Afet ve Salgınların Sağlık Hizmeti Veren Kurumlara ve Tıbbi Mikrobiyoloji Laboratuvarlarına Etkileri
Özet
Afetler ve salgınlar, sağlık kurumları ile tıbbi mikrobiyoloji laboratuvarları üzerinde ciddi etkiler yaratmaktadır. Bu tür olaylar sırasında sağlık tesislerinin fiziksel yapıları ve kapasiteleri zarar görebilir, bu da hizmet sunumunu ve acil müdahaleleri olumsuz yönde etkileyebilir. Ayrıca, iletişim altyapısındaki hasarlar müdahale sürecini zayıflatabilir. Sağlık kurumlarının maruz kaldığı zararlar, afetin büyüklüğü ve kurumların hazırlıklı olma düzeyine göre değişiklik gösterebilir. Afet ve salgınlardan olumsuz etkilenen laboratuvarlar, salgın hastalıkların kontrolünde ve enfeksiyon yönetiminde kritik bir rol oynamaktadır. Laboratuvarlar, salgın dönemlerinde enfeksiyonların doğru ve hızlı bir şekilde teşhis edilmesinde ve bu verilere dayalı önlemlerin alınmasında hayati öneme sahiptir. Ancak afetler ve salgınlar sırasında malzeme tedarikinde yaşanan sıkıntılar, laboratuvar ekipmanlarının kullanılamaz hale gelmesi ve personel eksiklikleri gibi zorluklar, bu kritik hizmetlerin aksamasına neden olabilir. Özellikle COVID-19 pandemisi süresince laboratuvarlar, artan test talebi nedeniyle iş yükünü karşılamakta zorlanmış, tedarik zincirindeki kesintiler nedeniyle gerekli malzemelere erişim güçleşmiştir. Bu durum, tanı ve tedavi süreçlerinde gecikmelere ve hizmet kalitesinde düşüşlere yol açmıştır. Sonuç olarak, afetler ve salgınların etkileri, sağlık sistemlerinin her düzeyinde hissedilmekte, sağlık kurumları ve laboratuvarlar üzerindeki baskı uzun vadeli olumsuz sonuçlar doğurmaktadır.
Bu etkilerin hafifletilebilmesi için sağlık kurumlarının ve laboratuvarların afet ve salgınlara karşı hazırlıklı olması, önceden belirlenmiş acil durum planlarının etkin bir şekilde uygulanması büyük önem taşımaktadır.
Disasters and epidemics have significant impacts on healthcare institutions and medical microbiology laboratories. During such events, the physical structures and capacities of healthcare facilities may be damaged, adversely affecting service delivery and emergency interventions. Furthermore, damage to communication infrastructure can weaken the response process. The extent of harm experienced by healthcare institutions may vary depending on the magnitude of the disaster and the level of institutional preparedness. Laboratories play a crucial role in controlling epidemic diseases and managing infections, especially when they are affected by disasters and epidemics. They are of vital importance for the accurate and rapid diagnosis of infections during epidemic periods and for implementing preventive measures based on these data. However, challenges such as difficulties in material supply, unusable laboratory equipment, and personnel shortages during disasters and epidemics can lead to interruptions in these critical services. Particularly during the COVID-19 pandemic, laboratories struggled to meet the increased workload due to rising test demands, and access to necessary materials became difficult due to disruptions in the supply chain. This situation led to delays in diagnosis and treatment processes and declines in service quality. In conclusion, the effects of disasters and epidemics are felt at every level of health systems, and the pressure on healthcare institutions and laboratories results in long-term negative consequences.
To mitigate these effects, it is of great importance that healthcare institutions and laboratories are prepared for disasters and epidemics, and that predetermined emergency plans are effectively implemented.
Referanslar
Madhav N, Oppenheim B, Gallivan M, Mulembakani P, Rubin E, Wolfe N. Pandemics: risks, impacts, and mitigation. Pp. 315-345. In: Jamison DT, Gelband H, Horton S, Jha P, Laxminarayan R, Mock CN, editors. Disease control priorities: improving health and reducing poverty. 2017, 3rd ed. Washington (DC): The World Bank; 2017.
