OBJECTIVE: To explore the feasibility of establishing a temporary trauma team led by trauma experts in primary hospitals for disaster medical rescue. METHODS: In the coal mine flooding accident in Xiaoyi City, Shanxi Province on December 15, 2021, according to the local emergency plan and the characteristics of the accident, the trauma experts trained the medical staff from the local primary hospital on advanced trauma life support (ATLS) and damage control surgery (DCS) in the short time interval between the occurrence of the mine disaster and the admission of medical staff to the disaster scene. A temporary trauma team composed of trauma experts, ATLS team, and DCS team was formed to provide early diagnosis and treatment for survivors before and in the hospital. RESULTS: The miners were found on the 36th hour of the disaster. All 22 miners were male, and 2 died underground. Another 20 people were rescued 39－43 hours after the disaster, with a median age of 48 years (34-57 years). All the survivors suffered from hypothermia, dehydration, maceration of feet and other injuries. There were 18 cases of acute inhalation tracheobronchitis, 14 cases of electrolyte acid-base disturbance, 6 cases of trunk contusion, 1 case of psoas major hematoma, and 1 case of lower extremity hematoma. Deep vein thrombosis was in 4 cases. The ATLS team focused on injury assessment, rewarming and rehydration within 50－60 minutes before admission, and completed auxiliary examinations within 2 hours after admission to clarify the diagnosis. The DCS team evaluated 6 patients with mechanical blunt trunk injury and excluded the indication of emergency surgery. The trauma experts conducted the whole process of supervision and quality control of disaster rescue. The positive rate of capillary refill test in the all survivors at the third hour of admission was significantly lower than that immediately after being rescued (75.0% vs. 15.0%, P=0.000 3), and they were discharged 4－7 days after admission. CONCLUSION Under the leadership of trauma experts and relying on the medical staff of primary hospitals, it is feasible to establish and train a temporary trauma team with ATLS and DCS functions to participate in the medical rescue of disasters, which is in line with the current national conditions of China.
Humans ; Adult ; Middle Aged ; Male ; Rescue Work/organization & administration* ; China ; Disasters ; Patient Care Team/organization & administration* ; Wounds and Injuries/therapy* ; Advanced Trauma Life Support Care/organization & administration* ; Disaster Planning/organization & administration* ; Emergency Medical Services/organization & administration*

Betacoronavirus ; Communicable Disease Control ; organization & administration ; Coronavirus Infections ; epidemiology ; prevention & control ; transmission ; Disaster Planning ; organization & administration ; Humans ; Nuclear Medicine ; organization & administration ; Pandemics ; prevention & control ; Pneumonia, Viral ; epidemiology ; prevention & control ; transmission ; Singapore

OBJECTIVES: The pandemic of novel influenza A (H1N1) virus has required decision-makers to act in the face of the substantial uncertainties. In this study, we evaluated the potential impact of the pandemic response strategies in the Republic of Korea using a mathematical model. METHODS: We developed a deterministic model of a pandemic (H1N1) 2009 in a structured population using the demographic data from the Korean population and the epidemiological feature of the pandemic (H1N1) 2009. To estimate the parameter values for the deterministic model, we used the available data from the previous studies on pandemic influenza. The pandemic response strategies of the Republic of Korea for novel influenza A (H1N1) virus such as school closure, mass vaccination (70% of population in 30 days), and a policy for anti-viral drug (treatment or prophylaxis) were applied to the deterministic model. RESULTS: The effect of two-week school closure on the attack rate was low regardless of the timing of the intervention. The earlier vaccination showed the effect of greater delays in reaching the peak of outbreaks. When it was no vaccination, vaccination at initiation of outbreak, vaccination 90 days after the initiation of outbreak and vaccination at the epidemic peak point, the total number of clinical cases for 400 days were 20.8 million, 4.4 million, 4.7 million and 12.6 million, respectively. The pandemic response strategies of the Republic of Korea delayed the peak of outbreaks (about 40 days) and decreased the number of cumulative clinical cases (8 million). CONCLUSIONS: Rapid vaccination was the most important factor to control the spread of pandemic influenza, and the response strategies of the Republic of Korea were shown to delay the spread of pandemic influenza in this deterministic model.
Antiviral Agents/therapeutic use ; Disaster Planning/*organization & administration ; *Disease Outbreaks ; Health Policy ; Humans ; Immunization Programs/organization & administration ; *Influenza A Virus, H1N1 Subtype ; Influenza, Human/drug therapy/*epidemiology/prevention & control ; *Models, Theoretical ; Quarantine/organization & administration ; Republic of Korea/epidemiology

OBJECTIVES: To evaluate the policies on 2009 influenza pandemic in Korea at the end of first wave. METHODS: The main policies and the estimation of these were described according to the progress of 2009 influenza pandemic. RESULTS: The public health measures for containment were estimated to be successful in the early stage. The preparedness of antiviral agents and vaccines before the pandemic, risk-communication on pandemic influenza and policies of government including vaccines, and the education of health care worker and support of health care institutions was not enough to respond to the pandemic. CONCLUSIONS: The additional evaluation should be performed at the end of the pandemic in various aspects including health and socioeconomic effects.
Antiviral Agents/therapeutic use ; Disaster Planning/*organization & administration ; *Disease Outbreaks ; *Health Policy ; Humans ; *Influenza A Virus, H1N1 Subtype ; Influenza Vaccines ; Influenza, Human/drug therapy/*epidemiology/prevention & control ; Program Evaluation ; Republic of Korea/epidemiology

