Health in Emergencies and Disasters Quarterly
Volume:9 Issue: 1, Autumn 2024

The coronavirus disease 2019 (COVID-19) pandemic affected all social, economic, and religious strata of life. An epidemic may result in the death of many people, which is more severe in the case of highly contagious diseases such as COVID-19 [1]. Corpse management of the disease victims includes a series of activities, from searching, finding, and organizing corpses to their storage, identification, documenting, and eventual delivery to their families for proper burial based on regional beliefs. Handling dead bodies is one of the most challenging aspects of the primary disaster response phase [2].

Earthquake, an unpredictable natural disaster, poses a significant threat to public health, causing physical, human, social, cultural, and economic damages [1]. Iran is among the world’s top 10 earthquake-prone countries—remembering earthquakes cause the greatest human casualties. Preparedness and safe behavior before and during earthquakes are crucially important to reduce the damage of earthquakes and prevent life-threatening incidents and property damage [2]. Each year, unexpected events affect 200 million people, resulting in economic losses of up to 3% of the affected countries’ GDP (gross domestic product). By observing safe behaviors during earthquakes, it is possible to reduce risks and prevent casualties and damages [3].

The COVID-19 pandemic has inflicted tremendous pressure on people, including older adults. Frail older adults are more susceptible to the adverse consequences of the pandemic. Although many studies have investigated the susceptibility and poor medical outcomes of COVID-19 in frail people, a few studies have explored the psychosocial effects of the pandemic on this group of vulnerable people. This study overviews the psychosocial consequences of the pandemic and necessary public interventions for frail older adults.

An integrative review method was utilized to gather, analyze, and structure the study data. PubMed, Web of Science, and Scopus databases were searched to extract the published English papers based on a designed strategy. The keywords and used Boolean operators in their titles or abstracts were ([“COVID-19” OR “CORONA” OR “SARS-CoV-2”] AND [“frail” OR “frailty”]). A total of 50 articles (47 quantitative, 2 qualitative, and 1 mixed method) were selected for the final analysis.

Anxiety and depression were reported as the most significant psychological consequences in the related studies. The results also indicated the social relations of older frail people and their access to health services noticeably reduced during the pandemic. On the other hand, physical exercise programs, telemedicine, and reading activities were the most preventive measures to mitigate the impacts of public restrictions during the pandemic.

The results of this review can assist policymakers in reflecting appropriate psychosocial support for frail seniors during the pandemic. As most studies on the psychosocial aspects of the COVID-19 pandemic among frail older adults are quantitative and have been performed in developed countries, it is suggested to conduct further qualitative studies. These studies should explore frail older adults’ experiences and perceptions and their challenges during the pandemic, particularly in developing countries.

Building fires are the most common threatening and distressing hazard in hospitals. Fire is one of the top 10 hazards that threaten Iranian hospitals. Nevertheless, no study has been done on the features of fires in Iran hospitals. So, this study aimed to investigate the characteristics of fires taking place in Iranian hospitals.

In this cross-sectional study, news related to fire broke out in Iranian hospitals was retrieved from the archive of 5 reputable Persian news agencies using the Persian search terms: “Fire”, “hospital”, and “clinic”. Quantitative content analysis was used to assess retrieved news text. Data gathered by the Emergency Operation Center of the Iranian Ministry of Health and Medical Education were also studied. 

In total, 86 incident reports were assessed for the period spanning from 2005 to 2020, with more than half accessed just through reputable news agencies. The electrical short circuit was the most reported incident cause, and the medical care environment was the most reported place of incident. Twenty-five incident reports indicated that partial or complete emergency evacuation was executed. 

It is imperative to raise awareness about the lack of an integrated mechanism for registering such incidents. Future research can be conducted designing a critical registry system that collects, analyzes, and disseminates hospital incident data.

Scene management in accidents reduces losses, speeds treatment, and facilitates immediate victim transfer. Learning the related skills through theory-based educational intervention makes this task possible. This study aimed to determine the effect of theory-based educational intervention on emergency medical personnel skills to manage the scene in chemical accidents.