Jazieh AR, Kozlakidis Z. Healthcare transformation in the post-coronavirus pandemic era. Front Med (Lausanne) 2020;7:429.
Gully PR. Pandemics, regional outbreaks, and sudden-onset disasters. Healthc Manage Forum. 2020;33(4):164-169.
Makwana N. Public health care system's preparedness to combat epidemics after natural disasters. J Family Med Prim Care 2020;9(10):5107-5112.
Issel LM. Disasters and health care management research. Health Care Manage Rev 2019;44(1):1-2.
Akpan-Idiok PA, Akpan-Idiok AU. Disasters: implications for public health and health care system. Glob J Med Sci 2010;9(1-2):13-26.
The World Bank. Supporting post-earthquake recovery in China [Internet]. 2012 [cited 2022 Jul 28]. Available from: https://www.worldbank.org/en/news/feature/2012/12/04/supporting-post-earthquake-recovery-in-china
Watts J. China's health challenges after the earthquake. Lancet 2008;371(9627):1825-1826.
Centers for Disease Control and Prevention (CDC). Remediation and infection control considerations for reopening healthcare facilities closed due to extensive water and wind damage [Internet]. 2017 [cited 2022 Jul 18]. Available from: https://www.cdc.gov/disasters/reopen_healthfacilities.html
Pourhosseini SS, Ardalan A, Mehrolhassani MH. Key aspects of providing healthcare services in disaster response stage. Iran J Public Health 2015;44(1):111-118. PMID: 26060782.
Bell SA, Abir M, Choi H, Cooke C, Iwashyna T. All-cause hospital admissions among older adults after a natural disaster. Ann Emerg Med 2018;71(6):746-754.e2.
Correl R. Public health threats during and after a natural disaster [Internet]. Very well Health; 2022 May 12 [cited 2022 Jul 10]. Available from: https://www.verywellhealth.com/health-threats-and-epidemics-after-natural-disasters-4149848
Waring SC, Brown BJ. The threat of communicable diseases following natural disasters: a public health response. Disaster Manag Response 2005;3(1):41-47.
Gultekin T, Varol N. Disasters and the elderly: the Turkey case. Pap Anthropol 2019;28(1):36-46.
Davis JR, Wilson S, Brock-Martin A, Glover S, Svendsen ER. The impact of disasters on populations with health and health care disparities. Disaster Med Public Health Prep 2010;4(1):30-38.
Curran M, Howley E, Duggan J. An analytics framework to support surge capacity planning for emerging epidemics. Pp: 151-155. In: Proceedings of the 6th International Conference on Digital Health; 2016 April.
Itzwerth RL, Macintyre CR, Shah S, Plant AJ. Pandemic influenza and critical infrastructure dependencies: possible impact on hospitals. Med J Aust 2006;185(S10)
Dinçer S, Kumru S. Afet ve acil durumlar için sağlık personelinin hazırlıklı olma durumu. Gumushane Univ Sag Bilim Derg 2021;10(1):32-43.
Preti E, Di Mattei V, Perego G, Ferrari F, Mazzetti M, Taranto P, et al. The psychological impact of epidemic and pandemic outbreaks on healthcare workers: rapid review of the evidence. Curr Psychiatry Rep 2020;22(8):43.
Türk Tabipleri Birliği. 3. ay deprem raporu: birinci basamak sağlık hizmetlerine erişim ve sağlık çalışanlarının sağlığı. 1-30 Nisan 2023 [Internet]. Ankara; 2023 [cited 2023 Jul 25]. Available from: www.ttb.org.tr/userfiles/files/3ayraporu.pdf
World Health Organization. WHO launches first ever global report on infection prevention and control [Internet]. 2022 May 6 [cited 2022 Jul 10]. Available from: https://www.who.int/news/item/06-05-2022-who-launches-first-ever-global-report-on-infection-prevention-and-control
Durmaz S, Küçük EF, Şimşek S, Durgun K, Karakaş EB, Durusoy R. Outcomes of COVID-19 contact tracing in hospital healthcare workers: a retrospective cohort study. J Pak Med Assoc 2022;72(4):707-713.