The World Health Organization (WHO) announced the emergence of a novel influenza on April 24, 2009, and they declared pandemic on June 11. In Korea, the proportion of influenza-like illness and the consumption of antiviral agents peaked in early November. The government established the Central Headquarters for Influenza Control and operated the emergency response system. In the quarantine stations, we checked the body temperature and collected quarantine questionnaires from all the arrivals from infected countries. We also isolated the confirmed cases in the national isolation hospitals. However, as the community outbreaks were reported, we changed strategy from containment to mitigation. We changed the antiviral agent prescription guideline so that doctors could prescribe antiviral agents to all patients with acute febrile respiratory illness, without a laboratory diagnosis. Also the 470 designated hospitals were activated to enhance the efficacy of treatment. We vaccinated about 12 million people and manage the adverse event following the immunization management system. In 2010, we will establish additional national isolation wards and support hospitals to establish fever clinics and isolation intensive care unit (ICU) beds. We will also make a computer program for managing the national isolation hospitals and designated hospitals. We will establish isolation rooms and expand the laboratory in quarantine stations and we will construct a bio-safety level 3 laboratory in each province. In addition, we plan to construct a bio-safety level 4 laboratory at a new Korea Centers for Disease Control and Prevention (KCDC) facilities in Ossong.
Antiviral Agents/therapeutic use ; Disaster Planning/*organization & administration ; *Disease Outbreaks ; Humans ; *Influenza A Virus, H1N1 Subtype ; Influenza, Human/drug therapy/*epidemiology ; Quarantine/organization & administration ; Republic of Korea/epidemiology ; World Health Organization

Disaster Planning ; organization & administration ; Emergencies ; Emergency Medical Services ; organization & administration ; Humans ; Public Health ; methods

China ; epidemiology ; Disaster Planning ; organization & administration ; Disease Outbreaks ; prevention & control ; Humans ; Influenza A Virus, H1N1 Subtype ; Influenza, Human ; epidemiology ; prevention & control

OBJECTIVES: Bioterrorism (BT) preparedness and response plans are particularly important among healthcare workers who will be among the first involved in the outbreak situations. This study was conducted to evaluate the current status of education for BT preparedness and response in healthcare-related colleges/junior colleges and to develop learning objectives for use in their regular curricula. METHODS: We surveyed all medical colleges/schools, colleges/junior colleges that train nurses, emergency medical technicians or clinical pathologists, and 10% (randomly selected) of them that train general hygienists in Korea. The survey was conducted via mail from March to July of 2007. We surveyed 35 experts to determine if there was a consensus of learning objectives among healthcare workers. RESULTS: Only 31.3% of medical colleges/schools and 13.3% of nursing colleges/junior colleges had education programs that included BT preparedness and responses in their curricula. The most common reason given for the lack of BT educational programs was 'There is not much need for education regarding BT preparedness and response in Korea'. None of the colleges/junior colleges that train clinical pathologists, or general hygienists had an education program for BT response. After evaluating the expert opinions, we developed individual learning objectives designed specifically for educational institutions. CONCLUSIONS: There were only a few colleges/junior colleges that enforce the requirement to provide education for BT preparedness and response in curricula. It is necessary to raise the perception of BT preparedness and response to induce the schools to provide such programs.
*Bioterrorism ; Curriculum ; Disaster Planning/*organization & administration ; Humans ; Korea ; Schools, Health Occupations/*organization & administration

Due to heightened concerns regarding possible bioterrorist attacks, the Korea Center for Disease Control and Prevention introduced syndromic surveillance systems, which have been run by emergency departments in hospitals throughout Korea since 2002. These systems are designed to identify illness clusters before diagnoses are confirmed and reported to public health agencies, to mobilize a rapid response, and thereby to reduce morbidity and mortality. The Korea Center for Disease Control and Prevention performed drop-in syndromic surveillance successfully during the World Cup Football Games in 2002, the Universiad games in 2004, and the Asian Pacific Economic Cooperation meeting in 2005. In addition, sustainable syndromic surveillance system involving the collaborative efforts of 125 sentinel hospitals has been in operation nationwide since 2002. Because active data collection can bias decisions a physician makes, there is a need to generate an automatic and passive data collection system. Therefore, the Korea Center for Disease Control and Prevention plans to establish computerized automatic data collection systems in the near future. These systems will be used not only for the early detection of bioterrorism but also for more effective public health responses to disease.
*Bioterrorism ; Disaster Planning/organization & administration ; Disease Notification/*methods ; Disease Outbreaks/prevention & control ; Emergency Service, Hospital/*organization & administration ; Humans ; Korea ; Public Health Informatics/*organization & administration ; *Sentinel Surveillance ; Syndrome

Bioterrorism events have worldwide impacts, not only in terms of security and public health policy, but also in other related sectors. Many countries, including Korea, have set up new administrative and operational structures and adapted their preparedness and response plans in order to deal with new kinds of threats. Korea has dual surveillance systems for the early detection of bioterrorism. The first is syndromic surveillance that typically monitors non-specific clinical information that may indicate possible bioterrorismassociated diseases before specific diagnoses are made. The other is infectious disease specialist network that diagnoses and responds to specific illnesses caused by intentional release of biologic agents. Infectious disease physicians, clinical microbiologists, and infection control professionals play critical and complementary roles in these networks. Infectious disease specialists should develop practical and realistic response plans for their institutions in partnership with local and state health departments, in preparation for a real or suspected bioterrorism attack.
*Bioterrorism ; Communicable Disease Control/organization & administration ; Disaster Planning/*organization & administration ; Disease Notification/methods ; Disease Outbreaks/prevention & control ; *Health Policy ; Humans ; Korea ; *Sentinel Surveillance ; Specialties, Medical/organization & administration