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Earthquakes, known for their widespread devastation, annually inflict catastrophic consequences globally. Swift and well-structured healthcare responses following earthquakes are pivotal in reducing their impact and mitigating loss of life. However, achieving this demands proactive strategic planning and effective preparedness before disaster strikes. While countries craft disaster response plans, their implementation often proves inadequate in managing the ensuing crisis comprehensively. This study proposes a paradigm shift by advocating for the utilization of widely accessible Family Health Centers (FHCs) as crucial hubs for post-earthquake healthcare continuity. Focused on these community-centric health units, our research delineates a strategic blueprint ensuring uninterrupted health services post an Istanbul earthquake. Integrating SWOT analysis, balanced scorecard, and operations research, this study holistically assesses the current landscape of FHCs and identifies imperative post-earthquake requisites. Insights gleaned from extensive literature review and expert consultations underpin this multifaceted approach. [ABSTRACT FROM AUTHOR]

Local perspectives provide different insights into disaster planning and response as compared to those of experts. Eliciting them, however, can be challenging, particularly for marginalised groups whose viewpoints have historically been excluded from planning processes. Fuzzy cognitive mapping (FCM) provides a semi‐quantitative approach to representing the collective understanding or ‘mental models’ of diverse individuals and communities. This study involved 23 FCM interviews across three neighbourhoods of Saint Martin to comprehend: (i) how individuals' mental models of Hurricane Irma (2017) differ based on their context; (ii) how aligned mental models are with policy and planning documents; and (iii) the implications for the inclusiveness and representativeness of disaster response policies. It found that the residents of different neighbourhoods provided unique insights into the factors driving the social‐ecological system, and that official policies aligned closely with priorities. The paper argues that the inclusion of the perspectives of different groups in disaster recovery is essential for an equitable process. [ABSTRACT FROM AUTHOR]

Background/Aim. Resuscitation and surgical medical aid are the most important medical procedures in disaster relief operations. The limited time frame available for lifesaving activities in such circumstances demands that resuscitation and surgical medical teams be established and trained for timely reaction and disaster medical support prior to disaster occurrence. The aim of the study was to analyze the awareness among the hospital medical staff in the Plovdiv Region of the hospital response plan in case of disaster, which concerns surgical and resuscitation team composition and tasks for disaster medical support. Methods. An anonymous survey, consisting of 55 questions about hospital staff awareness of the medical activities described in the hospital disaster medical support plan, was conducted between July and September 2019 among 295 hospital medical professionals in the Plovdiv Region, Bulgaria. Descriptive statistics and Pearson's χ2 test were used in the statistical analysis of results. Results. The survey showed that the majority of medical staff demonstrated complete ignorance regarding the presence, number, and tasks of the specialized medical teams planned for hospital disaster response. Employees of multidisciplinary hospitals for active treatment were more familiar with the aforementioned plans than their colleagues from the university multidisciplinary hospitals. Conclusion. Insufficient awareness about human resources foreseen for disaster medical support negatively impacts the hospital surge capacity, leading to inadequate medical assistance in such cases. Hospital tactical disaster preparedness must be ameliorated by conducting a more rigorous training program among medical staff related to the planned hospital activities in case of disastrous events, especially for those working in emergency departments, intensive care units, and surgical departments. [ABSTRACT FROM AUTHOR]

Preparedness to endure extreme situations such as natural disasters or military conflicts is not commonplace in healthcare training programs. Moreover, multidisciplinary teams in health services rarely (if ever) include experts in security. However, when emergency situations occur, prevailing healthcare demands do not cease to exist, and unexpected demands often surge due to the shortage of other services and supplies or as a consequence of the emergency condition itself. With services in 45 countries, AIDS Healthcare Foundation (AHF) has operated in several conflict zones, facing broad and challenging security demands. Since 2017 AHF has implemented the Global Department of Safety and Security (GDSS), a dedicated intelligence and safety program that had a key role in the security monitoring, preparedness, and defense responses, assisting staff members and clients during recent conflicts. In this manuscript, we describe the experience of AHF's GDSS in three recent military conflicts in Ethiopia, Myanmar, and Ukraine, and provide insights into steps that can be taken to assure staff safety and support the mission of caring for patients throughout catastrophic events. [ABSTRACT FROM AUTHOR]

Background/Aim. In the event of a disaster, it is necessary for medical personnel to demonstrate the operational component of disaster resilience, which requires certain knowledge and skills regarding disaster medical response algorithms. The aim of this study was to analyze the preparedness of hospital's healthcare staff for maintaining hospital disaster resilience. Methods. An anonymous survey was conducted from July to September 2019 among 295 medical staff employed in hospitals in the territory of the city of Plovdiv, Bulgaria. Pearson's Chi-square test, Student's t-test, and graphical analysis were used in the statistical analysis. Results. Most of the medical staff, i.e., 85.8%, believed that disaster drills are not held regularly in hospitals, 30.8% thought that the training period was shorter than two years, and the majority, i.e., 86.1%, did not participate in exercises. Conclusion. Due to the irregular implementation of exercises and the small number of participants in them, the level of preparedness for responding to disasters is not maintained at a high level in hospitals in the Plovdiv region. Therefore, it is necessary to introduce a specific training program and exercise once a year, which should have a beneficial effect on increasing the preparedness of the medical staff for disasters and improving the operational resilience of the hospital. [ABSTRACT FROM AUTHOR]

The purpose of this study is to determine the level of preparedness for disasters in Turkish hospitals and to determine whether hospital disaster preparedness differs depending on hospital characteristics. The population of this study consists of hospitals affiliated with the Ministry of Health. 210 hospitals were selected as the sample. Data were collected from the hospital directors and staff commissioned by the hospital using a questionnaire method. The Turkish version of the guide developed by the World Health Organization was used as the data collection form. The results of the survey revealed that the average score of hospitals was 156. 83±21. 43. The highest mean score was obtained for the command control subdimension (12. 93 ± 1. 37), and the lowest mean score was obtained for the human resources subdimension (22. 48 ± 4. 80). It was found that there was a large difference in the overall disaster prevention score depending on the number of patients per day per nurse. [ABSTRACT FROM AUTHOR]