National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy; Forum on Medical and Public Health Preparedness for Disasters and Emergencies. Engaging the private-sector health care system in building capacity to respond to threats to the public's health and national security: proceedings of a workshop. Washington (DC): National Academies Press (US); 2018.
Bar-Dayan Y, Leiba A, Beard P, Mankuta D, Engelhart D, Beer Y, et al. Multidisciplinary field hospital as a substitute for medical hospital care in the aftermath of an earthquake: the experience of the Israeli Defense Forces Field Hospital in Duzce, Turkey, 1999. Prehosp Disaster Med 2005;20(2):103-106.
World Health Organization. COVID-19: occupational health and safety for health workers: interim guidance, 2 February 2021. Geneva: World Health Organization; 2021. Report No.: WHO/2019-nCoV/HCW_advice/2021.1.
Iserson KV. Augmenting the disaster healthcare workforce. West J Emerg Med 2020;21(3):490-496.
T.C. Sağlık Bakanlığı Acil Hizmetleri Genel Müdürlüğü. Hastane Afet ve Acil Durum Planı (HAP) hazırlama kılavuzu (sürüm 2) [Internet]. Ankara; 2021 [cited 2023 Jul 25]. Available from: https://www.saglik.gov.tr/TR1789/hastane-afet-ve-acil-durum-plani-hap-hazirlama-kilavuzu.html
Ofrin RH, Nelwan I. Disaster risk reduction through strengthened primary health care. Reg Health Forum 2009;13(1):29-34.
Warren J, Mohamed EN, Shears P, Lacroix C, Reich A, Sanborn W, et al. Health laboratory facilities in emergency and disaster situations. WHO Reg Publ East Mediterr Ser 1994;(6):1-30.
Emori TG, Gaynes RP. An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev 1993;6(4):428-442.
Marcino D, Gordon K. An overview of the National Microbiology Laboratory emergency management program. Can Commun Dis Rep 2018;44(5):102-105.
Toney D, Pentella M, Blank E, Becker S. Creating a blueprint for the future: lessons learned from public health laboratories in the COVID-19 response. J Public Health Manag Pract 2021;27(Suppl 1)
Catalán P, Alonso R, Alcalá L, Marín M, Moure Z, Pescador P, et al. The challenge of COVID-19 for a clinical microbiology department. Diagn Microbiol Infect Dis 2021;101(2):115426.
Delić S. Will the COVID-19 pandemic change anything? A view from the angle of experts in microbiology. Zdrav Zast 2020;49(3):89-96.
Martin I, Meltzer K, Mills McNeill J, Miller D. Laboratory surge capacity and pandemic influenza. Emerg Infect Dis 2010;16(1):147-148.
Leber AL, Peterson E, Dien Bard J; Personnel Standards and Workforce Subcommittee, American Society for Microbiology. The hidden crisis in the times of COVID-19: critical shortages of medical laboratory professionals in clinical microbiology. J Clin Microbiol 2022;60(8).
Prasad K, McLoughlin C, Stillman M, Poplau S, Goelz E, Taylor S, et al. Prevalence and correlates of stress and burnout among U.S. healthcare workers during the COVID-19 pandemic: a national cross-sectional survey study. EClinicalMedicine 2021;35:100879.
Dantas E, Tosin M, Cunha Jr A. Zika virus in Brazil: calibration of an epidemic model for the 2016 outbreak. Proc Ser Braz Soc Comput Appl Math 2018;6(1):1-15.
Fischer C, Drosten C, Drexler JF. The difficulties in obtaining reliable Zika virus diagnostics. Lancet Infect Dis 2019;19(3):240-241.
