Author: Taybah Alam

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Willingness and Ability of Essential Workers to Work During the Pandemic

In an emergency disaster, essential workers are expected to report to duty. Research articles published over thirty years ago caution that emergency planners have to take into account that personnel has varying degrees of willingness and ability to report. For instance, during infectious disease outbreaks, the fear of contagion is greater, and “dilemmas of loyalty” or personal obligations can conflict with professional expectations leading to staff shortages.

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Healthcare workers’ ability and willingness to report to duty during catastrophic disasters

With the occurrence of a catastrophic disaster, it can be immensely difficult for healthcare systems to manage an acute and large influx of patients. During these acutely stressful periods, specialized efforts are required to keep up with the demand of space, resources, and healthcare professionals that can tend to the patients. In urban settings with high population densities, it is imperative to analyze how healthcare workers can respond to catastrophic events when there are discrepancies in staff availability.

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Dua Sheikh and Oumou Dao’s Disaster Plan for Flooding in Pakistan

Flooding is very prevalent in Karachi, Pakistan, due to dam malfunctions, broken glacial lakes, or heavy monsoon rains. Poor infrastructure and sewage systems further aggravate the issue. The National Disaster Management Authority (NMDA) of Pakistan coordinates responses to threatening disasters and the NYU students have developed a plan to partner the NMDA with the Orangi Pilot Project.

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Strategies to Improve Hospital Capacity During the COVID-19 Pandemic

This study used a stochastic discrete-event simulation (DES) model of a generic U.S.-based 200-bed tertiary hospital that has routine inpatient and outpatient services and covers COVID-19 and emergency cases. This model aims to show how the functionality of the hospital overall, within specific units, and within specialized designated care paths are impacted during various surge levels of COVID-19 patients. The 10 critical units that were included in this study are the Emergency Department (ED), Intensive Care Unit (ICU), Surgical Intensive Care Unit (SICU), Stepdown, Operating Rooms (ORs), internal general wards (IGW), ED Trauma, Preop, Post Anesthesia Care Unit (PACU), and laboratories.

In this investigation, operations details were modeled from the John Hopkins Hospital system and the John Hopkins Office of Critical Event Preparedness and Response. The four surge levels that were used (Getting Ready, Initial Onset, Outbreak, and Hot Spot) were categorized according to the influx of patients and capacity to treat. For instance, during the Hot Spot level, most of the hospital resources were re-directed to COVID-19 patient care paths.

The investigators ran each simulation for 62 days with the first twenty days considered as a warm-up period until the hospital reaches a steady state. Each outcome measured consisted of randomly generated activities given random values to capture the variability in day-to-day behaviors and situations of reality. 

Key findings suggest that during the initial onset, half the number of ED beds and three-fourths of the number of IGW beds can house 75% of the typical ED demand. However, excess ED beds will be depleted and ICU will not be able to accommodate as high as 67% of patients, indicating that the hospital will still need to turn away emergency patients. Additionally, with 25 COVID-19 patients and 200 emergency patients arriving daily, each ICU bed can house up to 5 patients per month, which will decrease to 3.5 since COVID-19 patients have longer hospital stays than routine cases.

During the outbreak surge level, increasing IGW bed space requires canceling elective surgeries. This creates opportunities for COVID-19 and routine emergency patients, who may have been otherwise turned away, to receive care. Treatment options that reduce ICU length of stay by at least one day should be prioritized since this enhances capacity by 24%. 

The Hot Spot surge level requires redesigning the hospital to accept COVID-19 patients only since this allows the facility to manage 5 times the usual number of cases. However, only threefold can be accommodated before standards of care start to diminish.  

This study provides strategies to improve hospital functionality since it has been a great area of concern when responding to the impacts of the pandemic.

Read the full study here.

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Evaluating the Psychological Effects of COVID-19 on Healthcare Workers

A cross-sectional study conducted in Pakistan revealed the extent of psychological effects on healthcare workers during the first wave of the COVID-19 pandemic. Using snowball sampling, 428 healthcare workers responded to a survey that used the Generalized Anxiety Scale (GAD-7) and the Patient Health Questionnaire (PHQ-9) to measure depression symptoms, and the Brief-COPE questionnaire to assess coping mechanisms. 398 doctors, nurses, and pharmacists were included in the study, one third reported having direct contact with COVID-19 patients, and only one third reported receiving training on infection prevention. The participants were found to have high levels of depression and anxiety, 78.7%, 13.1% 8.3% of respondents had none-mild, moderate, and severe anxiety respectively. 22% of HCW fulfilled the PHQ-9 scale’s criteria for depression, with respondents falling under the categories of minimal-none (35.9%), mild (42.2%), moderate (12.8%), moderately severe (7.3%), and severe (1.8%). Risk factors for developing worse depression scores included frontline work and not receiving infection prevention training. The most commonly sought-out coping mechanisms, such as religious coping, coping planning, acceptance, positive reframing, and substance misuse were measured in this study. The authors call on proactive steps to enhance resilience and protect the mental wellbeing of healthcare workers during the pandemic. 

Read the full study here. 

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I AM GPH interview with Dr. Robyn Gershon

Listen to this insightful interview with Dr. Robyn Gershon regarding the importance of promoting the health and safety of essential workers. Dr. Gershon speaks of the art and science of health protection, promotion, and empowerment of communities to take control of their health; from working on needle-stick injuries among health care workers to improving the standards that define how we conduct business in workplaces.

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Tiffany Hamil

Tiffany Hamil returned to NYU to complete a Doctor of Nursing Practice Degree at the NYU College of Nursing. After graduating with a Bachelor of Nursing from NYU, she worked throughout the Pediatrics Department for eight years. She obtained her Pediatric Nurse Practitioner degree from Columbia University while working as a full-time Registered Nurse.

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Cindy Martinez’s Independent Study Report on Skillsets in Public Health Disaster Management Practice

Cindy Martinez writes about the growing field of public health disaster management that demands analytical, critical, and problem-solving skills in its practitioners. According to data from a 2020 FEMA report, there is an increase in diverse emergency management programs, including non-traditional, military, and first-generation groups. This independent study conducts a quantitative study that collects responses from 6 NYU alumni graduates working in positions within the public health disaster preparedness and management field.  The majority of respondents reported that project management is the most important skillset in the field of practice, followed by time management and financial management. Since there is an abundance of disaster events globally, including the concurrent pandemic, Cindy recommends that students interested in the field should hone their skillsets to make them competitive and competent candidates after graduation. 

Read the independent study here, and download the presentation here.  

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Cindy Martinez Interviews Hannah Myers to Find Which Skills are in Demand Within the Practice of Public Health Disaster Management

Cindy Martinez conducted a wonderful interview with Hannah Myers, an Emergency Management Specialist in Texas, on the specialized skills required to be successful in the field of public health disaster management. They discussed the importance of pursuing opportunities to continue learning throughout a professional career and beyond. Hannah gives an example of training “on-the-job” when she learned a new skill set in weather monitoring and learned to use tools and equipment to measure and forecast the weather. Cindy also questions Hannah on how she applied the skills she learned from the courses she took when she was a student at NYU. Hannah reports that risk communication and project management were the most valuable since she uses these skills daily in her job. The emergence of COVID-19 helped create her position and Hannah recognizes that the field of public health disaster management is constantly evolving and will continue to grow.

Read the full interview here.