Background: Floods are a natural hydrological hazard that causes human and environmental damage. In the response phase, evacuation is necessary to reduce deterioration. This study explains the influential factors on flood evacuation based on the opinion of the stakeholders. Materials and Methods: This is a conventional content analysis study conducted in 2021. A total of 27 participants were selected using the purposive sampling method. Data collection was performed using semi-structured interviews. Interviews continued until information saturation was reached. The recorded interviews were handwritten word by word and then analyzed. The criteria for entering the study included flood experience, the ability to communicate, and willingness to participate. The period of the interview was 40 to 70 min. Written consent was obtained from the interviewees for audio recording. The Granheim and Lundman method was used for data analysis. This study's reliability was based on the Goba and Lincoln method. Results: Data analysis extracted four main categories with ten sub-categories, including human factors (a subcategory of individual characteristics and risk perception), social factors (a sub-category of cultural conditions and financial status), geographical factors (a sub-category of urban location and climate conditions), and infrastructure factors (a sub-category of facilities related to transportation tools and routes, urban constructions, communication infrastructure, and meteorological facilities). Conclusion: Reaching a successful evacuation requires determining the relevant factors. These factors include human, social, geographic, and infrastructure factors. The findings of this study can help managers in flood management. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this article is to describe the planning, implementation, and findings of a "person with a weapon" exercise for an inpatient pharmacy department. Summary There has been an increased focus on workplace violence in healthcare within the last few years. The health-system pharmacy workforce should take an active role in planning for workplace violence events by completing a risk assessment analysis and performing tabletop and functional exercises. This study provides an example of how health-system pharmacists collaborated with an emergency management team, security, and communications to carry out a person with a weapon exercise in an inpatient hospital pharmacy. Areas for improvement were identified for pharmacy, communications, and security during education sessions and the tabletop and functional exercises, demonstrating the importance of a multidisciplinary approach when planning for a person with a weapon event. As a result of this exercise, there was increased awareness of the "run, hide, fight" tactic, an increase in workplace violence education and staff awareness, and an enhancement of security measures, including technology improvements. Conclusion This workplace violence exercise provides an example of how the pharmacy workforce can engage in emergency preparedness planning and risk mitigation for a workplace violence event. Other health systems can use the action plan, findings, and improvements to raise awareness and train about workplace violence events and support the safety of the pharmacy workforce. [ABSTRACT FROM AUTHOR]

On August 4, 2020, Lebanon suffered its largest mass casualty incident (MCI) to date: the Beirut Port blast. Hospital emergency response to MCIs is particularly challenging in low- and middle-income countries, where emergency medical services are not well developed and where hospitals have to rapidly scale up capacity to receive large influxes of casualties. This article describes the American University of Beirut Medical Center (AUBMC) response to the Beirut Port blast and outlines the lessons learned. The Beirut Port blast reinforced the importance of proper preparedness and flexibility in managing an MCI. Effective elements of AUBMC's MCI plan included geographic-based activation criteria, along with use of Wi-Fi messaging systems for timely notification of disaster teams. Crowd control through planned facility closures allowed medical teams to focus on patient care. Pre-identified surge areas with prepared disaster cart deployment allowed the teams to scale up quickly. Several challenges were identified related to electronic medical records (EMRs), including patient registration, staff training on EMR disaster modules, and cumbersome EMR admission process workflows. Finally, this experience highlights the importance of psychological debriefs after MCIs. Hospital MCI preparedness plans can integrate several strategies that are effective in quickly scaling up capacity to respond to large MCIs. These are especially necessary in countries that lack coordinated prehospital systems. [ABSTRACT FROM AUTHOR]

Background and research question: In case of events such as a cyber attack or a mass casualty incident, ad hoc measures have to be taken in hospitals. As part of the critical infrastructure, hospitals are required by law to prepare, update and exercise alarm and emergency plans for various special situations. The processes and instruments involved for emergency response are defined in the hospital alert and emergency planning. The present study aims to explain with which resources and for which special situations hospitals are prepared. Methods: A prospective, exploratory, anonymous survey of hospitals in Germany was conducted. Hospitals with both internal medicine and surgery departments were included. Out of 2497 hospitals listed in the German Hospital Directory (www.deutsches-krankenhaus-verzeichnis.de), 1049 met the inclusion criteria. After correcting for hospital groups with shared administrations, 850 employees were identified and contacted by e‑mail. Quality and risk management managers were asked about resources, risks, and content of their own hospital alert and emergency planning using a standardized questionnaire. The survey was conducted using the online platform EFS Survey (Tivian XI GmbH, Cologne) via www.unipark.de. Access to the survey was via a nonpersonalized hyperlink. Apart from the size and type of hospital surveyed, no data were collected that would allow identification of an individual person. Results: Of the participating hospitals 45% (n = 43) were primary care hospitals, 24% (n = 23) were specialty care hospitals, 10% (n = 9) were nonuniversity maximum care hospitals, and 21% (n = 20) were university maximum care hospitals. In total 95 hospitals participated in the survey, of which 98% (n = 93) reported having a hospital alert and emergency plan. Preparation for individual scenarios varied widely. Of the participating hospitals 45% (n = 43) reported having been the target of cyber attacks with an emphasis on maximum care hospitals (55%, n = 11 of 20). Technical redundancy for computer systems is available in 67% (n = 63) of participating hospitals, while independent means of communication exist in 50% (n = 47) of hospitals. A physician-staffed crisis and disaster management unit existed in 60% (n = 56) of the surveyed hospitals. At least a part time position for planning issues was installed in 12 hospitals. Conclusion: Most participating hospitals are aware of the need for a hospital alert and emergency plan and have various scenario-specific plans in place. Especially mass casualty events, fire and hospital evacuation scenarios are uniformly covered among participating hospitals; however, gaps appear to exist not only for chemical, biological or radionuclear situations but also especially in the area of extreme weather events and infrastructure failures. Only about two thirds of all participating hospitals have contingency plans for water supply and/or heating failures. An important limitation of the study is the comparatively low response rate of 12.9% (n = 95 of 850). While primary care hospitals were underrepresented in the study, 32% of Germany's larger hospitals (> 800 beds) participated. In the future, there is a particular need to engage enough medical staff in the area of hospital alert and emergency planning and refunding of these measures by hospitals. [ABSTRACT FROM AUTHOR]

The U. S. Department of Homeland Security launched the Ready public service campaign in 2003 to educate and provide the resources for the American people to prepare, respond, and mitigate emergencies and disasters. The web site provides tools for creating an emergency plan, and ways to stay informed and get involved in community preparedness. The goal of the web site and the campaign is to utilize public involvement to ease and lesson the affects of an emergency or disaster. [ABSTRACT FROM AUTHOR]

