Socialists have historically thought a lot about the catastrophic risks society faces. Today many DSA chapters have gotten involved in mutual aid to respond to the Covid crisis, generating a debate about how mutual aid fits into socialist work. One form of community engagement that is likely to be increasingly necessary, and is an opportunity for radicalizing angry neighbors, is disaster preparedness. While the prepper subculture is perceived as right-wing, and parts are tied into the militia movement, there (...) are also opportunities for progressive organizations to work with FEMA and local governments. This essay discusses distinctive socialist perspectives on disasters past and future and gives examples of strategic ways socialists can help build disaster-resilient communities. (shrink)

This article focuses on some «disaster ethics» considerations on disaster preparedness and its related responsibilities. After recalling that concerns about preparedness and vulnerability have come to the fore in the domains of «disaster risk reduction» over the last decades, the article will endorse the view that the demarcation between natural disasters and human-induced disasters has becoming blurred and even questionable in many cases. Then, it will be argued that the ethical assessment of disasters needs to (...) consider the entire disaster cycle and that ethical duties extend to the phase of disaster preparedness and require a framework of prospective and shared responsibilities. Accordingly, a number of ethical duties concerning disaster preparedness will be commented upon. Finally, the article will discuss a specific socio-epistemic dynamics of blame assignment that unbalances the appraisal of both vulnerability conditions and moral responsibilities of certain worst-off disaster victims. (shrink)

The terrorist attacks of 2001 were a reminder that individual and collective safety cannot be taken for granted. Since then, physicians, alongside public health professionals and other healthcare professionals as well as nonhealthcare personnel, have been developing plans to enhance the protection of public health and the provision of medical care in response to various threats, including acts of terrorism or bioterrorism. Included in those plans are strategies to attend to large numbers of victims and help prevent greater harm to (...) even larger populations. (shrink)

After the terrorist attacks of September 11, 2001, the worst disaster in the history of New York City, the Fire Department of New York faced a monumental challenge in rebuilding the Department, and in continuing to provide emergency services for New York City in a daunting new threat environment. Fire Commissioner Nicholas Scoppetta, who took over the agency in December 2001, describes how the FDNY has rebounded and what lessons were learned that terrible day.

Background:Since 2010, the United States has experienced 228 disasters, affecting over 86 million people. Because of population shifts, the growing number of people living with chronic conditions or disabilities, and the growing number of older citizens living independently, access and service gaps often exist for those without money or other transferable resources. There is a lack of evidence regarding individual community members’ capacity to prepare for emergencies.Research objective:The purpose of this study is to highlight participant experiences in becoming better prepared (...) for emergencies and provide insight from a social justice perspective.Research design:This is a descriptive qualitative study, staying very close to the data as an end product rather than a beginning for interpretation.Participants and research context:A total of 13 low-income, uninsured, or under-insured attendees at a medical outreach clinic were interviewed.Ethical considerations:Institutional Review Board approval was obtained from the University of Texas at Tyler.Findings:Four themes emerged from the interview data: (a) evaluation of the emergency-preparedness education, (b) making emergency plans, (c) challenges in preparing for emergencies, and (d) facilitators of emergency preparedness.Discussion:Identifying the potential challenges to individual emergency preparedness among vulnerable populations is the first step in overcoming them. The capacity to comply with such measures, especially the ability of those with limited incomes and other vulnerable populations, must be considered.Conclusion:Synchronized, well-ordered assistance will close gaps in recovery and enhance efficiency in pre- and post-event aid. Theoretically, doing so will promote engaged and resilient members of society who are better able to withstand adverse events. The importance of the relationship between individual preparedness levels and the resiliency of nations supports the social justice imperative to address the needs of vulnerable populations in the mitigation and planning phase of the emergency management cycle. (shrink)

Acommon theme throughout the greatest public health achievements of the 20th century is the importance of law. From the seminal successes in immunizations and motor vehicle safety to the recognition and control of tobacco as a health hazard, laws have been invaluable. More recently in this century, laws have been fundamental in public health preparedness to address environmental disasters and terrorist threats. In fact, the first National Summit on Legal Preparedness in 2007 focused on these “urgent threats.” It (...) only seemed natural that the second summit would focus on the “urgent realities” posed by the continuing epidemic of obesity — an epidemic that directly attacks our children’s health and drains our nation’s wealth.Recognized worldwide as an energy imbalance resulting from excess caloric intake and reduced energy expenditure, obesity contributes to diabetes, heart disease, other multiple chronic diseases, impaired quality of life, and premature mortality. (shrink)

Acommon theme throughout the greatest public health achievements of the 20th century is the importance of law. From the seminal successes in immunizations and motor vehicle safety to the recognition and control of tobacco as a health hazard, laws have been invaluable. More recently in this century, laws have been fundamental in public health preparedness to address environmental disasters and terrorist threats. In fact, the first National Summit on Legal Preparedness in 2007 focused on these “urgent threats.” It (...) only seemed natural that the second summit would focus on the “urgent realities” posed by the continuing epidemic of obesity — an epidemic that directly attacks our children’s health and drains our nation’s wealth.Recognized worldwide as an energy imbalance resulting from excess caloric intake and reduced energy expenditure, obesity contributes to diabetes, heart disease, other multiple chronic diseases, impaired quality of life, and premature mortality. (shrink)

