The establishment of rapid response teams (RRTs) has gained increasing prominence due to the growing threats of emerging infectious diseases, natural disasters, and other public health emergencies. As a center for Hajj and a regional hub for commerce and travel, the Kingdom of Saudi Arabia (KSA) faces distinct challenges. This study explores the Ministry of Health’s main reasons and challenges in establishing RRTs.

We employed a cross-sectional qualitative design, utilizing in-depth interviews with key stakeholders and document analysis to explore the historical process of establishing RRTs in KSA and the challenges encountered.

Specialists’ insights revealed that the concept of RRTs was formally introduced and applied following the initiation of the Field Epidemiology Training Program (FETP) in KSA in 1989. However, its primary implementation began after the Middle East respiratory syndrome (MERS) outbreak in 2014. Identified challenges included a lack of trained personnel and resource availability due to unclear governance. There is a need for real-time data collection and technological solutions, improved inter-agency collaboration and information sharing, and governance.

The establishment of RRTs in KSA is estimated to have started with the initiation of the FETP. The challenges encountered provide valuable lessons for future emergency responses.

Mass gathering events represent complex operational environments that challenge emergency preparedness and prehospital medical response systems. Milano Pride, Italy’s largest LGBTQIA+ event, attracts over 300,000 attendees annually and combines a dynamic parade with a high-density static concert. This study reports a 3-year experience (2022-2024) of prehospital organization, operational deployment, and patient presentation patterns during the event.

A retrospective observational study was conducted using data from medical action plans, mission reports, and patient records collected during the final day of Milano Pride from 2022 to 2024. The integrated response system included 6 Basic Life Support ambulances, one Advanced Life Support unit, foot and bicycle rescue teams, a field hospital, and a centralized command center.

A total of 165 missions were recorded across the 3 editions. Most cases were minor and managed on site; 8-20% required field hospital care and ≤7% hospital transport. Substance- and alcohol-related presentations accounted for approximately one quarter of cases annually. Trauma-related cases decreased over time. The mean patient age was 32 years, and the medical incident rate (0.17-0.20 per 1,000 participants) was lower than rates reported for comparable international events.

A structured, multidisciplinary prehospital system ensured effective on-site care while minimizing hospital impact, highlighting the importance of proactive planning and coordinated response in large urban mass gatherings.

The purpose of this study was to assess senior nursing students’ performance and perceived readiness following a fully immersive VR mass disaster triage simulation and evaluate the effectiveness of VR as an educational modality for emergency preparedness training.

A retrospective observational study assessed BSN students who participated in a VR simulation incorporating START triage and TeamSTEPPS™ principles. Sixty-four students completed the post-experience survey using validated PACT instruments and custom measures.

Students demonstrated successful application of START triage methods and TeamSTEPPS domains during the simulation. Students reported significant increases in perceived knowledge of emergency response (M = 64.3%, SD = 27.5), attitude toward mass disaster training importance (M = 76.8%, SD = 24.5), and ability to respond (M = 66.9%, SD = 26.2). Wilcoxon signed-rank tests revealed significant improvements in understanding of all TeamSTEPPS concepts (P <.05).

VR simulation effectively enhanced nursing students’ perceived readiness for mass disaster response and demonstrated successful application of emergency skills, supporting its integration into nursing curricula for Generation Z learners.

Children are uniquely vulnerable to chemical, biological, radiological, and nuclear (CBRN) events due to anatomical, physiological, and psychological differences. Current decontamination practices are adapted from adult protocols.

To evaluate current practices, challenges, and special considerations in pediatric decontamination during CBRN events.

A scoping review was conducted using six databases in accordance with PRISMA-ScR framework. Studies were eligible if they evaluated decontamination methods involving children (0-18 years) in real or simulated CBRN scenarios. Fourteen studies met the inclusion criteria, and data were thematically analyzed into four domains.

Disrobing is widely recognized as a critical first step in the decontamination process, and 43% of the studies reviewed identified it as such. When done immediately and appropriately, it can remove a significant amount of contaminants. Although its effectiveness varies based on how much of the body is covered and the nature of the exposure. Dry decontamination was discussed in 21% of studies, and wet decontamination was the most commonly reported approach, appearing in 93%. Key pediatric challenges included hypothermia, psychological distress, separation from caregivers, and difficulties managing non-ambulatory or special needs populations. Few studies addressed age-specific protocols or long-term psychological impacts. The results are presented in procedural order to reflect the typical sequence of decontamination in CBRN response.