Background: A coordinated disaster response needs a well-organized structure and a locally adapted framework. In light of this, the COVID-19 pandemic offered an opportunity to renovate the response structure, which exhibited deficiencies during the pandemic. Iran shares the experience of an integrated response structure named the reform incidents command system (RICS). It includes an integrated approach in which the organization lacks a unified commander in favor of a set of goals. Materials and Methods: This perspective article shows how Iran can develop its national disaster management system as seen through an expert's review perspective. Results: This paper elaborates on the RICS concept. This concept removes the challenges of unifying different thoughts and objectives by instilling a shared mental model to improve teamwork. Conclusion: This is one of the first articles to discuss the main joint goals of team members, encouraging collaboration between different parts of the team when interdependent organizations must coordinate their responses. [ABSTRACT FROM AUTHOR]

The purpose of this study is to examine changes in services offered by academic libraries belonging to the Association of Research Libraries (ARL) in response to the COVID-19 pandemic during the 2020–2021 academic year. The study reports on aggregate safety precautions libraries took, based on a corpus of public-facing policies from 112 institutions, but also provides insight into whether political affiliation, library expenditures, and public or private institution status had any bearing on library safety precautions. Findings of interest include (1) library expenditures and public or private institutional status were unrelated to the extent of precautions libraries took to prevent the spread of COVID-19 and (2) academic libraries in states with Republican governors were significantly more likely to employ fewer COVID-19 safety precautions than academic libraries in states with Democratic governors. The article concludes with a discussion of the partisan response to the COVID-19 crisis and provides recommendations for libraries based on the findings. [ABSTRACT FROM AUTHOR]

Disasters have always occurred in libraires, generally confined to regional areas, or singular buildings. However, COVID-19 has affected libraries across the globe. This research looks at the effect COVID-19 had on libraries' in the United States disaster planning. It seeks to understand if disaster plans were created in preparation or created in response to a disaster. This research showed that even as the COVID-19 pandemic continued, libraries were beginning to discuss revising their disaster plans to reflect the lessons learned. However, it is too soon to know the lasting impact that the pandemic will have on disaster planning in libraries. [ABSTRACT FROM AUTHOR]

As Türkiye is affected by various disasters due to its geographical location, steps are being taken for risk reduction policies on an urban scale against these disasters. The phenomenon of urbanization, which started with the Industrial Revolution, has come to include laws and regulations regarding disaster management over the years. The material and moral destruction caused by the 1999 Marmara earthquake and the February 6, 2023, Kahramanmaraş earthquake in Türkiye's history show the need to re-examine disaster management policies that have been going on for years. In this context, the main topic of the study is the analysis of the impact of the studies carried out for disasterresistant cities on the urbanization process over time. The study considers the period starting with the Proclamation of the Republic in 1923. It examines the laws and regulations put into effect until 2023, the disasters experienced, the damages they caused, and the work done after the disaster. The relationship between disaster and studies on disaster and their impact on the urbanization process has been analyzed under four main period headings. As a result of examining the effect of disaster management policies implemented in the last hundred years on the country, it is important to consider the long-term effects of future works within the scope of urbanization to revise the architectural perspective in building design towards disaster and to ensure that the control mechanism operates following the relevant regulations. It is also recommended that the laws that will be put into effect in the future should be sustainable and applicable and provide the potential to become a city resilient to possible disasters together with the relevant stakeholders. [ABSTRACT FROM AUTHOR]

To survive the 2017/18 water crisis in the Western Cape Province of South Africa and to prepare for a challenging water future, the Western Cape Government developed and implemented plans to ensure water supply to certain of its critical service delivery facilities through the use of localized groundwater supply systems. The case study research of this programme provides both current and future disaster preparedness planners with an improved understanding of the levels of water resilience achievable through this strategy and the methodology to best achieve it. This also enables the critical success factors in pursuing this strategy to be distilled. [ABSTRACT FROM AUTHOR]

BACKGROUND: The threat of a disaster or potential for a disaster is something that may be experienced by individuals globally. Schools are places of daily mass gatherings which make them an ideal target for mass casualty, natural disasters, and biological incidents. METHODS: An integrative review using Whittemore and Knafl's model was conducted to explore peer‐reviewed publications about K‐12 schools and natural disasters and pandemic preparedness and planning. RESULTS: Themes identified from the systematic review of 12 articles reflected determinants and level of school preparedness, disaster plan components, compliance with government requirements, emergency equipment, supplies, drills, and training, collaboration with outside agencies, and perceptions of school preparedness. Preparedness for disasters and biological events among schools varies and multiple factors contribute to the level of preparedness. Perceptions of school preparedness differ among school community members. Schools perceive more preparedness for disasters than their actual level. CONCLUSIONS: Our nation's schools are not adequately prepared for disasters. There is a need for further research in schools to identify and understand preparedness for disasters. [ABSTRACT FROM AUTHOR]

Australia was a world leader in managing the earlier waves of the COVID‐19 pandemic. Subsequently, three major turning points changed the trajectory of the pandemic: mass vaccinations, emergence of more transmissible variants and re‐opening of Australia's borders. However, there were also concomitant missteps and premature shifts in pandemic response policy that led to mixed messaging, slow initial vaccination uptake and minimal mitigation measures in response to the Omicron variant. The latter marked Australia's entry into a new phase of (or approach to) the pandemic: widespread transmission. This led to an exponential increase in cases and significant impacts on the health system, particularly, EDs. This paper reflects on this phase of the pandemic to urge for system‐level changes that instal better safeguards for ED capacity, safety and staff well‐being for future pandemics. This is essential to strengthening our health system's resilience and to better protecting our communities against such emergencies. [ABSTRACT FROM AUTHOR]

Background: Social vulnerability occurs when the disadvantage conveyed by poor social conditions determines the degree to which one's life and livelihood are at risk from a particular and identifiable event in health, nature, or society. A common way to estimate social vulnerability is through an index aggregating social factors. This scoping review broadly aimed to map the literature on social vulnerability indices. Our main objectives were to characterize social vulnerability indices, understand the composition of social vulnerability indices, and describe how these indices are utilized in the literature. Methods: A scoping review was conducted in six electronic databases to identify original research, published in English, French, Dutch, Spanish or Portuguese, and which addressed the development or use of a social vulnerability index (SVI). Titles, abstracts, and full texts were screened and assessed for eligibility. Data were extracted on the indices and simple descriptive statistics and counts were used to produce a narrative summary. Results: In total, 292 studies were included, of which 126 studies came from environmental, climate change or disaster planning fields of study and 156 studies were from the fields of health or medicine. The mean number of items per index was 19 (SD 10.5) and the most common source of data was from censuses. There were 122 distinct items in the composition of these indices, categorized into 29 domains. The top three domains included in the SVIs were: at risk populations (e.g., % older adults, children or dependents), education, and socioeconomic status. SVIs were used to predict outcomes in 47.9% of studies, and rate of Covid-19 infection or mortality was the most common outcome measured. Conclusions: We provide an overview of SVIs in the literature up to December 2021, providing a novel summary of commonly used variables for social vulnerability indices. We also demonstrate that SVIs are commonly used in several fields of research, especially since 2010. Whether in the field of disaster planning, environmental science or health sciences, the SVIs are composed of similar items and domains. SVIs can be used to predict diverse outcomes, with implications for future use as tools in interdisciplinary collaborations. [ABSTRACT FROM AUTHOR]