Discussions about resource allocation commonly invoke concerns of unfair and variable decisions when physicians ration at the bedside. This concern is no less germane in disaster medicine, in which physicians make triage and allocation decisions under duress, and patients and their families may be challenged to self-advocate. Unfortunately, a real-time mechanism to support a process for ethical decision making may not be available to medical relief workers. Yet, resources for ethics decision support can be important for the moral well-being (...) of the clinician, the ethical integrity of the relief effort, and to bolster the trust and confidence of the population receiving medical services. The need for clinical ethical support should be anticipated in disaster preparedness planning. (shrink)

Animals in Disasters is a comprehensive book on animal rescue written by Dr. Dick Green who shares his experiences, best practices and lessons learned from well over 125 domestic and international disasters. It provides a step-by-step process for communities and states to more effectively address animal issues and enhance their animal response capabilities. Sections include an overview of the history of animal rescue, where we are today, and the steps needed to better prepare for tomorrow. This how-to book for emergency (...) managers who want to develop programs, craft policy, and build response capability/capacity is an ideal companion to their work. Clearly identifies the components of building a resilient community Introduces the Community Preparedness Checklist Helps readers develop and deliver effective animal response training. (shrink)

Theoretically, this study is framed within the semiotic tradition of communication theory, which theorizes communication as the intersubjective mediation by signs. Methodologically, this study is guided by Peirce’s semiotic ideas, especially his writing about the commens and commind, or the sign and the object, and the power of a community as the final interpretant performing the process of sensemaking. Results showed how the survivors of a natural calamity symbolically interacted with such calamity, and how this led to a reformation of (...) the way they view themselves and the world. The survivors’ symbolic images captured in narratives, in sketches and drawings, and in poetry helped them to reframe their sense of self and their worldview by believing in common sense and intuition, and by valuing the power of courage, initiative, preparedness, hope, and resilience. An unfortunate irony emerged in their symbolic interaction with the disaster such that their sinning and self-inflicted blame made them think they were worthy of punishment. Nonetheless, this unfortunate irony will change if the survivors continue to reflect on their civic roles, interrogate their environmental and political contexts, and expand their awareness and social consciousness. As these unfold, the survivors will be able to accomplish empowerment, emancipation, and an independent mind. (shrink)

The primary function of the police in a critical incident is the maintenance of public safety, public security, and maintaining public order. This has been further complicated as a result of the increasing presence of the internet, digital communications and social media, all of which hold both promise and challenge. There are many aspects of crisis and disaster management, including communications, interoperability, leadership, and police responsibility. Risk identification and management are essential part of dealing with crises and disasters. There (...) is a significant threat to organizational reputation and public trust for any police or security organization that depends entirely on how that organization responds to a crisis or disaster. -/- This chapter examines Hurricane Katrina (2005) in the USA which caused large-scale damage to infrastructure and loss of life, and the response as handled by some government agencies. The management of crises and disasters is a cyclical process. It includes risk assessment, planning, preparation, mitigation and contingency, response, recovery, and finally, an evaluation. The core features, and the elements of an effective response, of a crisis or disaster, as well as the criticality of effective leadership are examined. This chapter also studies the fundamentals of Disaster Victim Identification (DVI). (shrink)

Public health emergencies have occurred throughout history, encompassing such events as plagues and famines arising from natural causes, disease pandemics interrelated with wars, and industrial accidents such as the 1986 Chernobyl disaster, among others. Law and legal tools have played an important role in addressing such emergencies. Three prime U.S. examples are Congressional authorization of quarantine as early as 1796, legally mandated smallpox vaccination upheld in a landmark 1905 U.S. Supreme Court ruling, and the President's 2003 executive order adding (...) SARS to the federal government's list of “quarantinable communicable diseases.”The public health emergencies of the present — both actual and potential — pose equally serious threats but do so in the context of greatly magnified expectations that stem directly from the attacks of September 11, 2001, and the immediately following anthrax attacks. (shrink)

Public health emergencies have occurred throughout history, encompassing such events as plagues and famines arising from natural causes, disease pandemics interrelated with wars, and industrial accidents such as the 1986 Chernobyl disaster, among others. Law and legal tools have played an important role in addressing such emergencies. Three prime U.S. examples are Congressional authorization of quarantine as early as 1796, legally mandated smallpox vaccination upheld in a landmark 1905 U.S. Supreme Court ruling, and the President's 2003 executive order adding (...) SARS to the federal government's list of “quarantinable communicable diseases.”The public health emergencies of the present — both actual and potential — pose equally serious threats but do so in the context of greatly magnified expectations that stem directly from the attacks of September 11, 2001, and the immediately following anthrax attacks. (shrink)

This book uses interview data from public officials tasked with planning and executing preparation and response to natural disasters to analyze how pets, livestock, and other companion animals complicate disaster preparedness. Because many families view animal welfare as a priority, evacuation and sheltering preparations and responses must account for animals.