Current decontamination guidelines inadequately address pediatric-specific needs. There is a critical need for standardized, age-appropriate guidelines that integrate caregiver support and psychosocial considerations. A pediatric decontamination algorithm was developed to consolidate current evidence into a practical framework for CBRN mass casualty incidents.

Rural and urban environments are exposed to the same types of climate-induced disasters, but rural populations are considered particularly vulnerable to the adverse health effects associated with these disasters. This study compares individual-level public health preparedness for climate-induced disasters in rural versus urban environments and examines the impact of rurality on variables that influence preparedness attitudes and behaviors.

A national, online survey was conducted from April to June 2024. Chi-squared tests and multiple logistic regression models with interaction terms were used to compare the preparedness attitudes and behaviors reported by rural and urban populations.

Rural and urban populations generally shared preparedness attitudes and behaviors, but several significant differences were observed. Regression analysis suggested that rurality interacted with age and income to play a significant role in modifying the odds of having an evacuation plan and reporting concern about the severity of future climate-induced disasters.

Rurality appears to influence certain attitudes and behaviors related to preparedness for climate-induced disasters. Should climate-induced behaviors become more frequent and severe in the future, dedicated efforts should be taken to ensure that these events do not exacerbate health disparities between rural and urban environments.

CBRN events can occur randomly or intentionally. Rapid and appropriate response to CBRN events can significantly mitigate the adverse effects on physical health and reduce mortality rates. The effectiveness of these responses largely depends on the preparedness of hospital emergency Clinical staff.

This study was a mixed-methods research aiming to develop and validate a psychometric research instrument in 2025. Based on the review of the literature regarding CBRN events, the items were extracted, rewritten, and validated. In the quantitative phase, the validity of the questionnaire was evaluated in terms of face, content, and construct validity, and its reliability was evaluated based on internal consistency and stability (Cronbach’s alpha and Interclass Correlation Coefficient [ICC]).

The designed questionnaire included 6 dimensions and 65 items. The dimensions included (1) programs and guidelines, treatment of the injured; (2) exercise; (3) decontamination and waste management; (4) education and human resources; (5) prevention, coordination, and security; and (6) PPE. The content and face validity of the questionnaire were approved by the specialists and experts of hospital emergency and health in disasters and emergencies. The content validity ratio was >0.6 for all items. The content validity index was also approved for all items. The Cronbach’s alpha coefficient and ICC were respectively 0.977 and 0.972 for the total questionnaire.

Hospital Emergency Clinical Staff play a vital role in responding to CBRN events; therefore, policies, programs, coordination efforts, budgets, and other necessary measures are strongly recommended to increase ED clinical staff preparedness against CBRN events.

We aimed to investigate the private health service delivery sector’s engagement in public health emergency preparedness and response in Cambodia, Laos, and Vietnam.

Between November 2022 and March 2023, private health care providers from registered clinics and hospitals (n = 574) and pharmacies (n = 1008) were surveyed on their participation and willingness to engage in specific public health emergency preparedness and response activities.

In Vietnam, 40% of respondents reported being engaged in emergency response between 2020 and 2022, compared to 33% in Cambodia and 25% in Laos. Provider and pharmacist participation in the COVID-19 response was largely through their own initiative and included on-the-job COVID-19 trainings, providing health information to patients, and assisting with testing and contact tracing. Respondents expressed high levels of willingness to participate in a broad range of proposed activities, particularly those from clinics or hospitals and those with previous experience.

While respondent willingness for involvement in preparedness and response is high, only a small proportion of respondents had been engaged by health authorities, revealing missed opportunities for fully leveraging private health care providers. Future policy and programmatic efforts to strengthen health security in view of more resilient mixed health systems should proactively engage private sector actors.

Evaluate factors influencing the decision-making processes of school administrators and investigate the existence and use of emergency operations plans (EOPs) during the COVID-19 pandemic.

Using survey data representative of US K-12 public schools in 2022, the prevalence of 16 factors that influenced reporting school administrators’ COVID-19 prevention strategy implementation decision-making (Wave 4; N = 399) and the presence and use of school EOPs (Wave 5; N = 400) are presented overall and by urban-rural classification, poverty level, and school level. Qualitative interviews were conducted with a subset of school administrators and used thematic analysis to understand factors influencing implementation of prevention strategies and emergency preparedness.