The article presents recommendations for nonantidote medications in the emergency department (ED) during a mass casualty incident (MSI). It describes the use of medications for ED patients during surge capacity including analgesics, anesthetics, anti-infectives, vasoactive agents, respiratory agents and alternative medications during drug shortages. Emphasis is given on the importance for hospitals to develop MCI management plans that address gaps in preparedness.

Recent scholarship has explored the impact of interest groups on policy in the United States. However, little remains known about lobbying efforts and their effects in emergency management. Through analysis of a large data set of declared political activities from 1999 to 2020, we describe lobbying efforts in disaster planning and emergencies. Our findings suggest that lobbying efforts and expenditure are positively associated with appropriations (but not disaster incidence or severity), that corporations and trade associations are the organizations most involved in lobbying and that many of these efforts appear to be aimed at impacting legislation and the procurement of public funds for recovery efforts. We also find that only a minuscule number of lobbying efforts are related to socially vulnerable populations or social equity concerns. Collectively, these insights raise important questions about this process, demonstrating the need for further research to better understand lobbying and emergency management in the United States across all phases of the disaster life cycle. [ABSTRACT FROM AUTHOR]

Background: Maintaining the performance of healthcare centers during an earthquake is essential. Evaluating the seismic vulnerability of these centers is a priority. This study aims to evaluate seismic vulnerability using geographic information systems (GIS) in urban and rural health service centers of Hamadan Province, Iran, in 2021. Materials and Methods: This is a descriptive, analytical cross-sectional study that was conducted in comprehensive health centers. The data of this study were collected in the form of a questionnaire and a map and analyzed using the hierarchical analysis model. In the study, 10 criteria, such as the type of materials, the age of the building, the quality of the building, the number of floors, the area of the centers, as well as the distance from the existing fault lines, and the proximity to the hazardous centers, are defined using a valuation questionnaire, using the chain analysis method, weighting and prioritizing, and using GIS, vulnerability maps of comprehensive urban and rural health centers of Hamadan province were obtained. Results: Among the indices, the distance from the fault index with a weight of 0.328 has the highest and the area distance with a weight of 0.17 has the lowest final weight. The vulnerability distribution of the centers included 46.99% very low vulnerability, 7.23% low vulnerability, 5.42% moderate vulnerability, 20.48% high vulnerability, and 19.88% very high vulnerability. Conclusion: Considering that many urban and rural health service centers are vulnerable to seismic hazards, it is necessary to strengthen vulnerable centers against earthquakes. [ABSTRACT FROM AUTHOR]

A European response plan to burn mass casualty incidents has been jointly developed by the European Commission and the European Burn Association. Upon request for assistance by an affected country, the plan outlines a mechanism for coordinated international assistance, aiming to alleviate the burden of care in the affected country and to offer adequate specialized care to all patients who can benefit from it. To that aim, Burn Assessment Teams are deployed to assess and triage patients. Their transportation priority recommendations are used to distribute outnumbering burn casualties to foreign burn centers. Following an appropriate medical evacuation, these casualties receive specialized care in those facilities. The European Burns Association's disaster committee developed medical-organizational guidelines to support this European plan. The experts identified fields of interest, defined questions to be addressed, performed relevant literature searches, and added their expertise in burn disaster preparedness and response. Due to the lack of high-level evidence in the available literature, recommendations and specially designed implementation tools were provided from expert opinion. The European Burns Association officially endorsed the draft recommendations in 2019, and the final full text was approved by the EBA executive committee in 2022. The resulting 46 recommendations address four fields. Field 1 underlines the need for national preparedness plans and the necessary core items within such plans, including coordination and integration with an international response. Field 2 describes Burn Assessment Teams' roles, composition, training requirements, and reporting goals. Field 3 addresses the goals of specialized in-hospital triage, appropriate severity criteria, and their effects on priorities and triage. Finally, field 4 covers medical evacuations, including their timing and organization, the composition of evacuation teams and their assets, preparation, and the principles of en route care. • These guidelines support the European burn disaster response plan in four fields. • National preparedness is a prerequisite and should link with international response. • Casualties should be assessed by deployed Burn Assessment Teams in a shared standard. • Specialized in-hospital triage should guide casualty transport and burn center referral. • Medical evacuations need careful planning, preparation, coordination and implementation. [ABSTRACT FROM AUTHOR]

Flash-flooding affected Iran in March 2019 causing the displacement of thousands of people. Social workers established a Child Friendly Space (CFS) and applied comprehensive case management to provide psychosocial support for people who were affected by flooding (PWAF) (n = 565) in a community in Poldokhtar, covering a period of 3 months. Outreach services, involving community-volunteers, providing counseling, establishing CFS, training PWAF for reducing violence, and preventing child abuse were essential social work post-disaster interventions to support vulnerable populations. The article reflects upon the often-neglected role of social workers in post-disaster settings, and brings new material for discussion from the unexplored field of Iranian social workers. [ABSTRACT FROM AUTHOR]

The Caribbean region is highly vulnerable to multiple hazards. Resultant impacts may be derived from single or multiple cascading risks caused by hydrological-meteorological, seismic, geologic, or anthropological triggers, disturbances, or events. Studies suggest that event records and data related to hazards, risk, damage, and loss are limited in this region. National Disaster Risk Reduction (DRR) planning and response require data of sufficient quantity and quality to generate actionable information, statistical inferences, and insights to guide continual policy improvements for effective DRR, national preparedness, and response in both time and space. To address this knowledge gap, we review the current state of knowledge, data, models, and tools, identifying potential opportunities, capacity needs, and long-term benefits for integrating Earth Observation (EO) understanding, data, models, and tools to further enhance and strengthen the national DRR framework using two common disasters in Jamaica: floods and landslides. This review serves as an analysis of the current state of DRR management and assess future opportunities. Equally, to illustrate and guide other United Nations Disaster Risk Reduction (UNDRR) priority countries in the Pacific region, known as Small Island Developing States (SIDS), to grapple with threats of multiple and compounding hazards in the face of increasing frequency, intensity, and duration of extreme weather events, and climate change impact. [ABSTRACT FROM AUTHOR]

