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Waring S, Bromley C, Giles S. Evaluating emergency service response to COVID-19: A scoping review. Int J Health Plann Manage 2024; 39:1009-1021. [PMID: 38215038 DOI: 10.1002/hpm.3767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 01/06/2024] [Indexed: 01/14/2024] Open
Abstract
INTRODUCTION The issue of how emergency services (police, fire, ambulance, local authorities) respond to pandemics has received greater research focus recently in relation to the COVID-19 outbreak, which saw agencies going beyond usual roles to support communities for prolonged periods. A critical appraisal is needed of this published evidence to take stock of what is known about the effectiveness of emergency service response to Covid-19. METHOD A scoping review of scientific and grey literature identified 17 qualitative (N = 9), quantitative (N = 6), or mixed methods (N = 2) studies from across the UK and internationally that focus on the effectiveness of emergency service response to the Covid-19 outbreak. A narrative review was conducted using an interpretive approach. Papers were read, summarised, and then sorted into inductive themes that addressed some aspect of the review question. Eight critical themes emerged from the narrative review. RESULTS Across countries, emergency services were required to quickly adapt working practices to reduce spread of infection, support partner agencies facing unprecedented demands, and make effective use of limited resources. Use of technology, access to timely, accurate and relevant information, strong leadership, prior experience, and emergency training were critical to this. However, most research is descriptive rather than evaluative. CONCLUSIONS Overall, findings highlight the need for further research that examines what mechanisms facilitate and hinder emergency response to pandemics. This scoping review provides a knowledge framework for informing future research that can support emergency services in preparing for events of national and international significance.
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Affiliation(s)
- Sara Waring
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Caitlin Bromley
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
| | - Susan Giles
- Department of Psychological Sciences, University of Liverpool, Liverpool, UK
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Olani A, Beza Demisse L, Alemayehu M, Sultan M. Factors Associated with Willingness to Call Emergency Medical Services for Worsening Symptoms of COVID-19 in Addis Ababa, Ethiopia. Open Access Emerg Med 2022; 14:563-572. [PMID: 36285006 PMCID: PMC9588289 DOI: 10.2147/oaem.s380566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/30/2022] [Indexed: 11/05/2022] Open
Abstract
Background In response to the COVID-19 pandemic, the Ethiopian Ministry of Health has established ambulances and dispatch centers specifically designed to transport COVID-19 patients to city medical centers. Due to a lack of evidence in this area, it is critical to assess the factors that influence the willingness to call for emergency medical services. Methods A community-based cross-sectional study was conducted from June to July 2021 in Addis Ababa. The data were gathered through use of a pretested questionnaire and analyzed using SPSS 25. Logistic regression was used to calculate odds ratios with and without confounding variable controls, and significant associations were declared at (0.05). For the variables that show significant associations in bivariate and multivariate analyses, a 95% confidence interval is provided. Results Three-quarters of those surveyed said they would call ambulance if they experienced worsening COVID-19 symptoms. The individual’s language was associated with the willingness to call EMS for worsening COVID-19 symptoms [AOR 0.51(95% CI: 0.28–0.92)].; awareness of the availability of toll-free ambulance services [AOR 3.4(95% CI: 1.92–5.95)]; recalling an EMS number [AOR 4.3(95% CI: 1.71–10.67)]; ambulance crew quality of care perception [AOR 3.6(95% CI: 2.09–6.10)]; ambulance service adequacy and accessibility perception [AOR 0.25(95% CI: 0.11–0.55)]. Conclusion The study showed significant portion of the Addis Ababa community recognized the need to call EMS due to worsening COVID-19 symptoms. The individual’s language, awareness of toll-free ambulance; ability to recall an ambulance number, perception of the ambulance crew’s quality of care and adequacy and accessibility of service in the city influence the decision to call an ambulance. The finding highlights the significance of addressing problems through various media outlet, for advocacy and public awareness. More research, including qualitative studies, is needed to investigate the factors that encourage people to seek EMS.