No matter one’s wealth or social position, all are subject to the threats of natural hazards. Be it fire, flood, hurricane, earthquake, tornado, or drought, the reality of hazard risk is universal. In response, governments, non-profits, and the private sector all support research to study hazards. Each has a common end in mind: to increase the resilience of vulnerable communities. While this end goal is shared across hazards, the conception of how to get there can diverge considerably. The earthquake and (...) hurricane research endeavors in the US provide an illustrative contrast. The earthquake community sets out to increase resilience through a research process that simultaneously promotes both high quality and usable – preparedness-focused - science. In order to do so, the logic suggests that research must be collaborative, responsive, and transparent. Hurricane research, by contrast, largely promotes high quality science – predictions - alone, and presumes that usability should flow from there. This process is not collaborative, responsive, or transparent. Experience suggests, however, that the latter model – hurricane research - does not prepare communities or decision makers to use the high quality science it has produced when a storm does hit. The predictions are good, but they are not used effectively. Earthquake research, on the other hand, is developed through a collaborative process that equips decision makers to know and use hazards research knowledge as soon as an earthquake hits. The contrast between the two fields suggests that earthquake research is more likely to meet the end goal of resilience than is hurricane research, and thus that communities might be more resilient to hurricanes were the model by which research is funded and conducted to change. The earthquake research experience can provide lessons for this shift. This paper employs the Public Value Mapping (PVM) framework to explore these two divergent public value logics, their end results, and opportunities for improvement. (shrink)

The United States National Preparedness System has evolved significantly in the recent past. These changes have affected the system structures and goals for disaster response. At the same time, actors such as private businesses have become increasingly involved in disaster efforts. In this paper, we begin to fill the gap in the cross-sector literature regarding interactions that have systemic impacts by investigating how the simultaneous processes of systemic change and intensifying cross-sector interaction worked and interacted in the (...) context of the preparedness system. We examine these inter-linkages through a qualitative study in the setting of Hurricane Sandy. Drawing from systems theory, we develop a grounded model that provides an explanation for the system change and highlights how cross-sector interaction relates to the changes observed in the system. (shrink)

Among the many components of legal preparedness for public health emergencies is the assurance that the public health workforce and its private sector partners are competent to use the law to facilitate the performance of essential public health services and functions. This is a significant challenge. Multiple categories of emergencies, stemming from natural disasters to emerging infectious diseases, confront public health practitioners. Interpreting, assessing, and applying legal principles during emergencies are complicated by the changing legal environment and differences in (...) governmental organization of emergency management functions. While law and legal competencies are essential to routine public health practices, once government declares a state of public health emergency or disaster, the legal landscape changes. Typical legal responses to protect the public's health may no longer be the norm. Public health practitioners, legal counsel, health care partners, and others need to be able to assess changing laws and policies and apply them in real-time. (shrink)

Among the many components of legal preparedness for public health emergencies is the assurance that the public health workforce and its private sector partners are competent to use the law to facilitate the performance of essential public health services and functions. This is a significant challenge. Multiple categories of emergencies, stemming from natural disasters to emerging infectious diseases, confront public health practitioners. Interpreting, assessing, and applying legal principles during emergencies are complicated by the changing legal environment and differences in (...) governmental organization of emergency management functions. While law and legal competencies are essential to routine public health practices, once government declares a state of public health emergency or disaster, the legal landscape changes. Typical legal responses to protect the public's health may no longer be the norm. Public health practitioners, legal counsel, health care partners, and others need to be able to assess changing laws and policies and apply them in real-time. (shrink)

This paper is one of the four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention and multi-disciplinary partners. Each of the action agenda papers deals with one of the four core elements of legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by (...) policymakers and practitioners — in all jurisdictions and all relevant sectors and disciplines — with responsibilities for all-hazards emergency preparedness.One expert's framing of the mission of public health may help improve understanding of the range of hazards for which to be legally prepared. These hazards include urgent realities — such as chronic disease, injury, disabilities, conventional communicable diseases, and an aging and obese population — and urgent threats, such as pandemic influenza, natural disasters, and terrorism. (shrink)