In this article four main things are done. First, the difference between 'disaster preparedness' and the established field of 'disaster planning' is denoted. The latter, confusingly, is seen as post hoc aftermath response rather than prepared forethought. Second, there is a discussion about the similarities between 'disaster clean-up' in Roman times which was extorted as taxation from the poor to subsidize the rich and neo-liberal taxation policy in today's advanced economies, which similarly expropriate the poor to enable the rich to extort more wealth at the poor's expense. Third, we explore some weaknesses of ostensibly 'green' policy-making, which betrays traits of narcissism, egotism and vanity which should be avoided at all costs because they occasion failure and further raids on the taxpayer base in many cases. Finally, 10 papers are introduced, ranging from varieties of 'circular City', to rainfall harvesting, green space accounting and transition to wooden construction and revitalization of urban shrinkage settings. [ABSTRACT FROM AUTHOR]

This study aims to explore the association of hospital infection prevention and control (IPC) structure (i.e. a dedicated IPC team and/or IPC committee) and IPC capacity in Korean hospitals, as well as its implications in the response and preparedness to COVID-19. This was a cross-sectional study using data collected through a nationwide survey. Participating hospitals completed an online questionnaire. Participation was voluntary. The survey questionnaire was developed by the government in consultation with IPC experts. The questionnaire was distributed to 2108 hospitals, including both acute and long-term care hospitals. The independent variables were the presence of an IPC team and/or IPC committee. The dependent variables were IPC activities and capacity measures, which were based on the World Health Organisation (WHO) recommendations on the core components in IPC. A total of 1442 hospitals completed the survey. Hospitals with IPC structures conducted significantly more IPC activities in all outcome measures compared with hospitals without IPC structures, with the exceptions of monitoring hand hygiene and screening for infectious diseases that showed non-significant differences. Hospitals with IPC structures showed a significant difference in performance in IPC risk assessment, operating outbreak response teams and appraisal of hospital IPC policies compared with hospitals without IPC structures. The presence of a dedicated IPC team and IPC committee was associated with increased IPC activities and IPC capacity. Hospitals with IPC teams and IPC committees showed strong implementation of planning, appraisal, resource management and outbreak response, indicating that strengthening IPC structures within hospitals is the key to more effective IPC and disaster response. [ABSTRACT FROM AUTHOR]

Small island developing States, such as those in the Pacific, are often prone to multiple hazards that have potential to result in disaster and / or restrict development. Hazard data can be limited in resolution or omitted in or near SIDS' coasts, but a growing and improved range of datasets are becoming available. Through an analysis of approximately 100 policy documents on hazards and disaster risk management in Pacific island nations, we found: limited information on hazards and how they manifest to disasters at local levels, thus not fully connecting drivers and subsequent risk; at times a non-specific multi-hazard approach prompting the need to address more specific hazards; and restricted temporal and spatial scales of analysis that potentially limit continuity of actions where mitigation methods evolve. These limitations suggest that appropriate and timely high resolution hazard data is needed from the top-down to underpin the design and development of local disaster risk management plans, simultaneous to local, bottom-up knowledge and interpretation to bring the realities of such hazard data to life. Developing and ensuring openly available hazard data will enable island States to develop more robust, inclusive disaster risk management plans and mitigation policies, plus aid inter-island comparison for communal learning. [ABSTRACT FROM AUTHOR]

Background: Burn care is centralized in highly specialized burn centers in Europe. These centers are of limited capacity and may be overwhelmed by a sudden surge in case of a burn mass casualty incident. Prior incidents in Europe and abroad have sustained high standards of care through well-orchestrated responses to share the burden of care in several burn centers. A burn mass casualty incident in Romania in 2015 sparked an initiative to strengthen the existing EU mechanisms. This paper aims to provide insight into developing a response plan for burn mass casualties within the EU Civil Protection Mechanism.Methods: The European Burns Association drafted medical guidelines for burn mass casualty incidents based on a literature review and an in-depth analysis of the Romanian incident. An online questionnaire surveyed European burn centers and EU States for burn mass casualty preparedness.Results: The Romanian burn mass casualty in 2015 highlighted the lack of a burn-specific mechanism, leading to the late onset of international transfers. In Europe, 71% of respondents had existing mass casualty response plans, though only 35% reported having a burn-specific plan. A burns response plan for burn mass casualties was developed and adopted as a Commission staff working document in preparation for further implementation. The plan builds on the existing Union Civil Protection Mechanism framework and the standards of the WHO Emergency Medical Teams initiative to provide 1) burn assessment teams for specialized in-hospital triage of patients, 2) specialized burn care across European burn centers, and 3) medevac capacities from participating states.Conclusion: The European burn mass casualty response plan could enable the delivery of high-level burn care in the face of an overwhelming incident in an affected European country. Further steps for integration and implementation of the plan within the Union Civil Protection Mechanism framework are needed. [ABSTRACT FROM AUTHOR]

Background: Knowledge on healthcare utilization after mass trauma is needed to strengthen the public health preparedness to such incidents. Using register-based data, this study had a unique opportunity to investigate how young survivors' use of primary care physicians (PCP) and mental health services (MHS) changed after a terrorist attack. Methods: We examined register-based data on PCP and MHS consultations among 255 survivors (52% male) of the 2011 Utøya youth camp attack in Norway 3 years before and after the attack, and their reason for encounter with the PCP according to the International Classification for Primary Care (ICPC− 2). Results: The PCP and MHS consultation rates (CR) were higher in female than male survivors both acutely and at long-term. The mean yearly CRs increased from 2.25 to 4.41 for PCP and 1.77 to 13.59 for MHS the year before and after the attack in female survivors, and from 1.45 to 3.65 for PCP and 1.02 to 11.77 for MHS in male survivors. The third year post-attack CRs for PCP were 3.55 and 2.00; and CRs for MHS were 5.24 and 2.30 in female and male survivors, respectively. Among female survivors, 76% consulted PCP and 12% MHS the year preceding the attack; post-attack 93% consulted PCP and 73% MHS the first year; decreasing to 87 and 40% the third year. Among male survivors, 61% consulted PCP and 7% MHS the year preceding the attack; post-attack 86% consulted PCP and 61% MHS the first year, and 67 and 31% the third year. As for PCP consultations, there was a particular increase in psychological reasons for encounter following the attack. Conclusions: This study indicates that it is important to anticipate an increased healthcare utilization several years following mass trauma, particularly of MHS. Both PCP and MHS practitioners played important roles in providing healthcare for psychological problems in young survivors of terrorism in a country with universal and largely publicly financed healthcare and a gatekeeping system. The healthcare utilization could be different in countries with other health systems or psychosocial care responses to mass trauma. [ABSTRACT FROM AUTHOR]