Viswanathan R, Chakrabarty A, Basu S. Active support after natural disasters: a review of a microbiologist's role. Trans R Soc Trop Med Hyg 2021;115(1):110-116.
Cartwright K, Lewis D, Roberts C, Bint A, Nichols T, Warburton F. Workload and stress in consultant medical microbiologists and virologists: a questionnaire survey. J Clin Pathol 2002;55(3):200-205.
Moore JE, Millar BC. Enhanced clinical microbiology methods in outbreak management. J Infect Prev 2021;22(1):39-41.
Emori TG, Gaynes RP. An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev 1993;6(4):428-442.
Sood G, Vaidya D, Dam L, Grubb LM, Zenilman J, Krout K, et al. A polymicrobial fungal outbreak in a regional burn center after Hurricane Sandy. Am J Infect Control 2018;46(9):1047-1050.
Klinik Mikrobiyoloji Uzmanlık Derneği (KLIMUD). Mikrobiyoloji uzmanları için pandemi rehberi. 1. baskı. Ankara: KLİMUD; 2021 [cited 2023 Jul 15]. Available from: https://www.klimud.org/public/uploads/content/files/KL%C4%B0MUD%20Pandemi%20Rehberi_ver1.0.pdf
Pınar A. Afetlerde mikrobiyoloji laboratuvarları yönetimi. Pp: 307-316. In: Altıntaş KH, Bayraktar N, Erden Z, Koçer B, Demiröz F, editors. Hamer acil ve afet durumlarında sağlık yönetimi. 2013, Ankara: Hecettepe Üniversitesi Yayınları.
Ergönül Ö, Keske Ş, Ksinzik A, Güldan M, Özbek L, Azap A, et al. The challenges in the monitoring of infectious diseases after the earthquake in Türkiye in 2023. Lancet Infect Dis 2023; 23(11):e482-e488.
Referanslar
Madhav N, Oppenheim B, Gallivan M, Mulembakani P, Rubin E, Wolfe N. Pandemics: risks, impacts, and mitigation. Pp. 315-345. In: Jamison DT, Gelband H, Horton S, Jha P, Laxminarayan R, Mock CN, editors. Disease control priorities: improving health and reducing poverty. 2017, 3rd ed. Washington (DC): The World Bank; 2017.
Jazieh AR, Kozlakidis Z. Healthcare transformation in the post-coronavirus pandemic era. Front Med (Lausanne) 2020;7:429.
Gully PR. Pandemics, regional outbreaks, and sudden-onset disasters. Healthc Manage Forum. 2020;33(4):164-169.
Makwana N. Public health care system's preparedness to combat epidemics after natural disasters. J Family Med Prim Care 2020;9(10):5107-5112.
Issel LM. Disasters and health care management research. Health Care Manage Rev 2019;44(1):1-2.
Akpan-Idiok PA, Akpan-Idiok AU. Disasters: implications for public health and health care system. Glob J Med Sci 2010;9(1-2):13-26.
The World Bank. Supporting post-earthquake recovery in China [Internet]. 2012 [cited 2022 Jul 28]. Available from: https://www.worldbank.org/en/news/feature/2012/12/04/supporting-post-earthquake-recovery-in-china
Watts J. China's health challenges after the earthquake. Lancet 2008;371(9627):1825-1826.
Centers for Disease Control and Prevention (CDC). Remediation and infection control considerations for reopening healthcare facilities closed due to extensive water and wind damage [Internet]. 2017 [cited 2022 Jul 18]. Available from: https://www.cdc.gov/disasters/reopen_healthfacilities.html
Pourhosseini SS, Ardalan A, Mehrolhassani MH. Key aspects of providing healthcare services in disaster response stage. Iran J Public Health 2015;44(1):111-118. PMID: 26060782.
Bell SA, Abir M, Choi H, Cooke C, Iwashyna T. All-cause hospital admissions among older adults after a natural disaster. Ann Emerg Med 2018;71(6):746-754.e2.