This paper is one of the four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention and multi-disciplinary partners. Each of the action agenda papers deals with one of the four core elements of legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by (...) policymakers and practitioners — in all jurisdictions and all relevant sectors and disciplines — with responsibilities for all-hazards emergency preparedness.One expert's framing of the mission of public health may help improve understanding of the range of hazards for which to be legally prepared. These hazards include urgent realities — such as chronic disease, injury, disabilities, conventional communicable diseases, and an aging and obese population — and urgent threats, such as pandemic influenza, natural disasters, and terrorism. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Feminist Studies 46, no. 2. © 2020 by Feminist Studies, Inc. 431 Cynthia Belmont and Angela Stroud Bugging Out: Apocalyptic Masculinity and Disaster Consumerism in Offgrid Magazine Popular conceptions of survivalism in the United States typically feature the eccentric, backwoods, working-class figures found in television shows such as Doomsday Preppers and Prepper Hillbillies. Offgrid magazine, which first hit the stands in the summer of 2013, however, sells a (...) compellingly bourgeois personal connection to disaster in the vein of men’s self-improvement literature, wherein successful masculinity requires courage, preparedness for calamity, and the resources to shop. Each issue of Offgrid focuses on a “real-life” survivalist or a singular catastrophic event that is dramatically represented on the cover by a self-sufficient man decked out in gear that will allow him to survive a crash landing, escape a city devastated by an earthquake, navigate the hazards of a hacker-created blackout, or evade the destruction of an erupting volcano.1 Filled with articles offering tips on how to prepare, self-defense strategies, profiles of survivalists, disaster scenarios, gear reviews, and advertisements, Offgrid mainstreams prepper culture by retooling the The authors contributed equally to this article; the order listed is alphabetical and should not be construed as implying differing contributions. 1. The terms “survivalist” and “prepper” apply to anyone committed to honing the skills and acquiring the resources required to survive in any context, including disasters, and are used interchangeably in Offgrid. 432 Cynthia Belmont and Angela Stroud face of apocalyptic survival as a regular-guy protagonist whose low-profile normalcy disguises the smoldering heroic potential that will ignite within him when disaster strikes. In this article, drawing upon insights from the sociology of masculinity, environmental feminism, and ecocriticism, we examine the representation of gender, nature, and disaster in issues of Offgrid, spanning nearly three years, from June 2015 through February 2018. While vivid depictions of cataclysm might seem provocative enough to captivate the Offgrid reader, we argue that its principal appeal is that it gives its ninety -one-percent male audience the opportunity to engage directly in what Casey Kelly terms “apocalyptic manhood,” an emergent version of American masculinity that “confirm[s] the necessity of masculine skills as society meets its demise.”2 Thus, Offgrid provides an occasion for readers to salvage a masculinity that feels perpetually threatened within contemporary American culture—a highly effective strategy in promoting the expansion of what we term disaster consumerism. We concur with ecofeminist Greta Gaard’s contention that “masculine gender identity has been constructed as so very antiecological, and thus its interrogation and transformation seem especially crucial” at this time of environmental crisis; this concern resonates particularly poignantly with regard to the apocalyptic imaginary.3 Marketing Disaster, Selling Masculinity Scholars have long argued that commercial media play an important role in circulating gender ideals that are “rooted in consumer capitalism wherein profit can be produced by generating insecurity about one’s body and one’s consumer choices.”4 Of course, despite their influence, advertisers do not create insecurities out of whole cloth; rather, they operate within the context of shifting gender discourses and cultural anxieties. Whereas the authors of a 2005 study found that alcohol ads portrayed men as affable losers who, rejected by strong women, 2. “2018 Recoil Offgrid Media Kit,” Recoil Offgrid; Casey Ryan Kelly, “The Man-pocalypse: Doomsday Preppers and the Rituals of Apocalyptic Manhood,” Text and Performance Quarterly 36, no. 2–3 (2016): 96. 3. Greta Gaard, Critical Ecofeminism (New York: Lexington Books, 2017), 167 (italics in original). 4. Susan M. Alexander, “Stylish Hard Bodies: Branded Masculinity in Men’s Health Magazine,” Sociological Perspectives 46, no. 4 (2003): 551. Cynthia Belmont and Angela Stroud 433 were driven to drink with their buddies, an analysis of Super Bowl commercials just five years later demonstrated that the tone had become “a simpler, angrier one [that was] crafted to galvanize men to buy.”5 The authors of the latter study suggest that the masculine aggression in the ads they analyzed reflects men’s economic insecurities, which advertisers exploit by encouraging men to feel nostalgic for and frustrated about their diminished power. Ads telling men to “wear the pants” and take a stand... (shrink)

This essay considers the potential role of bioethics in disaster response planning and preparedness. Bioethicists can make substantial contributions, by ensuring that decision-making and distribution of resources during crises is carried out in a fair and just manner, as well as by examining the assumptions upon which disaster planning are based. Bioethicists should also be aware of potential pitfalls of overly-hasty engagement with this new field.

Civil Protection and disaster risk specific agencies legally responsible to enhance individual and community resilience, still utilize in their risk and crisis communication efforts, the “deficit model” even though its basic assumption and approach have been criticized. Recent studies indicate that information seeking behavior is not necessarily a measure of enhanced individual preparedness. A qualitative change from “blindly” following directions to practicing emergency planning and becoming your own disaster risk manager is required. For pandemics, the challenge is (...) even more complicated due to their unique characteristics. Community based exercises, a framework concept encompassing a variety of interactive activities, have recently started being utilized to develop resilience amongst citizens. Existing models of resilience can pinpoint to the required knowledge, skills and attitude. Research in the factors influencing behavioral change could offer new understanding of the interplay between cognitive and demographic drivers/factors of resilience. Such knowledge could be utilized for setting targeted objectives, developing appropriate activities and the corresponding training for the CBEx facilitators. Despite the importance of preparation, the current covid-19 crisis indicates that high levels of adaptive resilience can be displayed even in the absence of any risk communication effort beforehand by utilizing a pre-existing collective understanding of the system situation. (shrink)

In the light of the environmental crisis caused by unprecedented accelerating interrelated changes accompanied by the most recent ones caused by the COVID-19 pandemic and the humanitarian, refugee, and nuclear crisis provoked by the Russian invasion of Ukraine, contemporary society has been challenged to confront these complex and uncertain times and to recognise a considerable need to respond not only to the environmental crisis but to multiple crises in general. Another critical question to be answered by contemporary society, which is (...) also a research question in this review, is how an efficient response to crises caused by those accelerating interrelated changes should be organised. Therefore, for the purpose of answering the above research questions, this literature review-based article aims to examine the empirical studies on community responses to environmental crises. The results of the seventeen analysed articles on community responses to environmental crises and disasters indicate that these responses, given by either members of the directly affected community or by local, regional, or central authorities, were in majority of cases not integrated, as if the collective effort to cope with the emergency were organised simultaneously yet apart. Another observation is that the first respondents on site, who often were also directly affected by an emergency, performed a significant role in response as they had and pooled necessary material and non-material resources, for instance, experience, practical knowledge, and equipment. Based on these findings, the author argues that for future crisis and disaster research, it is essential to examine those cases where there has been indeed an efficient integrated response organised as a result of joint cooperation between all affected actors so that such accounts are incorporated into future disaster preparedness strategies for the organisation of more effective response. (shrink)