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Affiliation(s)
- Ararso Olani
- College of Medicine and Health Science, Arba Minch University, Arbaminch, Ethiopia
| | - Lemlem Beza Demisse
- Department of Emergency Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia,Correspondence: Lemlem Beza Demisse, Department of Emergency Medicine, College of Health Sciences, Addis Ababa University, Po Box 2021, Bole Road, Addis Ababa, Ethiopia, Tel +251 923-092533, Email
| | | | - Menbeu Sultan
- Department of Emergency Medicine and Critical Care, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Response to Mass-Casualty Incidents and Outbreaks: A Prehospital Disaster Training Package Developed for the National Emergency Medical Service in Sierra Leone. Prehosp Disaster Med 2022; 37:701-705. [PMID: 35861110 PMCID: PMC9470523 DOI: 10.1017/s1049023x22001029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Sierra Leone is a country highly prone to disasters, still recovering from the catastrophic 2014 Ebola epidemic. In 2018, the country launched its first National Emergency Medical Service (NEMS) aiming to strengthen the provision of essential health services to the population with the long-term goal of creating a resilient health system able to effectively respond to and recover from emergencies. The Center for Research and Training in Disaster Medicine, Humanitarian Aid, and Global Health (CRIMEDIM), together with the Italian NGO Doctors with Africa (CUAMM), under the direct supervision of the Ministry of Health and Sanitation (MoHS), developed a prehospital Disaster Training Package (DTP) to be delivered to all NEMS personnel to boost the prehospital management of mass-casualty incidents (MCIs) and outbreaks. The DTP included a first phase in which NEMS local trainers underwent a training-of-trainers (ToT) course, enabling them to deliver cascade trainings to 16 district ambulance supervisors, 441 paramedics, 441 ambulance drivers, and 36 operators working in the NEMS operation center. This on-going training package represents the first Disaster Medicine training course for prehospital health professionals in Sierra Leone.
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Liu Z, Gao L, Xue C, Zhao C, Liu T, Tia A, Wang L, Sun J, Li Z, Harding D. Epidemiological Trends of Coronavirus Disease 2019 in Sierra Leone From March 2020 to October 2021. Front Public Health 2022; 10:949425. [PMID: 35844842 PMCID: PMC9276960 DOI: 10.3389/fpubh.2022.949425] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 06/06/2022] [Indexed: 11/23/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19), a serious public health challenge the world over, has led to significant health concerns in Sierra Leone. In the present study, epidemic indices, such as the number of cases, positivity rate, reproduction rate (R0), case fatality rate (CFR), age, and sex, were used to characterize the epidemiological trends of COVID-19. As of October 31, 2021, a total of 6,398 cases and 121 related deaths had been confirmed. The total number of COVID-19 reverse transcription polymerase chain reaction (RT-PCR) tests conducted to October 31, 2021, was 249,534, and the average positivity rate was 2.56%. Three waves of COVID-19 were recorded, occurring during weeks 15–46 in 2020 (2,369 cases), week 47 in 2020 to week 16 in 2021 (1,665 cases), and weeks 17–43 in 2021 (2,364 cases), respectively. Remarkably, there was no increase in the numbers of confirmed COVID-19 cases despite rising test numbers throughout the three waves. Moreover, three high R0 values were observed before each wave. The number of positive cases significantly correlated with positive numbers of international arrivals (P < 0.01), deaths (P < 0.01), and the positivity rate of tested samples (P < 0.01). Moreover, all of the deaths occurred during the peak of the three waves. Our results indicate that there was a low level of COVID-19 epidemic in Sierra Leone and that COVID-19's introduction led to local transmission. It is vital to fight against the spread of SARS-CoV-2 from the source of origin by strengthening testing and management of people entering the country. Our findings will provide important clues for expanding sample screening and will contribute to the reasonable allocation of medical resources.
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Affiliation(s)
- Zhiguo Liu
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Liping Gao
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chuizhao Xue
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai, China
| | - Chunchun Zhao
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Tiezhu Liu
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Alie Tia
- Sierra Leone-China Friendship Biological Safety Laboratory, Freetown, Sierra Leone
| | - Lili Wang
- Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Junling Sun
- Key Laboratory of Surveillance and Early-Warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
- *Correspondence: Junling Sun
| | - Zhenjun Li
- National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Zhenjun Li
| | - Doris Harding
- Central Public Health Reference Laboratories, Ministry of Health and Sanitation, Freetown, Sierra Leone
- Doris Harding
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Stress in emergency telephone number operators during the COVID-19 pandemic: the role of self-efficacy and Big Five personality traits. HEALTH PSYCHOLOGY REPORT 2022. [DOI: 10.5114/hpr/115820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
BackgroundEmergency telephone number operators experience many challenges in their work during the COVID-19 pandemic. Their personality traits and self-efficacy may act as important factors in their level of perceived stress. The aim of this study was to determine the relationship between Big Five personality traits, self-efficacy and perceived stress among emergency tele-phone number operators during the COVID-19 pandemic.Participants and procedureOne hundred emergency telephone number operators participated in the study. The Perceived Stress Scale (PSS-10), Ten Item Personality Inventory (TIPI) and Generalized Self Efficacy Scale (GSES) were used.ResultsEmergency telephone number operators experienced a moderate level of perceived stress. The level of perceived stress was associated with all Big Five personality traits and self-efficacy. Stepwise regression showed that self-efficacy and emotional stability were significant predictors of perceived stress in a tested sample of emergency telephone number operators. Self-efficacy acted as a mediator between the 4 Big Five personality traits (except extraversion) and perceived stress.ConclusionsSelf-efficacy can be a very important resource during the struggle of emergency telephone number operators with the suc-cessive waves of the COVID-19 pandemic. Operators with a high level of this resource can more effectively cope with the changes and perceive stress as lower. Individuals’ personality traits may affect the level of self-efficacy that determines how stress is perceived. It is important to strengthen the self-efficacy of those involved in the fight against the COVID-19 pan-demic.
