The 2005 London Bombings and the Haddon Matrix

Development of a Haddon Matrix Framework for Higher Education Pandemic Preparedness: Scoping Review and Experiences of Malaysian Universities During the COVID-19 Pandemic

Managing education and research during pandemics has increased in importance since the onset of epidemics such as avian flu, SARS and now CoViD-19. Successful management in times of crisis ensures business continuity and institutional survival, making preparedness preceding an impending pandemic essential. Institutions of higher education (IHEs) must maintain balance between academic continuity and preventing morbidity during a pandemic crisis. To date, however, no general pandemic preparedness frameworks exist for IHEs. The aim of this paper is to report on the development of a Haddon matrix framework for IHE pandemic preparedness based on a scoping literature review of past IHE responses including pre-, during and post-pandemic phases. First, a review of previous global responses by IHEs during past pandemics was carried out. The review findings were then collated into a new IHE-centric Haddon matrix for pandemic preparedness. The content of the matrix is then illustrated through the documented responses of Malaysian universities during the early stages of the COVID-19 pandemic. The resulting IHE Haddon matrix can be used by universities as a general guide to identify preparedness gaps and intervention opportunities for business continuity during pandemics.

Urban Food Supply Chain Resilience for Crises Threatening Food Security: A Qualitative Study

BACKGROUND

Businesses and organizations involved in growing, distributing, and supplying food may face severe disruptions from natural and human-generated hazards, ranging from extreme weather to political unrest. Baltimore, Maryland, is developing policies to improve local food system organizations' ability to prepare for, respond to, and recover from disruptive events and ultimately to contribute to food system resilience.

OBJECTIVES

To identify factors that may be associated with organization-level food system resilience, how these factors may play out in disaster response, and how they may relate to organizations' confidence in their ability to withstand disruptive events.

DESIGN

Semi-structured in-depth interviews with representatives of key food system businesses and organizations identified by means of stratified purposive sampling and snowball sampling.

PARTICIPANTS/SETTING

Representatives of 26 food system businesses and organizations in Baltimore stratified by two informant categories: organizations focused on promoting food access, such as governmental offices and nonprofits, and businesses and organizations involved in supplying and distributing food in Baltimore City, such as retailers, wholesalers, and producers.

ANALYSES

Interviews were analyzed using a phronetic iterative approach.

RESULTS

The following 10 factors that may contribute to organization-level resilience were identified: formal emergency planning; staff training; staff attendance; redundancy of food supply, food suppliers, infrastructure, location, and service providers; insurance; and post-event learning. Organizations that were larger, better resourced, and affiliated with national or government partners typically demonstrated more resilience factors compared with smaller, independent, and nonprofit organizations.

CONCLUSION

To ensure reliable access to safe food for all people, food system organizations must strengthen their operations to safeguard against a variety of potential threats. This study's examination of factors that contribute to resilience can help food system organizations, researchers, and government officials identify priorities for investigating vulnerabilities in diverse operations and potential strategies to improve resilience in the face of ongoing and growing threats.

The Use of Haddon’s Matrix to Plan for Injury and Illness Prevention at Outdoor Music Festivals

Introduction

Mass-gathering music events, such as outdoor music festivals (OMFs), increase the risk of injuries and illnesses among attendees. This increased risk is associated with access to alcohol and other drugs by young people and an environment that places many people in close contact with each other.

Aim

The purpose of this report was to demonstrate how Haddon’s matrix was used to examine the factors that contributed to injuries and illnesses that occurred at 26 OMFs using data from the Ranse and Hutton’s minimum data set.

Methods

To help understand the kinds of injuries and illnesses experienced, Hutton et al identified previous patterns of patient presentations at 26 OMFs in Australia. To develop effective prevention strategies, the next logical step was to examine the risk factors associated with each illness/injury event. The Haddon matrix allows event practitioners to formulate anticipatory planning for celebratory-type events.

Results

What was evident from this work was that the host, the agent, and the physical and social environments contributed to the development of injuries and illness at an event. The physical environment could be controlled, to a certain extent, through event design, safety guidelines, and legislation. However, balancing cultural norms, such as the importance placed on celebratory events, with the social environment is more difficult.

Discussion

The use of the Haddon matrix demonstrates that interventions need to be targeted at all stages of the event, particularly both pre-event and during the event. The opportunity to promote health is lost by the time of post event. The matrix provided vital information on what factors may contribute to injury at OMFs; form this information, event planners can strategize possible interventions.

HuttonA, SavageC, RanseJ, FinnellD, KubJ. The use of Haddon’s matrix to plan for injury and illness prevention at outdoor music festivals. Prehosp Disaster Med2015; 30(2):1-9

Developing a consensus framework and risk profile for agents of opportunity in academic medical centers: implications for public health preparedness

Agents of opportunity (AO) in academic medical centers (AMC) are defined as unregulated or lightly regulated substances used for medical research or patient care that can be used as "dual purpose" substances by terrorists to inflict damage upon populations. Most of these agents are used routinely throughout AMC either during research or for general clinical practice. To date, the lack of careful regulations for AOs creates uncertain security conditions and increased malicious potential. Using a consensus-based approach, we collected information and opinions from staff working in an AMC and 4 AMC-affiliated hospitals concerning identification of AO, AO attributes, and AMC risk and preparedness, focusing on AO security and dissemination mechanisms and likely hospital response. The goal was to develop a risk profile and framework for AO in the institution. Agents of opportunity in 4 classes were identified and an AO profile was developed, comprising 16 attributes denoting information critical to preparedness for AO misuse. Agents of opportunity found in AMC present a unique and vital gap in public health preparedness. Findings of this project may provide a foundation for a discussion and consensus efforts to determine a nationally accepted risk profile framework for AO. This foundation may further lead to the implementation of appropriate regulatory policies to improve public health preparedness. Agents of opportunity modeling of dissemination properties should be developed to better predict AO risk.

Burn Disasters—An Audit of the Literature

All events that result in disasters are unique, and it is impossible to become fully prepared. However, through thorough planning and preparedness, it is possible to gain a better understanding of the typical injury patterns and problems that arise from a variety of hazards. Such events have the potential to claim many lives and overwhelm local medical resources. Burn disasters vary in scope of injury and procedures required, and are much more labor and resource intensive than non-burn disasters.

This review of the literature should help determine whether, despite each event having its own unique features, there still are common problems disaster responders face in the prehospital and hospital phases, what recommendations were made from these disasters, and whether these recommendations have been implemented into practice and the current disaster planning processes.

The objective of this review was to assess: (1) prehospital and hospital responses used during past burn disasters; (2) problems faced during those disaster responses; (3) recommendations made following those disasters; (4) whether these recommendations were integrated into practice; and (5) the key characteristics of burn disasters and how they differ from other disasters. This review is important to determine why, despite having disaster plans, things still go wrong.