Environmental Health Ethics illuminates the conflicts between protecting the environment and promoting human health. In this study, David B. Resnik develops a method for making ethical decisions on environmental health issues. He applies this method to various issues, including pesticide use, antibiotic resistance, nutrition policy, vegetarianism, urban development, occupational safety, disaster preparedness and global climate change. Resnik provides readers with the scientific and technical background necessary to understand these issues. He explains that environmental health controversies cannot simply be (...) reduced to humanity versus environment and explores the ways in which human values and concerns - health, economic development, rights and justice - interact with environmental protection. (shrink)

In this article, we argue that the scope of bioethical debate concerning justice in health should expand beyond the topic of access to health care and cover such issues as occupational hazards, safe housing, air pollution, water quality, food and drug safety, pest control, public health, childhood nutrition, disaster preparedness, literacy, and many other environmental factors that can cause differences in health. Since society does not have sufficient resources to address all of these environmental factors at one time, (...) it is important to set priorities for bioethical theorizing and policy formation. Two considerations should be used to set these priorities: (1) the impact of the environmental factor on health inequality, and (2) the practicality of addressing the factor. (shrink)

The AMA's Council on Ethical and Judicial Affairs' position statement on “Disaster Preparedness and Response” is a welcome discussion of an important issue: the extent to which physicians have a responsibility to treat people affected by disasters in which the nature, source, and cause of the harm is unclear and where the risk is largely unknown.

Those who read only the introductory section of “Physician Obligation in Disaster Preparedness and Response,” the statement from the AMA's Council on Ethical and Judicial Affairs, apparently an elaboration on CEJA Opinion 3-I-04, E-9.067, will find an expression of laudable professional responsibility in the face of a disaster. There the AMA authors explicitly acknowledge “that unique responsibilities beyond planning rest on the shoulders of the medical profession”. They also declare that, “physicians are needed to care for victims. (...) In some instances, this will require individual physicians to place their health or their lives at risk”. As the AMA authors note, these responsibilities have been accepted at least since the writing of Thomas Percival in 1803 and endorsed by the AMA in posting their 1847 code. The commitments are also asserted in the preamble of the AMA's most current Principles of Medical Ethics, which states that “a physician must recognize responsibility to patients, first and foremost,” and again in Principle VIII, which states that “[a] physician shall, when caring for a patient, regard responsibility to the patient as paramount”. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Moral Distress: The Face of Workplace BullyingJohn S. MurrayAfter a 28–year long distinguished military career I accepted a research position in a tertiary academic health science center, which I considered to be my dream job following retirement. Initially I was to be responsible for one department. A second was added because of my expertise with disaster preparedness. Following my orientation, I immersed myself into my new roles (...) recognizing that there was much to be done to achieve the goal of getting both departmental research programs up to par with the rest of the organization. In a short time, I began to recognize one of my bosses was going to be challenging to work with.She expected that her name be included on all grant proposals and manuscripts despite making no substantial intellectual contributions to either. Additionally, she wanted unwarranted control over all research and scholarship activities I was engaged in with staff despite having no research experience. Even meeting with her to discuss my plans for the direction of research in this department, my efforts were met with argumentative and condescending behavior. She would agree to discuss my plans. When I showed up for meetings in her office she would get angry with me oftentimes for situations, which she herself created. I continued to move forward with my work feeling that how I had conducted research and scholarly work in the past, with integrity and uncompromising ethical standards, was going to be threatened. This created great moral stress for me. I felt overwhelmed, powerless and frustrated as a result of the uncertainty as to whether or not I could fulfill my responsibilities while still meeting moral obligations.Over time, my moral compass prevented me from deviating from the principles, which helped me to build a long–standing stellar reputation as a leader in the field of pediatric nursing. However, this came with a cost. Working for this particular boss was like being on an emotional rollercoaster. One day I would feel like she was pleased with my work, but the next day my efforts could be met with anger, demeaning and dismissive behaviors. Once she praised me in front of staff for the “great” work I was doing with the evidence–based practice initiative nurse leaders. The following day she reprimanded me for not working closely with this group. She was extremely well versed at singing my praises in front of staff. Behind her closed office door was a very different experience.I confided in some colleagues in this department how I was being treated. I quickly learned that all staff were treated in this manner by this one individual. They shared that condescending language and fear and intimidation were the norm. When [End Page 112] I asked them why no one had the awareness or courage to say this treatment was not right, they quickly shared with me that staff were deterred from speaking up for fear of greater bullying behaviors. Sadly, while everyone knew what was the right thing to do, institutional constraints made it nearly impossible to pursue the right course of action. It was readily apparent these nurses were missing advocacy. At that point, I decided it was important to seek a remedy to this problem recognizing it would be no easy task.Progressively, my work environment with this particular boss became intolerable. Despite working relentlessly to develop a research program, unwarranted criticism, unjustified blame, exclusion, isolation, unreasonable demands and denied opportunities persisted. By this time, I was suffering from nightmares, headaches, fear, anxiety, depression, difficulty concentrating, and problems with self–esteem. I felt like my professional competence and reputation was being unjustifiably denigrated by this one individual.In the past, I confided in trusted organizational leaders for guidance when faced with difficult situations. As such, I approached my other boss and shared what was happening. She was deeply concerned. She encouraged me to seek guidance from a safe and confidential environment where staff members can share concerns and receive assistance with how to handle these apprehensions. I had used a program like this in the past when dealing with moral distress. This experience was very helpful. In fact, I returned on multiple... (shrink)