Correl R. Public health threats during and after a natural disaster [Internet]. Very well Health; 2022 May 12 [cited 2022 Jul 10]. Available from: https://www.verywellhealth.com/health-threats-and-epidemics-after-natural-disasters-4149848
Waring SC, Brown BJ. The threat of communicable diseases following natural disasters: a public health response. Disaster Manag Response 2005;3(1):41-47.
Gultekin T, Varol N. Disasters and the elderly: the Turkey case. Pap Anthropol 2019;28(1):36-46.
Davis JR, Wilson S, Brock-Martin A, Glover S, Svendsen ER. The impact of disasters on populations with health and health care disparities. Disaster Med Public Health Prep 2010;4(1):30-38.
Curran M, Howley E, Duggan J. An analytics framework to support surge capacity planning for emerging epidemics. Pp: 151-155. In: Proceedings of the 6th International Conference on Digital Health; 2016 April.
Itzwerth RL, Macintyre CR, Shah S, Plant AJ. Pandemic influenza and critical infrastructure dependencies: possible impact on hospitals. Med J Aust 2006;185(S10)
Dinçer S, Kumru S. Afet ve acil durumlar için sağlık personelinin hazırlıklı olma durumu. Gumushane Univ Sag Bilim Derg 2021;10(1):32-43.
Preti E, Di Mattei V, Perego G, Ferrari F, Mazzetti M, Taranto P, et al. The psychological impact of epidemic and pandemic outbreaks on healthcare workers: rapid review of the evidence. Curr Psychiatry Rep 2020;22(8):43.
Türk Tabipleri Birliği. 3. ay deprem raporu: birinci basamak sağlık hizmetlerine erişim ve sağlık çalışanlarının sağlığı. 1-30 Nisan 2023 [Internet]. Ankara; 2023 [cited 2023 Jul 25]. Available from: www.ttb.org.tr/userfiles/files/3ayraporu.pdf
World Health Organization. WHO launches first ever global report on infection prevention and control [Internet]. 2022 May 6 [cited 2022 Jul 10]. Available from: https://www.who.int/news/item/06-05-2022-who-launches-first-ever-global-report-on-infection-prevention-and-control
Durmaz S, Küçük EF, Şimşek S, Durgun K, Karakaş EB, Durusoy R. Outcomes of COVID-19 contact tracing in hospital healthcare workers: a retrospective cohort study. J Pak Med Assoc 2022;72(4):707-713.
National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy; Forum on Medical and Public Health Preparedness for Disasters and Emergencies. Engaging the private-sector health care system in building capacity to respond to threats to the public's health and national security: proceedings of a workshop. Washington (DC): National Academies Press (US); 2018.
Bar-Dayan Y, Leiba A, Beard P, Mankuta D, Engelhart D, Beer Y, et al. Multidisciplinary field hospital as a substitute for medical hospital care in the aftermath of an earthquake: the experience of the Israeli Defense Forces Field Hospital in Duzce, Turkey, 1999. Prehosp Disaster Med 2005;20(2):103-106.
World Health Organization. COVID-19: occupational health and safety for health workers: interim guidance, 2 February 2021. Geneva: World Health Organization; 2021. Report No.: WHO/2019-nCoV/HCW_advice/2021.1.
Iserson KV. Augmenting the disaster healthcare workforce. West J Emerg Med 2020;21(3):490-496.
T.C. Sağlık Bakanlığı Acil Hizmetleri Genel Müdürlüğü. Hastane Afet ve Acil Durum Planı (HAP) hazırlama kılavuzu (sürüm 2) [Internet]. Ankara; 2021 [cited 2023 Jul 25]. Available from: https://www.saglik.gov.tr/TR1789/hastane-afet-ve-acil-durum-plani-hap-hazirlama-kilavuzu.html
Ofrin RH, Nelwan I. Disaster risk reduction through strengthened primary health care. Reg Health Forum 2009;13(1):29-34.
