Findings from an Assessment and Inventory of a Regional, Decentralized Stockpile

Preparing for mass casualty events despite COVID-19

Preparedness for mass casualty events is essential at local, national, and global levels. Much more needs to be done by all stakeholders to avoid unnecessary morbidity and mortality despite the challenges that COVID-19 continues to present. In this editorial, we highlight the challenges and solutions for mass casualty incident preparations.

Rural infection preventionists' experiences during the COVID-19 pandemic: Findings from focus groups conducted with association of professionals in infection control & epidemiology (APIC) members

Background

SARS CoV-2, the virus that causes COVID-19, was identified and quickly developed into a pandemic in spring, 2020. This event posed immense difficulties for healthcare nationally, with rural areas experiencing different challenges than other regions.

Methods

The Association of Professionals in Infection Control & Epidemiology conducted focus groups with infection preventionist (IP) members in September and October, 2020. Zoom sessions were recorded and transcribed. Content analysis was used to identify themes.

Results

In all, 38 IPs who work at a critical access hospital or a healthcare facility in a rural location participated. Major challenges identified by IPs in this study included addressing the lack of access to personal protective equipment (PPE), overwhelming workloads caused by the pandemic and multiple roles/responsibilities, inaccurate social media messages, and generalized disbelief and disregard about the pandemic among rural community members.

Conclusions

Gaps in preparedness identified in this study, such as the lack of PPE, need to be addressed to prevent occupational illness. In addition, health disparities and inaccurate beliefs about COVID-19 heard by IPs in this study need to be addressed in order to increase compliance with public health safeguards among rural community members and minimize morbidity and mortality in these regions.

Quality Assurance Sampling Plans in US Stockpiles for Personal Protective Equipment: A Computer Simulation to Examine Degradation Rates

Medical countermeasure stockpiles in the United States are designed to support healthcare workers and the public during public health emergencies; they include supplies of personal protective equipment (PPE). As part of typical PPE manufacturing processes, appropriate test methods are used to ensure that the devices provide adequate protective performance. At the time of manufacture, performance is often measured and weighed against an objective standard of quality, resulting in a pass or fail attribute being assigned to individual PPE items and thence to production lots. Incorporating periodic performance testing for stockpiled PPE can ensure that they maintain their protective qualities and integrity over time while in storage. There is an absence of guidance regarding how to design quality assurance programs for stockpiled PPE. The applicability of the Lot Quality Assurance Sampling (LQAS) approach to stockpiled PPE was examined in a previous study that compared and contrasted different sample sizes in recovering the true percentage of defective units in large lots in the LQAS framework. The current study carries this line of inquiry forward by integrating PPE degradation over time and comparing different sampling time intervals in recovering the true underlying degradation rate. The results suggest that product degradation is more easily detected when tested at shorter time intervals and for higher degradation rates. They further suggest that sampling interval groupings can be made based on the proficiency with which they recover the true underlying degradation rate.

Emergency Medical Services Personnel's Pandemic Influenza Training Received and Willingness to Work during a Future Pandemic

Objective: Identify determinants of emergency medical service (EMS) personnel's willingness to work during an influenza pandemic. Background: Little is known about the willingness of EMS personnel to work during a future influenza pandemic or the extent to which they are receiving pandemic training. Methods: EMS personnel were surveyed in July 2018 - Feb 2019 using a cross-sectional approach; the survey was available both electronically and on paper. Participants were provided a pandemic scenario and asked about their willingness to respond if requested or required; additional questions assessed their attitudes and beliefs and training received. Chi-square tests assessed differences in attitude/belief questions by willingness to work. Logistic regressions were used to identify significant predictors of response willingness when requested or required, controlling for gender and race. Results: 433 individuals completed the survey (response rate = 82.9%). A quarter (26.8%, n = 116) received no pandemic training; 14.3% (n = 62) participated in a pandemic exercise. Significantly more EMS personnel were willing to work when required versus when only requested (88.2% vs 76.9%, X² = 164.1, p < .001). Predictors of willingness to work when requested included believing it is their responsibility to work, believing their coworkers were likely to work, receiving prophylaxis for themselves and their family members, and feeling safe working during a pandemic. Discussion: Many emergency medical services personnel report lacking training or disaster exercises related to influenza pandemics, and a fair percentage are unwilling to work during a future event. This may limit healthcare surge capacity and could contribute to increased morbidity and mortality. Findings from this study indicate that prehospital staff's attitudes and beliefs about pandemics influence their willingness to work. Pre-event training and planning should address these concerns.