Background: Despite the increased demand for nurses worldwide, discussion of nurses' duty to care is lacking. This study aimed to examine nurses' duty to care during the coronavirus disease 2019 (COVID-19) pandemic and to identify the influencing factors. Methods: This was a cross-sectional descriptive research study that used a structured online questionnaire. Registered Korean nurses answered a demographic questionnaire and the Nash Duty to Care Scale. Results: Age and employment at tertiary hospitals increased nurses' duty to care. Male sex, a highly educated status, and employment at tertiary hospitals increased the perceived risk. Male sex and employment at tertiary or general hospitals increased confidence in the employer, while a high level of education and a longer total clinical career decreased the same. Age and a higher monthly wage increased perceived obligation. Age, lack of religious beliefs, and clinical experience of 3–7 years increased professional preparedness. Conclusion: Without enough nursing manpower, the disaster response system could prove to be inefficient. Considering that adequate nurse staffing is essential in disaster management, it is crucial to ensure that nurses have a will to provide care in the case of disaster. In the future, a more active discussion on nurses' duty to care and additional research on factors that may hinder and facilitate the same are needed. [ABSTRACT FROM AUTHOR]

LGBTQ+ communities comprise 16 million individuals in the United States, yet this population is often rendered invisible within disaster policies. Bias in federal disaster response programmes, a lack of recognition of LGBTQ+ families, and the prevalence of faith‐based organisations in disaster relief services together heighten the risks that LGBTQ+ individuals face. This paper describes the ways in which this reality combines with the contextual vulnerability of LGBTQ+ communities, whereby existing inequalities and marginalisation are exacerbated during disasters and in their aftermath. As a result, the immediate trauma of a disaster, such as physical injury or the loss of loved ones or possessions, is compounded in multiple ways for LGBTQ+ individuals, making them less likely to benefit from disaster relief services. To address these inequalities, the paper concludes with a set of policy recommendations to inform prevention, mitigation, and recovery planning, as well as to reduce the impacts of disasters on LGBTQ+ individuals. [ABSTRACT FROM AUTHOR]

Although the field of crisis management has grown considerably, academic curricula do not seem to have kept pace. This study investigates how library and information science (LIS) programs are addressing the need to provide adequate and relevant crisis management course content, so as to better empower librarians and other information professionals during community-based disasters and unpredictable circumstances. Twenty-eight ALA-accredited MLIS programs were evaluated. A four-phase model for evaluating crisis management content in LIS education (CM-LIS) has been developed. Crisis management topics were identified and categorized under the four phases: landscape survey, strategic planning, crisis management, and organizational learning. Six broad LIS subject modules were also identified to analyze the percentage of coverage of these topics. In the 264 course syllabi evaluated, curricula indirectly prepare librarians on how to meet and respond to crises and disasters within their communities; however, in many cases, this is given low priority. There is not a strong consideration for natural disasters and the societal calamities and unrest that dominate the media and occupy the minds of individual communities. This study gives insight into crisis-management education within LIS graduate degrees and should stimulate additional research to further investigate the preparedness of librarians and other information professionals to interact with communities in need in times of crises. [ABSTRACT FROM AUTHOR]

Among other business types, hotels serving as temporary accommodation for visitors with solid ties to local conditions present unique hazard-prone characteristics, and show vulnerabilities based on their location. Departing from the significance of the topic for the Turkish case, this paper focuses on the risk perception and responsiveness of the lodging industry. In doing so, an empirical study was carried out in Ankara city. Data from 75 hotels were gathered via a questionnaire designed to identify their locational attributes and operationalized by multiple logistic regression analysis. Although hotels in the sample accepted that safety is a significant issue for both the continuity of their operationality and guests, hotels were reluctant in developing systematic and effective tools for disaster management.. [ABSTRACT FROM AUTHOR]

Purpose: Assess whether full-scale simulation exercises improved hospital pharmacies' disaster preparedness.Methods: Swiss hospital pharmacies performed successive full-scale simulation exercises at least four months apart. An interprofessional team created two scenarios, each representing credible regional-scale disasters involving approximately fifty casualties (a major road accident and a terrorist attack). Four exercise assessors used appraisal forms to evaluate participants' actions and responses during the simulation (rating them using five-point Likert scales).Results: Four hospital pharmacies performed two full-scale simulation exercises each. Differences between exercises one and two were observed. On average, the four hospitals accomplished 69% ± 6% of the actions expected of them during exercise one. The mean rate of expected actions accomplished increased to 84% ± 7% (p < 0.005) during exercise two. Moreover, the average quality of actions improved from 3.0/5 to 3.6/5 (p = 0.01), and the time required to gather a crisis management team drastically decreased between simulations (from 23 to 5 min). The main challenges were communication (reformulation) and crisis management. Simulation exercise number one resulted in three hospital pharmacies creating disaster action plans and the fourth improving its already existing plan.Conclusion: This study highlighted the value of carrying out full-scale disaster simulations for hospital pharmacies as they improved overall institutional preparedness and increased staff awareness. The number of expected actions accomplished increased significantly. In the future, large-scale studies and concept dissemination are warranted. [ABSTRACT FROM AUTHOR]

Disaster assistance in the United States has faced criticism for widening the unequal impacts of disasters, but little is known about whether and how this phenomenon applies to businesses. Small businesses make up most businesses in the United States, but they are particularly vulnerable to hazards given their relative lack of capital. Because recovery assistance to businesses is primarily loan based, this lack of capital can create conflicts in how aid is perceived and allocated. Assistance providers must balance aiding the most severely damaged businesses and lending to those that will be able to repay; for small business, the threat of additional debt can make even low-interest loans seem risky. With this research I attempted to better understand how these competing factors play out in recovery through regression analyses of approved loan amounts and loan utilization decisions in Galveston (TX) after Hurricane Ike. I found that businesses with higher repayment ability such as larger businesses, older businesses, and corporations were approved for high loan amounts. Smaller businesses, businesses with higher damage, and businesses with longer loan terms were less likely to use the loans in their recovery, despite being approved. These findings suggest that businesses with the resources to recover were more likely to be the ones benefiting from additional disaster assistance. These findings suggest that planners may need to create their own recovery programs specifically targeting subgroups of businesses that are important to their communities. Although important to many economic development initiatives, very small businesses, entrepreneurs, and sole proprietors may not benefit from federal assistance, particularly if they were severely damaged. [ABSTRACT FROM AUTHOR]