The present study employed a quasi-experimental design with pre- and post-intervention measurements. Using the random sampling method, 70 emergency medical technicians working in Qazvin Province, Iran, were selected and assigned to experimental and control groups. The data collection tools included demographic questions and scales to assess the theory of planned behavior. The intervention program consisted of 4 sessions. Data were analyzed by SPSS software, version 23 using descriptive statistics and analysis of covariance.

The Mean±SD age of the participants was 35.03±5.57 years, and 82.6% (57 people) were married. After the intervention, the Mean±SD scores of attitudes (40.11±4.77), subjective norms (15.06±4.27), perceived behavior control (18.53±2.55), and behavioral intention (8.49±2.27) increased significantly in the experimental group (P<0.001). Also, the self-report behavior in the experimental group improved significantly (P<0.001). 

Theory-based educational intervention improved psychological variables and safe behaviors in chemical accident management. Implementing educational interventions based on this theory enhances the safety performance of medical emergency technicians in chemical accidents.

Temporary medical centers can properly compensate for the shortage of hospitals during biological emergencies. They bolster the capacity of medical centers regarding patient admissions, provide efficient care, and mitigate the progression of critical situations. This study aims to identify the advantages of setting up temporary medical centers in responding to the COVID-19 pandemic. 

This qualitative study engaged 25 people involved in managing temporary medical centers during the COVID-19 pandemic. The participants included patients, construction experts, and specialists who equipped and set up temporary medical centers in Tehran City, Iran. All had possessed a history of responding to biological agents. Considering the maximal diversity, the participants were selected based on work experience, age, gender, education level, and managerial background. The inclusion criteria comprised willingness to participate, ability to communicate with the interviewer, and informed consent. The exclusion criterion included the inability to continue the research. The study data were analyzed by MAXQDA-2020 software using the Graneheim and Lundman method. The results were validated against the Guba and Lincoln criteria.

Based on the results, the advantages of temporary medical centers were classified into 8 sub-themes: human-centered care, quick performance and response, helping the health system, preventing the burnout of treatment staff, saving the costs, justice and equality, leveling and providing classified services at various levels, and timely patient transfer. 

With specific criteria for accepting patients, temporary medical centers ensure their safety in care, help to break internal transmission, and pay attention to patients’ social and emotional needs. As a rapid response mechanism, they can answer to the current COVID-19 pandemic and other epidemics in future disasters. The result of this study can help manage biological emergencies in the future, as it presents a clear picture of the advantages of temporary treatment centers.

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.

This perspective article shows how Iran can develop its national disaster management system as seen through an expert’s review perspective.

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. 

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.

An ammonia gas explosion poses immediate health hazards such as respiratory tract burns, skin and eye irritation, and potential death within seconds. It also causes long-term negative impacts on biodiversity, affecting aquatic life and vegetation. An explosion in the Firuzabad sodium carbonate factory in Iran led to massive ammonia gas leakage and the poisoning of several employees. This study evaluates the risks of ammonia gas release caused by the explosion and the rescue team’s response in the same factory.

This study was conducted in 2020 in Firuzabad City, Iran. The investigation was based on case reports and data analysis obtained via field observations, document reviews, interviews, and experiments. Technical and specialized information on explosion were analyzed by ALOHA software.

Based on data analysis, red, orange, and yellow zones around the explosion area were identified. The red zone had an ammonia emission range of 1.2 km with an explosive power of 10 kW, causing potential death in 60 seconds. Orange zone had a range of about 1.7 km, an explosive power of 5 kW, and the potential for second-degree burns and respiratory damage within 60 seconds of release. The yellow zone covered an area of about 3.3 km. Interviews and field observations provided information on the risk-based response process, response equipment, medical treatment, hazardous materials, handling and response equipment, personal protective equipment, mutual aid, and resource typing.

The results of this study show that the immediate evacuation of the area, employment of the rapid warning system, the triage of the injured, the presence of an emergency operation plan to control hazardous and toxic materials disasters, the performance of the rapid response team and multi-specialty teams were among the existing challenges of the operation team. Background of this study confirms the potential hazards associated with ammonia gas emissions from explosions in sodium carbonate plants.