Globally, a traditional management model has generally been used to manage disaster situations, including in Bangladesh. In Bangladesh, the government mostly uses the preparedness policy for pandemic outbreak case management. With regard to the limitations arising from the pandemic outbreak the current research will investigate the following questions: when facing a devastating situation, what exactly is the nature of the pandemic outbreak management model incorporated at the governmental level? Keeping these questions in mind, the intention of the existing (...) model is to provide smooth and appropriate assistance to recover from a pandemic outbreak, and to implement effective governance of the situation. This research will identify deficiencies in the current epidemic management policy in Bangladesh, and will assist in forming a new model and developing a systematic procedure for managing future pandemic outbreak situations. The main deficiency in Bangladesh’s pandemic management is that the policy paper has failed to identify all hazardous events that may occur in a pandemic outbreak. In most cases, it has underestimated the issues of bioethical responsibility toward the different stakeholders affected during the devastating situation of a pandemic outbreak. The policy does not emphasize the bioethical model; therefore, it fails to encourage support for either public protection or an ethically friendly management system. The model proposed in this article demonstrates an appropriate way to reduce or, if possible, avoid potential damages and losses from a pandemic outbreak. The model aims to prioritize the problems that need assistance to recover from the outbreak. (shrink)

Globally, a traditional management model has generally been used to manage disaster situations, including in Bangladesh. In Bangladesh, the government mostly uses the preparedness policy for pandemic outbreak case management. With regard to the limitations arising from the pandemic outbreak the current research will investigate the following questions: when facing a devastating situation, what exactly is the nature of the pandemic outbreak management model incorporated at the governmental level? Keeping these questions in mind, the intention of the existing (...) model is to provide smooth and appropriate assistance to recover from a pandemic outbreak, and to implement effective governance of the situation. This research will identify deficiencies in the current epidemic management policy in Bangladesh, and will assist in forming a new model and developing a systematic procedure for managing future pandemic outbreak situations. The main deficiency in Bangladesh’s pandemic management is that the policy paper has failed to identify all hazardous events that may occur in a pandemic outbreak. In most cases, it has underestimated the issues of bioethical responsibility toward the different stakeholders affected during the devastating situation of a pandemic outbreak. The policy does not emphasize the bioethical model; therefore, it fails to encourage support for either public protection or an ethically friendly management system. The model proposed in this article demonstrates an appropriate way to reduce or, if possible, avoid potential damages and losses from a pandemic outbreak. The model aims to prioritize the problems that need assistance to recover from the outbreak. (shrink)

Major disasters and public health emergencies constantly test the nation's resolve to rally and recover from tragedy. Public health crises stemming from prolonged threats like the 2009/2010 H1N1 influenza pandemic require sustained preparedness and response over many months. Even shorter-duration events, like tornados, earthquakes, or hurricanes, leave lasting impacts for which full recovery may take years. Telling examples include the displacement of thousands of persons across the Gulf Coast states following Hurricane Katrina in 2005 and difficulties obtaining basic housing (...) and services that persisted in the Northeast months after Hurricane Sandy in 2012. Whether the result of natural disasters, infectious disease outbreaks, bioterrorism, or other causes, these events can change the societal landscape in affected regions.Despite the challenges of recovery across populations stemming from national or regional emergencies, Americans have consistently supported those directly affected. (shrink)

Major disasters and public health emergencies constantly test the nation's resolve to rally and recover from tragedy. Public health crises stemming from prolonged threats like the 2009/2010 H1N1 influenza pandemic require sustained preparedness and response over many months. Even shorter-duration events, like tornados, earthquakes, or hurricanes, leave lasting impacts for which full recovery may take years. Telling examples include the displacement of thousands of persons across the Gulf Coast states following Hurricane Katrina in 2005 and difficulties obtaining basic housing (...) and services that persisted in the Northeast months after Hurricane Sandy in 2012. Whether the result of natural disasters, infectious disease outbreaks, bioterrorism, or other causes, these events can change the societal landscape in affected regions.Despite the challenges of recovery across populations stemming from national or regional emergencies, Americans have consistently supported those directly affected. (shrink)