Warren J, Mohamed EN, Shears P, Lacroix C, Reich A, Sanborn W, et al. Health laboratory facilities in emergency and disaster situations. WHO Reg Publ East Mediterr Ser 1994;(6):1-30.
Emori TG, Gaynes RP. An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev 1993;6(4):428-442.
Marcino D, Gordon K. An overview of the National Microbiology Laboratory emergency management program. Can Commun Dis Rep 2018;44(5):102-105.
Toney D, Pentella M, Blank E, Becker S. Creating a blueprint for the future: lessons learned from public health laboratories in the COVID-19 response. J Public Health Manag Pract 2021;27(Suppl 1)
Catalán P, Alonso R, Alcalá L, Marín M, Moure Z, Pescador P, et al. The challenge of COVID-19 for a clinical microbiology department. Diagn Microbiol Infect Dis 2021;101(2):115426.
Delić S. Will the COVID-19 pandemic change anything? A view from the angle of experts in microbiology. Zdrav Zast 2020;49(3):89-96.
Martin I, Meltzer K, Mills McNeill J, Miller D. Laboratory surge capacity and pandemic influenza. Emerg Infect Dis 2010;16(1):147-148.
Leber AL, Peterson E, Dien Bard J; Personnel Standards and Workforce Subcommittee, American Society for Microbiology. The hidden crisis in the times of COVID-19: critical shortages of medical laboratory professionals in clinical microbiology. J Clin Microbiol 2022;60(8).
Prasad K, McLoughlin C, Stillman M, Poplau S, Goelz E, Taylor S, et al. Prevalence and correlates of stress and burnout among U.S. healthcare workers during the COVID-19 pandemic: a national cross-sectional survey study. EClinicalMedicine 2021;35:100879.
Dantas E, Tosin M, Cunha Jr A. Zika virus in Brazil: calibration of an epidemic model for the 2016 outbreak. Proc Ser Braz Soc Comput Appl Math 2018;6(1):1-15.
Fischer C, Drosten C, Drexler JF. The difficulties in obtaining reliable Zika virus diagnostics. Lancet Infect Dis 2019;19(3):240-241.
Viswanathan R, Chakrabarty A, Basu S. Active support after natural disasters: a review of a microbiologist's role. Trans R Soc Trop Med Hyg 2021;115(1):110-116.
Cartwright K, Lewis D, Roberts C, Bint A, Nichols T, Warburton F. Workload and stress in consultant medical microbiologists and virologists: a questionnaire survey. J Clin Pathol 2002;55(3):200-205.
Moore JE, Millar BC. Enhanced clinical microbiology methods in outbreak management. J Infect Prev 2021;22(1):39-41.
Emori TG, Gaynes RP. An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev 1993;6(4):428-442.
Sood G, Vaidya D, Dam L, Grubb LM, Zenilman J, Krout K, et al. A polymicrobial fungal outbreak in a regional burn center after Hurricane Sandy. Am J Infect Control 2018;46(9):1047-1050.
Klinik Mikrobiyoloji Uzmanlık Derneği (KLIMUD). Mikrobiyoloji uzmanları için pandemi rehberi. 1. baskı. Ankara: KLİMUD; 2021 [cited 2023 Jul 15]. Available from: https://www.klimud.org/public/uploads/content/files/KL%C4%B0MUD%20Pandemi%20Rehberi_ver1.0.pdf
Pınar A. Afetlerde mikrobiyoloji laboratuvarları yönetimi. Pp: 307-316. In: Altıntaş KH, Bayraktar N, Erden Z, Koçer B, Demiröz F, editors. Hamer acil ve afet durumlarında sağlık yönetimi. 2013, Ankara: Hecettepe Üniversitesi Yayınları.
Ergönül Ö, Keske Ş, Ksinzik A, Güldan M, Özbek L, Azap A, et al. The challenges in the monitoring of infectious diseases after the earthquake in Türkiye in 2023. Lancet Infect Dis 2023; 23(11):e482-e488.
