Impact of 2015 earthquakes on a local hospital in Nepal: A prospective hospital-based study

<div><p>Introduction</p><p>Natural disasters pose a great challenge to the health systems and individual health facilities. In low-resource settings, disaster preparedness systems are often limited and not been well described. Two devastating earthquakes hit Nepal within a 17-days period in 2015. This study aims to describe the burden and distribution of emergency cases to a local hospital.</p><p>Methods</p><p>This is a prospective observational study of patients presenting to a local hospital for a period of 21 days following the earthquake on April 25, 2015. Demographic and clinical information was prospectively registered for all patients in the systematic emergency registry. Systematic telephone interviews were conducted in a random sample of the patients 90 days after admission to the hospital.</p><p>Results</p><p>A total of 2,003 emergency patients were registered during the period. The average daily number of emergency patients during the first five days was almost five times higher (n = 150) than the pre-incident daily average (n = 35). The majority of injuries were fractures (58%), 348 (56%) in the lower extremities. A total of 345 surgical procedures were performed and the hospital treated 111 patients with severe injuries related to the earthquake (compartment syndrome, crush injury, and internal injury). Among those with follow-up interviews, over 90% reported that they had been severely affected by the earthquakes; complete house damage, living in temporary shelter, or loss of close family member.</p><p>Conclusion</p><p>The hospital experienced a very high caseload during the first days, and the majority of patients needed orthopaedic services. The proportion of severely injured and in-hospital deaths were relatively low, probably indicating that the most severely injured did not reach the hospital in time. The experiences underline the need for robust and easily available local health services that can respond to disasters.</p></div

Daily distribution of patients from first earthquake 25^th April including second earthquake 12^th of May.

<p>The horizontal axis refers to the patient presenting days to Dhulikhel Hospital (DH) starting from the first day of earthquake on April 25 (day 0) until day 21 including second earthquake on day 17. The figure shows less number of patients in the first two days but in reality we had overwhelming number of patients but the patient registration system could not be maintained. Number of earthquake injuries was almost five times higher in the first five days compared to pre-incident daily average. The number of patients increased for the first two days after the second earthquake on day 17, indicating the mobile health facilities were in place. NEQ patients increased from day 11 and COP subsequently increased from day 5. EQIs, Earthquake related injuries; NEQ, Non-earthquake related health problems; COP, Complication of pregnancy.</p

Type of injuries by body region in 815 earthquake patients with known injury diagnosis presenting to Dhulikhel Hospital from 25^th April to 16^th May 2015.

<p>Type of injuries by body region in 815 earthquake patients with known injury diagnosis presenting to Dhulikhel Hospital from 25^th April to 16^th May 2015.</p

Characteristics of earthquake related injuries and non-earthquake related health problems in Dhulikhel Hospital from 25^th April to 16^th May 2015.

<p>Characteristics of earthquake related injuries and non-earthquake related health problems in Dhulikhel Hospital from 25^th April to 16^th May 2015.</p

Characteristics of interviewed patients with earthquake injuries and non-earthquake related health problems treated in Dhulikhel Hospital during a 21 days period from an earthquake.

<p>Characteristics of interviewed patients with earthquake injuries and non-earthquake related health problems treated in Dhulikhel Hospital during a 21 days period from an earthquake.</p

COVID-19 Host Genetics Initiative. A first update on mapping the human genetic architecture of COVID-19

The COVID-19 pandemic continues to pose a major public health threat, especially in countries with low vaccination rates. To better understand the biological underpinnings of SARS-CoV-2 infection and COVID-19 severity, we formed the COVID-19 Host Genetics Initiative1. Here we present a genome-wide association study meta-analysis of up to 125,584 cases and over 2.5 million control individuals across 60 studies from 25 countries, adding 11 genome-wide significant loci compared with those previously identified2. Genes at new loci, including SFTPD, MUC5B and ACE2, reveal compelling insights regarding disease susceptibility and severity.</p