This article describes the historical emergence of vital systems security, analyzing it as a significant mutation in biopolitical modernity. The story begins in the early 20th century, when planners and policy-makers recognized the increasing dependence of collective life on interlinked systems such as transportation, electricity, and water. Over the following decades, new security mechanisms were invented to mitigate the vulnerability of these vital systems. While these techniques were initially developed as part of Cold War preparedness for nuclear war, they (...) eventually migrated to domains beyond national security to address a range of anticipated emergencies, such as large-scale natural disasters, pandemic disease outbreaks, and disruptions of critical infrastructure. In these various contexts, vital systems security operates as a form of reflexive biopolitics, managing risks that have arisen as the result of modernization processes. This analysis sheds new light on current discussions of the government of emergency and ‘states of exception’. Vital systems security does not require recourse to extraordinary executive powers. Rather, as an anticipatory technology for mitigating vulnerabilities and closing gaps in preparedness, it provides a ready-to-hand toolkit for administering emergencies as a normal part of constitutional government. (shrink)

High quality monitoring of mental health and well-being over an extended period is essential to understand how communities respond to the COVID-19 pandemic and how to best tailor interventions. Multiple community threats may also have cumulative impact on mental health, so examination across several contexts is important. The objective of this study is to report on changes in mental health and well-being in response to the Australian bushfires and COVID-19 pandemic. This study utilized an Experience-Sampling-Method, using the smartphone-based mood monitoring (...) application, MoodPrism. Participants were prompted once a day to complete a brief survey inquiring about symptoms of depression and anxiety, and several well-being indices, including arousal, emotional valence, self-esteem, motivation, social connectedness, meaning and purpose, and control. Participants were N = 755 Australians who downloaded and used MoodPrism, between 2018 and 2020. Results showed that anxiety symptoms significantly increased during the COVID-19 pandemic, but not during the bushfires. This may be explained by concurrent feelings of social connectedness maintained during the bushfires but not during the pandemic. In contrast, depressive symptoms increased significantly during the bushfires, which maintained during the pandemic. Most indices of well-being decreased significantly during the bushfires, and further again during the pandemic. Study findings highlight the unique responses to the bushfire and COVID-19 crises, revealing specific areas of resilience and vulnerability. Such information can help inform the development of public health interventions or individual clinical treatment, to improve treatment approaches and preparedness for potential future community disasters. (shrink)

Law plays a critical role in all stages of a public health emergency, including planning, response, and recovery. Public health emergencies introduce health concerns at the population level through, for example, the emergence of a novel infectious disease. In the United States, at the federal, state, and local levels, laws provide an infrastructure for public health emergency preparedness and response efforts: they grant the government the ability to officially declare an emergency, authorize responders to act, and facilitate interjurisdictional coordination. (...) Law is perhaps most visible during an emergency when the president or a state's governor issues a disaster declaration establishing the temporal and geographic parameters for the response and making financial and other resources available. This legal authority has increasingly been used during the last decade. (shrink)

Over the last century, droughts have caused more deaths internationally than any other weather- or climate-related disaster. Like other natural disasters, droughts cause significant changes in the environment that can lead to negative health outcomes. As droughts are becoming more frequent and intense with climate change, public health systems need to address impacts associated with these events. Partnering with federal and local entities, we evaluated the state of knowledge of drought and health in the United States through a National (...) Drought and Public Health Summit and a series of subsequent regional workshops. The intended outcome was to develop public health strategies for implementing activities to better support and prepare public health systems for future droughts. The information gathered from this work identified multiple policy and law options to address the public health issues associated with drought. These policy recommendations include the use of public health emergency declarations for drought events, increased usage of preparedness evaluations for drought emergencies, and engagement of drought and climate experts in state and local risk assessments. As drought events are projected to increase in frequency and magnitude with climate change, taking policy action now will help decrease the health impacts of drought and save lives. (shrink)

Background: The COVID-19 pandemic severely strained the already unprepared Italian healthcare system. This had repercussions on healthcare workers, stemming, in particular, from a lack of clear guidelines, adequate protective equipment, and professional preparedness. Such conditions were especially prevalent in Northern Italy.Objectives: This study aimed to examine COVID-19-related professional and psychoemotional stress among nurses and doctors in two hospitals in Northern Italy, along with the worst critical incidents affecting healthcare personnel. A parallel objective was to elicit healthcare professionals' opinions about (...) what changes are needed in the healthcare system's operations, as well as about the relational/emotional skills that are needed to better manage relationships with patients in emergency situations.Participants: Snowball sampling was used to recruit participants and yielded 17 hospital professionals: six nurses and 11 doctors. Three of these professionals worked in intensive care and the others in different wards. All had close contact with COVID-19 patients.Methods: The study employed a qualitative research design, using in-depth interviews of ~60 min each that were conducted via Skype video calls. The interviews were recorded and transcribed, then analysed. The qualitative analysis employed mixed methods to identify the most relevant and recursive themes from the interviews.Results: Four fundamental themes emerged from our analysis of the interview texts: disorganisation and psychoemotional stress; urgency and critical incidents; everything surreal; and disruptions in empathetic relationships with patients.Conclusions: Through our analysis of the interview narratives, we found that systematic and in-depth psychological training is needed to prepare professionals for altered relationships with patients in emergencies; use of exceptional medical equipment; elaboration of new bioethical models suitable for disasters and pandemics; and engagement with the themes of death and dying. (shrink)

