Overcrowding after a natural disaster is a risk factor for several airborne diseases and those transmitted by large droplets, including tuberculosis, varicella zoster virus, measles, meningococcal meningitis, and other emerging infectious diseases.[6] Therefore, flood planning should include plans to transfer patients to other facilities when patient acuity and volume exceeds the hospital's ability to respond. Plans for prioritized inpatient care and screening of outpatients for communicable diseases such as tuberculosis, influenza, and emerging infectious diseases should be fully agreed to and reviewed. In resource-limited settings, natural air ventilation based on predictable wind flow patterns away from HCWs and toward patients may be considered for use to limit the spread of potentially transmissible agents.
Several healthcare-associated noninfectious conditions during and after flooding deserve note. Exposure to particles of less than 10 microns in diameter during clean-up can exacerbate wheezing, asthma, and respiratory infections.[41,42] Exposure to carbon monoxide in a poorly ventilated area can induce tachypnea and reduce oxygen delivery to key organs.[43,44] Excess humidity has been associated with the growth of fungi. Sick-building syndrome can occur in buildings with high bacterial air bio-burdens.[45] Prolonged exposures to asbestos during demolition can occur.[46] Hospital administration should consider delaying re-opening units until indoor air quality has returned to normal. Serial monitoring of the hospital indoor air quality, and policies to exclude patients and HCWs from high-risk areas, or require mask use in high-risk areas if exposure is unavoidable, are relevant interventions to minimize occupational risks to HCWs and optimize patient safety postflooding.
Overcrowding after a natural disaster is a risk factor for several airborne diseases and those transmitted by large droplets, including tuberculosis, varicella zoster virus, measles, meningococcal meningitis, and other emerging infectious diseases.[6] Therefore, flood planning should include plans to transfer patients to other facilities when patient acuity and volume exceeds the hospital's ability to respond. Plans for prioritized inpatient care and screening of outpatients for communicable diseases such as tuberculosis, influenza, and emerging infectious diseases should be fully agreed to and reviewed. In resource-limited settings, natural air ventilation based on predictable wind flow patterns away from HCWs and toward patients may be considered for use to limit the spread of potentially transmissible agents.Several healthcare-associated noninfectious conditions during and after flooding deserve note. Exposure to particles of less than 10 microns in diameter during clean-up can exacerbate wheezing, asthma, and respiratory infections.[41,42] Exposure to carbon monoxide in a poorly ventilated area can induce tachypnea and reduce oxygen delivery to key organs.[43,44] Excess humidity has been associated with the growth of fungi. Sick-building syndrome can occur in buildings with high bacterial air bio-burdens.[45] Prolonged exposures to asbestos during demolition can occur.[46] Hospital administration should consider delaying re-opening units until indoor air quality has returned to normal. Serial monitoring of the hospital indoor air quality, and policies to exclude patients and HCWs from high-risk areas, or require mask use in high-risk areas if exposure is unavoidable, are relevant interventions to minimize occupational risks to HCWs and optimize patient safety postflooding.
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