Department of Cardiac Surgery, University Hospital Center Zagreb, Kispaticeva 12, 10 000, Zagreb, Croatia; University of Applied Health Sciences, Mlinarska Street 38, 10 000, Zagreb, Croatia.
University of Zagreb, School of Medicine, Salata 2, 10 000, Zagreb, Croatia; Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Sestre Milosrdnice, Vinogradska Cesta 29, 10 000, Zagreb, Croatia.
Environ Res. 2022 Mar;204(Pt B):112079. doi: 10.1016/j.envres.2021.112079. Epub 2021 Sep 24.
This paper is an analysis of complex crisis management and the importance of resilience on the example of co-occurring disasters. A resilience framework model was analyzed based on epidemiologic data and the interplay of several disasters; the COVID-19 pandemic and two 2020 Zagreb, Croatia earthquakes. A dose-response principle may be applied to a complex crisis scenario, within a resilience-vulnerability framework. The available data present the concept of balance between vulnerability and resilience of the population affected by complex crises as well as possible adaptation mechanisms. Multiple disasters that last for a prolonged period reduce the populations' resilience and increase the risk of the next crisis becoming a disaster as well. Such complex disasters should not be approached by multiple risk management protocols, but rather by a single, multilayered protocol. Health policies that predict the possible effects of complex disasters on health risk management need to provide measures to maintain and promote resilience instead of collapse. These is a clear need to adopt green environmental policies, reduce socioeconomic inequality, train volunteer managers during crises, introduce timely evidence-informed policies and transfer new research and innovations in society rapidly.
这篇论文分析了复杂危机管理以及弹性在并发灾害情况下的重要性。基于流行病学数据和多种灾害的相互作用，分析了一个弹性框架模型；COVID-19 大流行和 2020 年两次克罗地亚萨格勒布地震。在弹性-脆弱性框架内，可以将剂量反应原则应用于复杂危机情景。现有数据提出了一个概念，即在复杂危机中，受影响人群的脆弱性和弹性之间存在平衡，以及可能的适应机制。持续时间较长的多次灾害会降低人口的弹性，并增加下一次危机演变成灾害的风险。这种复杂的灾害不应通过多个风险管理协议来处理，而应通过一个单一的、多层次的协议来处理。预测复杂灾害对健康风险管理可能产生影响的卫生政策需要提供措施来维持和促进弹性，而不是崩溃。显然需要采取绿色环境政策，减少社会经济不平等，在危机期间培训志愿管理人员，及时引入循证政策，并在社会中迅速转移新的研究和创新。