Humanity entered the twenty-first century with revolutionary achievements in biomedical research. At the same time multiple “dual-use” results have been published. The battle against infectious diseases is meeting new challenges, with newly emerging and re-emerging infections. Both natural disaster epidemics, such as SARS, avian influenza, haemorrhagic fevers, XDR and MDR tuberculosis and many others, and the possibility of intentional mis-use, such as letters containing anthrax spores in USA, 2001, have raised awareness of the real threats. Many great men, including (...) Goethe, Spinoza, J.B. Shaw, Fr. Engels, J.F. Kennedy and others, have recognized that liberty is also a responsibility. That is why the liberty to decide now represents an acknowledged necessity: biomedical research should be supported, conducted and published with appropriate measures to prevent potential “dual use”. Biomedical scientists should work according to the ethical principles of their Code of Conduct, an analogue of Hippocrates Oath of doctors; and they should inform government, society and their juniors about the problem. National science consulting boards of experts should be created to prepare guidelines and control the problem at state level. An international board should develop minimum standards to be applicable by each country. Bio-preparedness is considered another key-measure. (shrink)

Local health departments and their employees are at the forefront of emergency preparedness and response. Yet, recent studies have found that some local public health workers are unwilling to report to work in a variety of disaster scenarios. This can greatly compromise a response, as many local health departments need “all hands on deck” to effectively meet increased demands. To address these concerns, local health departments have employed varied policy strategies to ensure that employees do report to work. (...) After describing different approaches taken by local health departments throughout the United States, we briefly identify and explore key ethics considerations that arise for local health departments when employees are required to report to work for emergency responses. We then discuss how these ethics considerations may inform local health department practices intended to promote a robust emergency response. (shrink)

The public safety, human services, health, and relief workers who comprise the first wave of a response to natural or man-made disasters play a critical role in emergency preparedness. These first responders provide care and services in the immediate aftermath of emergencies and may remain in affected communities for weeks or months. They often work long hours under stressful conditions, witnessing the human harms, physical destruction, and psychological devastation that can accompany disasters.

The public safety, human services, health, and relief workers who comprise the first wave of a response to natural or man-made disasters play a critical role in emergency preparedness. These first responders provide care and services in the immediate aftermath of emergencies and may remain in affected communities for weeks or months. They often work long hours under stressful conditions, witnessing the human harms, physical destruction, and psychological devastation that can accompany disasters.

Public health emergencies, including infectious disease outbreaks and natural disasters, are issues faced by every community. To address these threats, it is critical for all jurisdictions to understand how law can be used to enhance public health preparedness, as well as improve coordination and collaboration across jurisdictions. As sovereign entities, Tribal governments have the authority to create their own laws and take the necessary steps to prepare for, respond to, and recover from disasters and emergencies. Legal preparedness is (...) a key component of public health preparedness. This article first explains legal preparedness and Tribal sovereignty and then describes the relationship between Tribal Nations, the US government, and states. Specific Tribal concerns with respect to emergency preparedness and the importance of coordination and collaboration across jurisdictions for emergency preparedness are discussed. Examples of collaborative efforts between Tribal and other governments to enhance legal preparedness are described. (shrink)

This paper examines the challenge of the calculus of risk while arguing for the necessity of new risk architecture. The field of catastrophe risk management today is faced with disasters of a totally new nature and scale as well recent important events that pose significant challenges to the established paradigm. This paper proposes a new risk architecture based around the following six central features: Growing interdependencies/globalization; change in scale from local to global risks; extreme costs, extreme benefits ; confusing distribution (...) of roles and responsibilities of preparedness; celerity ; and uncertainty, if not ignorance. The paper then looks at large-scale natural disasters and terrorism threats as two illustrative cases for understanding this new threat architecture, arguing that uncertainty related to the estimate of future disaster is even more challenging because it is so dynamic. The paper argues that in this new era of global risks and interdependencies, how people make long-term decision under conditions of uncertainty will be an important element to consider in developing the new risk architecture. (shrink)

The disability viewpoint is the fundamental for understanding social justice in a given population. Disability rights need to be obeyed in the inclusive preparedness and response to all the disasters or during the crisis period including COVID-19 pandemic. COVID-19 pandemic jeopardized the health and rehabilitation services globally. The impact is much more in low resource developing countries like Bangladesh. In general, people with disability (PWD) suffer from multiple medical and rehabilitation complications and they need frequent rehabilitation consultations or hospital (...) admissions in comparison to people without disability. As a developing country, Bangladesh has poor ratios of doctors, nurses and technologists of 1:0.4:0.24 (WHO: 1:3:5) to face the COVID-19 challenge. Rehabilitation services have been disrupted in almost two-thirds (63%) of countries of the world. Even though rehabilitation is the key to recovery following severe illness from COVID-19. There are many concerns and debates about the preparedness, response and mitigation the process of COVID-19 on the part of the national government. According to recent study reports, the lives of about 100% of PWD have been impacted by the COVID-19 pandemic. COVID-19 National Technical Advisory Committee is working for strategic planning, response and mitigation process but omission of a representative of PWD or a rehabilitation physician in the committee has created much dissatisfaction. The difficult COVID-19 testing process due to country wide shutdown of rehabilitation essential services and central pulling of rehabilitation physicians have side lined the PWD inclusiveness. It is expected that the rehabilitation preparedness, response and mitigation of the pandemic should be based on an ethics driven process. (shrink)