BACKGROUND: Despite existing disaster preparedness policies in the Philippines, there has not been any validated assessment of the quality of disaster medical response, which would require reliable aggregate data on patient diagnoses and management.

OBJECTIVE: This mixed-methods study documented the diagnoses, triage classification and case management of patients seen by Philippine EMS groups who responded to the Typhoon Haiyan disaster in the Philippines in November and December 2013, as well as difficulties associated in gathering these data, using the Utstein-style Template for Uniform Data Reporting of Acute Medical Response in Disasters as framework.

METHODS: Three hundred (300) individuals vetted by EMS organizations were invited to answer a survey modeled after the Utstein-style template, and submit tallies of patients seen. Out of 52 responses received, policy recommendations were subsequently generated on concerns assessed by the template using the nominal group technique.

RESULTS: The submitted data yielded a total of 41,202 patients with information on age, sex, and diagnosis; 19,193 with triage classification; and 27,523 with information on case management. The focus group discussion underlined the absence of a standard communication and information management system. Participants recommended establishing such a system and highlighted the role of the Department of Health - Health Emergency Management Bureau in coordinating disaster medical response efforts and information management.

CONCLUSION: This study underlines the importance of effective communication, and multisectoral coordination, to generate reliable data and thus, facilitate resource allocation for disaster medical response.

Human ; Cyclonic Storms ; Disaster Medicine ; Emergency Medical Services ; Relief Work

BACKGROUND: Despite the implementation of policies related to disaster risk reduction and management in the Philippines, the response after Typhoon Haiyan in November 2013 was hampered by operational challenges.

OBJECTIVE: The purpose of this study was to document disaster response experiences of Typhoon Haiyan from field level emergency medical service (EMS) responders, a key component of the disaster response, specifically the enabling factors and hindrances to disaster medical response activities, including their self-perceived level of preparedness in these activities.

METHODS: In this mixed-methods study, 52 respondents identified enabling factors and hindrances to their disaster response and their corresponding self-perceived level of preparedness. In a subsequent focus group discussion, the researchers used the nominal group technique to process the respondents' experiences.

RESULTS: The respondents identified factors that enabled or hindered their response activities such as coordination, stress debriefing, infrastructure, and preparedness. Furthermore, an average of 33% of the respondents said they were adequately prepared to deliver the necessary medical services during the disaster response, thus validating previous studies on preparedness and disaster response operations.

CONCLUSION: The government should critically examine its cluster approach to disaster response and consider an integrated, inclusive, and proactive approach in disaster planning.

Human ; Male ; Female ; Disasters ; Emergency Medical Services

Background: and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. Conclusions During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.