School district requirements or recommendations (81.6%) was the top reported factor influencing decisions on the use of COVID-19 prevention strategies. Although most schools created or updated their EOP during the 2021/2022 school year (78.1%), only 26.7% implemented or exercised an EOP during the COVID-19 pandemic. Themes from qualitative analysis focused on factors influencing the implementation of prevention strategies, limitations of current EOPs, and importance of continuous investment in school preparedness.

Investing in actions to improve schools’ capacity to respond to emergencies such as developing comprehensive EOPs, building partnerships, and defining roles and responsibilities is important.

To identify changes in emergency department (ED) use in Houston, TX during the mid-summer Hurricane Beryl-induced power outage to inform future targeted public health interventions.

Syndromic surveillance system ED visit daily counts for total visits, heat-related illness, carbon monoxide poisoning, acute cardiac condition, stroke, dialysis, and medication refills post-hurricane were statistically compared to the 2 weeks prior and plotted alongside the percentage of the population with power outage.

Daily ED visits post-storm were statistically higher (P< 0.05) than the 2 weeks prior for total visits and acute cardiac events (Day 1, 2); heat-related illness (Day 1-3); dialysis (Day 0-3); and carbon monoxide poisoning and medication refill (Day 1-9).

While 50% of the city experienced power outages from high winds, total ED visits, acute cardiac events, and heat-related illness were statistically higher in the first 3 days after Beryl than expected. Houston developed targeted messaging to mitigate these events in future disasters.

About 13% of pregnant women with substance use disorder (SUD) receive treatment and many may encounter challenges in accessing perinatal care, making it critical for this population to receive uninterrupted care during a global pandemic.

From October 2021-January 2022, we conducted an online survey of pregnant and postpartum women and interviews with clinicians who provide care to this population. The survey was administered to pregnant and postpartum women who used substances or received SUD treatment during the COVID-19 pandemic.

Two hundred and ten respondents completed the survey. All respondents experienced pandemic-related barriers to routine health care services, including delays in prenatal care and SUD treatment. Disruptions in treatment were due to patient factors (38.2% canceled an appointment) and clinic factors (25.5% had a clinic cancel their appointment). Respondents were generally satisfied with telehealth (M = 3.97, SD = 0.82), though half preferred a combination of in-person and telehealth visits. Clinicians reported telehealth improved health care access for patients, however barriers were still observed.

Although strategies were employed to mitigate barriers in care during COVID-19, pregnant and postpartum women who used substances still experienced barriers in receiving consistent care. Telehealth may be a useful adjunct to enhance care access for pregnant and postpartum women during public health crises.

The roles and responsibilities of the public health emergency preparedness (PHEP) and response workforce have changed since the last iteration of competencies developed in 2010. This project aims to identify current competencies (i.e., knowledge, skills, and abilities) for the PHEP workforce, as well as all public health staff who may contribute to a response.

Five focus groups with members of the PHEP workforce across the US focused on their experiences with workforce needs in preparedness and response activities. Focus group transcripts were thematically analyzed using qualitative methods to identify key competencies needed in the workforce.

The focus groups revealed 7 domains: attitudes and motivations; collaboration; communications; data collection and analysis; preparedness and response; leadership and management; and public health foundations. Equity and social justice was identified as a cross-cutting theme across all domains.

Broad validation of competencies through ongoing engagement with the PHEP practice and academic communities is necessary. Competencies can be used to inform the design of PHEP educational programs and PHEP program development. Implementation of an up-to-date, validated competency model can help the workforce better prepare for and respond to disasters and emergencies.

Few empirical studies have examined the collective impact of and interplay between individual factors on collaborative outcomes during major infectious disease outbreaks and the direct and interactive effects of these factors and their underlying mechanisms. Therefore, this study investigates the effects and underlying mechanisms of emergency preparedness, support and assurance, task difficulty, organizational command, medical treatment, and epidemic prevention and protection on collaborative outcomes during major infectious disease outbreaks.

A structured questionnaire was distributed to medical personnel with experience in responding to major infectious disease outbreaks. SPSS software was used to perform the statistical analysis. Structural equation modeling was conducted using AMOS 24.0 to analyze the complex relationships among the study variables.

Organizational command, medical treatment, and epidemic prevention and protection had significant and positive impacts on collaborative outcomes. Emergency preparedness and supportive measures positively impacted collaborative outcomes during health crises and were mediated through organizational command, medical treatment, and epidemic prevention and protection.

The results underscore the critical roles of organizational command, medical treatment, and epidemic prevention and protection in achieving positive collaborative outcomes during health crises, with emergency preparedness and supportive measures enhancing these outcomes through the same key factors.