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Sevalie S, Youkee D, van Duinen AJ, Bailey E, Bangura T, Mangipudi S, Mansaray E, Odland ML, Parmar D, Samura S, van Delft D, Wurie H, Davies JI, Bolkan HA, Leather AJM. The impact of the COVID-19 pandemic on hospital utilisation in Sierra Leone. BMJ Glob Health 2021; 6:e005988. [PMID: 34635552 PMCID: PMC8506048 DOI: 10.1136/bmjgh-2021-005988] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/29/2021] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION The COVID-19 pandemic has adversely affected health systems in many countries, but little is known about effects on health systems in sub-Saharan Africa. This study examines the effects of COVID-19 on hospital utilisation in a sub-Saharan country, Sierra Leone. METHODS Mixed-methods study using longitudinal nationwide hospital data (admissions, operations, deliveries and referrals) and qualitative interviews with healthcare workers and patients. Hospital data were compared across quarters (Q) in 2020, with day 1 of Q2 representing the start of the pandemic in Sierra Leone. Admissions are reported in total and disaggregated by sex, service (surgical, medical, maternity and paediatric) and hospital type (government or private non-profit). Referrals in 2020 were compared with 2019 to assess whether any changes were the result of seasonality. Comparisons were performed using Student's t-test. Qualitative data were analysed using thematic analysis. RESULTS From Q1 to Q2, weekly mean hospital admissions decreased by 14.7% (p=0.005). Larger decreases were seen in male 18.8% than female 12.5% admissions. The largest decreases were in surgical admissions, a 49.8% decrease (p<0.001) and medical admissions, a 28.7% decrease (p=0.002). Paediatric and maternity admissions did not significantly change. Total operations decreased by 13.9% (p<0.001), while caesarean sections and facility-based deliveries showed significant increases: 12.7% (p=0.014) and 7.5% (p=0.03), respectively. In Q3, total admissions remained 13.2% lower (p<0.001) than Q1. Mean weekly referrals were lower in Q2 and Q3 of 2020 compared with 2019, suggesting findings were unlikely to be seasonal. Qualitative analysis identified both supply-side factors, prioritisation of essential services, introduction of COVID-19 services and pausing elective care, and demand-side factors, fear of nosocomial infection and financial hardship. CONCLUSION The study demonstrated a decrease in hospital utilisation during COVID-19, the decrease is less than reported in other countries during COVID-19 and less than reported during the Ebola epidemic.
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Affiliation(s)
- Stephen Sevalie
- 34th Military Hospital, Wilberforce, Freetown, Sierra Leone
- Case Management Pillar, National COVID-19 Emergency Response Centre, Freetown, Sierra Leone
| | - Daniel Youkee
- Case Management Pillar, National COVID-19 Emergency Response Centre, Freetown, Sierra Leone
- School of Population Health and Environmental Sciences, King's College London, London, UK
| | - A J van Duinen
- Institute of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Surgery, St Olavs Hospital University Hospital in Trondheim, Trondheim, Norway
| | - Emma Bailey
- King's Centre for Global Health and Health Partnerships, King's College London School of Population Health and Environmental Sciences, London, UK
| | - Thaimu Bangura
- King's Centre for Global Health and Health Partnerships, King's College London School of Population Health and Environmental Sciences, London, UK
| | - Sowmya Mangipudi
- King's Centre for Global Health and Health Partnerships, King's College London School of Population Health and Environmental Sciences, London, UK
| | - Esther Mansaray
- King's Centre for Global Health and Health Partnerships, King's College London School of Population Health and Environmental Sciences, London, UK
| | - Maria Lisa Odland
- Institute of Applied Health Research, University of Birmingham, Birmingham, Birmingham, UK
| | - Divya Parmar
- King's Centre for Global Health and Health Partnerships, King's College London School of Population Health and Environmental Sciences, London, UK
| | - Sorie Samura
- King's Centre for Global Health and Health Partnerships, King's College London School of Population Health and Environmental Sciences, London, UK
| | | | - Haja Wurie
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Western Area, Sierra Leone
| | - Justine I Davies
- Institute of Applied Health Research, University of Birmingham, Birmingham, Birmingham, UK
- Centre for Global Surgery, Department of Global Health, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - H A Bolkan
- Institute of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Surgery, St Olavs Hospital University Hospital in Trondheim, Trondheim, Norway
| | - Andrew J M Leather
- King's Centre for Global Health and Health Partnerships, King's College London School of Population Health and Environmental Sciences, London, UK
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