updates on policies about refugees, with special interest in Greece, is released weekly under the auspice of NKUoA. NKUoA has also established an Action Watch-Solidarity Network for the refugees with the participation of more than 100 doctors and scientific bodies in order to offer immediate and coordinated volunteer actions, including administrative support, healthcare services and supplies.

As the south-easterly boarder of European Union, Greece has found itself standing for the gateway to the largest mass movement of populations across Europe since the end of World War II (1). Currently, refugees in Greece are estimated around 57,000 with the context of the crisis still evolving (2).