Willingness to Respond (WTR) is the measurement of employees' preferences to come to work during off-hours when needed. Are these answers given before a disaster realistic? Another question of the study was, "Can we speed up the required staff to reach the hospital?" WTR survey has applied to emergency service staff. After that, the off-duty staff was called to work at a time they did not know beforehand. The study tried to identify how much WTR reflected the reality. Ninety of 98 (91.8%) participants whose surveys were evaluated answered "Yes" to "If you are called in case of disaster, would you come to duty?" question. When asked whether they will come to work according to disaster types, this rate was measured as 36.7% in "In the case of an infectious disease of which treatment is not clear". WTR surveys can be used to predict the level of participation of staff on off-hours in meeting the need for additional labor. These surveys' results can be expected to be similar to the labor participation rates in case of a real disaster and the arrival time of the staff at the hospital can be improved with new communication methods. [ABSTRACT FROM AUTHOR]

The use of motor vehicles to initiate mass casualty incidents is increasing in frequency and such events are called intentional vehicular assaults. Perpetrators are inspired by a range of terrorist ideologies or have extremist views, criminal intent, or mental health issues. Assaults using a motor vehicle as the principal weapon of attack are easy to launch and require little to no forward planning. This makes them difficult for police and security agencies to predict, prevent, or interdict. With the increasing frequency of intentional vehicular assaults, anaesthesiologists in various settings may be involved in caring for victims and should be engaged in preparing for them. This narrative review examines the literature on vehicle assaults committed around the world and provides an overview of the unique injury patterns and considerations for the pre-hospital, perioperative, and critical care management of victims of these mass casualty events. The article discusses planning, education, and training in an attempt to reduce the mortality and morbidity of intentional vehicular assaults. [ABSTRACT FROM AUTHOR]

Public participation is the democratic gateway to more just, inclusive, and resilient communities. However, infrastructure and hazard mitigation planning tends toward topdown, expert-driven processes that fail to meaningfully include communities most at risk of disasters. In this article, we critically examine the potential of citizen science in infrastructure and hazard mitigation planning with a focus on stormwater infrastructure and extreme wet-weather events, as floods are the most common disaster in the US. We review literature on various citizen science approaches, from crowdsourcing to community science, and offer a framework that situates them within Sherry Arnstein's foundational piece on public participation, a "Ladder of Citizen Participation." We discuss the opportunities different participatory methods offer for meaningful public involvement, knowledge generation, and ultimately community control and ownership of stormwater and flood infrastructure. We provide case study examples across the US of how public works departments, emergency management, and related organizations have engaged communities around hazard risks and flooding challenges, and offer recommendations for how these programs can be improved. We conclude that in order to produce data needed to mitigate flood disasters and increase trust and public interest in infrastructure needs, civic participation should be grounded in community science, utilizing a multimedia and technological platform. The methods applied and data generated can be leveraged toward public safety, and provide voice, agency, and power particularly to disenfranchised communities most at risk from current hazards and looming climate change impacts. [ABSTRACT FROM AUTHOR]

Post-acute and long-term care (PALTC) residents are disproportionately affected by coronavirus 2019 (COVID-19). We describe a health system approach that incorporated PALTC stakeholders to treat residents effectively and efficiently with monoclonal antibodies during the pandemic. Retrospective observational. Integrated health system headquartered in Sioux Falls, South Dakota, with urban hub and surrounding rural communities. Patients of the health system include PALTC and assisted living (AL) residents of facilities. Monoclonal Data Registry captured time to infusion after a positive COVID-19 test, residency (independent or PALTC), and site of infusion (PALTC, hospital outpatient, infusion center). AL residents are included in PALTC data. Registry limited to patients living in SD. Communication and operational resources were tailored to support PALTC infusions. The monoclonal antibody therapy administered to PALTC residents during the first 6 weeks after emergency use authorization (EUA) of monoclonal antibodies was bamlanivimab. The EUA for bamlanivimab was revoked due to lack of effectiveness against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants on April 16, 2021. The results are analyzed for the 6 weeks after bamlanivimab EUA. In PALTC, there was a median of 3 days between positive test and infusion. The total number of monoclonal antibody infusions captured in the registry during this time was 87 PALTC on-site infusions. A collaborative approach between health system executives and PALTC experts quickly enabled access to potentially life-saving therapy to a vulnerable population. PALTC settings should be routinely included in health system investment and planning to improve the capacity of the system to achieve optimal outcomes, prevent unnecessary mortality, and preserve health care resources. [ABSTRACT FROM AUTHOR]

To our knowledge, this is one of the pioneering studies that examined the associations between changes in different dimensions of social vulnerability from 2000 to 2016 on damage levels resulting from Hurricane Harvey. The empirical work was based on data obtained from the FEMA Modeled Building Damage Assessments Harvey 20170829 and the Agency for Toxic Substances and Disease Registry (ATSDR)'s Geospatial Research, Analysis & Services Program (GRASP). Results from linear mixed effects modeling and the spatial error and CAR models suggested that damage level was determined by certain aspects of social vulnerability; the level of damage increased with inundation depth, population aging, and the proportion of minority population. Efforts to promote resilience in natural disasters should focus on individuals living in areas characterized by increases in population aging and minority population. Results also revealed that certain processes associated with economic growth and urban development might affect an area's resilience and susceptibility to natural disasters and the processes associated with disaster response and mitigation. [ABSTRACT FROM AUTHOR]

The article discusses a pharmacy incident command structure's (PICS) organized response to disaster in 2021. Topics covered include its hierarchy of team functions that address pharmacy-specific incident responses, its sections of communications, employee safety, clinical, drug-use policy/formulary, operations, and logistics, each led by a section chief, and the chief pharmacy officer direction of all PICS activities. Also noted is the PICS's efficient response to the coronavirus pandemic.

Background Hospital inpatient and intensive care unit (ICU) bed shortfalls may arise due to regional surges in volume. We sought to determine how interregional transfers could alleviate bed shortfalls during a pandemic. Methods We used estimates of past and projected inpatient and ICU cases of coronavirus disease 2019 (COVID-19) from 4 February 2020 to 1 October 2020. For regions with bed shortfalls (where the number of patients exceeded bed capacity), transfers to the nearest region with unused beds were simulated using an algorithm that minimized total interregional transfer distances across the United States. Model scenarios used a range of predicted COVID-19 volumes (lower, mean, and upper bounds) and non–COVID-19 volumes (20%, 50%, or 80% of baseline hospital volumes). Scenarios were created for each day of data, and worst-case scenarios were created treating all regions' peak volumes as simultaneous. Mean per-patient transfer distances were calculated by scenario. Results For the worst-case scenarios, national bed shortfalls ranged from 669 to 58 562 inpatient beds and 3208 to 31 190 ICU beds, depending on model volume parameters. Mean transfer distances to alleviate daily bed shortfalls ranged from 23 to 352 miles for inpatient and 28 to 423 miles for ICU patients, depending on volume. Under all worst-case scenarios except the highest-volume ICU scenario, interregional transfers could fully resolve bed shortfalls. To do so, mean transfer distances would be 24 to 405 miles for inpatients and 73 to 476 miles for ICU patients. Conclusions Interregional transfers could mitigate regional bed shortfalls during pandemic hospital surges. [ABSTRACT FROM AUTHOR]

Nursing home residents are an at-risk population during disaster situations, and nursing homes face unique challenges in managing disasters. Nursing home social service departments can support their nursing homes in meeting the needs of residents during disasters, yet there is little research exploring their involvement. To address this gap, we use secondary data from the 2019 National Nursing Home Social Service Directors' study to explore social service directors' and their departments' involvement in disaster preparedness and response, and personal- and nursing home-level characteristics that predict involvement. Results show that nursing home social service directors and their staffs are predominantly involved; 61.9% (n = 562) of respondents stated always participating, and an additional 20.3% (n = 184) usually participating in disaster planning. The age of the director significantly predicted involvement, with older directors being most likely to always be involved. Further research is needed to understand why some nursing homes involve their social service directors in disaster planning and others do not, what roles those directors play, and to identify strategies to increase involvement within this role. [ABSTRACT FROM AUTHOR]

During a mass casualty disaster drill at NewYork-Presbyterian's Lower Manhattan Hospital in April 2019, the Emergency Department (ED) used telemedicine to see low-acuity 'walking wounded' patients. This telemedicine service is provided every day as ED Express Care Service and staffed by off-site, board-certified Emergency Medicine attending physicians. This novel use of the ED Express Care Service allowed the ED to provide timely, safe, quality care while expanding resources and ED capacity through rapid assessment, treatment and discharge of the low-acuity patients. [ABSTRACT FROM AUTHOR]

During a mass casualty disaster drill at NewYork-Presbyterian's Lower Manhattan Hospital in April 2019, the Emergency Department (ED) used telemedicine to see low-acuity 'walking wounded' patients. This telemedicine service is provided every day as ED Express Care Service and staffed by off-site, board-certified Emergency Medicine attending physicians. This novel use of the ED Express Care Service allowed the ED to provide timely, safe, quality care while expanding resources and ED capacity through rapid assessment, treatment and discharge of the low-acuity patients. [ABSTRACT FROM AUTHOR]

Background: Global evidence from the past 35 years confirmed the protective effect of breastfeeding and supported the guidance to protect, promote, and support breastfeeding practices, particularly in natural disaster and conflict settings. This study aimed to summarize the difficulties faced by disaster responders and mothers for optimal infant feeding during disasters in middle and high-income countries. Methods: A scoping literature review was conducted by searching databases for peer-reviewed literature and grey literature published between January 2010 and December 2018 that focused on infant feeding in the aftermath of disasters. Only disasters that occurred in middle or high-income countries as defined by the World Bank for the 2018 fiscal year were included. Results: The study found that a major challenge faced by organizations establishing infant feeding in emergencies (IFE) programs is the violation of The International Code of Marketing of Breastmilk Substitutes by other aid organizations and governments, such as acceptance of donated infant formula and untargeted distribution of formula. Additionally, many disaster responders were unfamiliar with IFE protocols. Mothers faced other barriers to breastfeed their infants during disasters. They often lacked privacy or spaces conducive to breastfeeding. Limited fluid and energy intake, stress, and exhaustion also deterred mothers from breastfeeding. Many challenges for responders and barriers mothers face for optimal infant feeding practices persist despite existing guidelines. Conclusions: The findings of this study reveal the lack of IFE preparedness and response capacity in middle and high-income countries, and the need for governments and aid organizations to adapt guidelines and establish policies and programs to support infant feeding in emergencies. [ABSTRACT FROM AUTHOR]

Background: During public health emergencies, people with opioid use disorder (PWOUD) may be particularly impacted. Emergent disasters such as the COVID-19 pandemic disrupt already-strained harm reduction efforts and treatment availability. This study aims to answer three research questions. How do public health emergencies impact PWOUD? How can health systems respond to novel public health emergencies to serve PWOUD? How can the results of this scoping review be contextualized to the province of Alberta to inform local stakeholder responses to the pandemic?Methods: We conducted a scoping review using the 6-stage Arksey and O'Malley framework to analyse early-pandemic and pre-pandemic disaster literature. The results of the scoping review were contextualized to the local pandemic response, through a Nominal Group Technique (NGT) process with frontline providers and stakeholders in Alberta, Canada.Results: Sixty one scientific journal articles and 72 grey literature resources were included after full-text screening. Forty sources pertained to early COVID-19 responses, and 21 focused on OUD treatment during other disasters. PWOUD may be more impacted than the general population by common COVID-19 stressors including loss of income, isolation, lack of rewarding activities, housing instability, as well as fear and anxiety. They may also face unique challenges including threats to drug supplies, stigma, difficulty accessing clean substance use supplies, and closure of substance use treatment centres. All of these impacts put PWOUD at risk of negative outcomes including fatal overdose. Two NGT groups were held. One group (n = 7) represented voices from urban services, and the other (n = 4) Indigenous contexts. Stakeholders suggested that simultaneous attention to multiple crises, with adequate resources to allow attention to both social and health systems issues, can prepare a system to serve PWOUD during disasters.Conclusion: This scoping review and NGT study uncovers how disasters impact PWOUD and offers suggestions for better serving PWOUD. [ABSTRACT FROM AUTHOR]