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old hospitals have less accessibility. eg wider corridors

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Rio de Janeiro had its worst ever flood that killed over 250 people in April 2010.

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Poor infrastructure has been linked with lead poisoning, accidents and injuries, and asthma

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https://www.portsmouth.co.uk/news/people/storm-eunice-cancels-appointments-at-queen-alexandra-hospital-3574251

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Storm Eunice cancels all in-person outpatient appointments at Queen Alexandra Hospital

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ALL in-person outpatient appointments at Portsmouth Hospitals University NHS Trust sites have been cancelled due to the threat posed by Storm Eunice.

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Severe flooding
South Yorkshire
A whole months rain fall fell in under 24 hours

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In the uk 2021 there were 149,779 fires

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https://www.swindonadvertiser.co.uk/news/19932173.nhs-officials-urge-people-think-long-hard-going-storm-eunice/

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NHS officials are urging members of the public to take extreme caution ahead of Storm Eunice.

The Bath,North East Somerset, Swindon and Wiltshire Clinical Commissioning Group is urging people to be wary of the 80mph winds set to hit the region tomorrow and to take notice of the weather warnings.

Medical director Dr Ruth Grabham said: "Many of us think we are invincible to the elements, but extremely strong winds, such as those forecast for our region, have the power to knock even the sturdiest of people off their feet.

"None of us ever set out to have an accident, so people, especially those who are older, should think long and hard about whether their morning run, daily cycle or just a quick walk to the shops is absolutely necessary in these stormy conditions.

"With local NHS services already under immense pressure, doing whatever we can to avoid accidents that would otherwise require medical intervention will help our hardworking teams to continue providing care to those most in need."

Great Western Hospital also put out a warning to anyone visiting the hospital as their main entrance can become very dangerous in high winds.

In a post on Facebook it said: "We want to encourage people to be careful when walking into the hospital as the wind is very strong under the canopy by our main atrium.

"This is likely to continue over the coming days so stay safe and leave plenty of time to attend appointments at GWH."

Any person who becomes injured during the bad weather has also been urged to think carefully about which service is most appropriate for their condition, as doing so will help already-busy medical teams prioritise those with the most urgent care needs.

Advice on how to care for cuts, bruises and sprains at home can be found through the NHS website at www.nhs.uk. Additionally, healthcare advice tailored to a person's specific symptoms can be accessed through the 111 service, which is available at www.111.nhs.uk or over the phone.

Calling 999 or visiting a hospital emergency department should be reserved for genuine, life-threatening conditions, such as chest pain, loss of consciousness and heavy bleeding. For more information on locally available healthcare services, visit www.bswccg.nhs.uk.

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NHS warn people to think before going out in 90mph winds

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NHS officials are urging members of the public to take extreme caution ahead of Storm Eunice. The Bath,North East Somerset, Swindon and Wiltshire Clinical Commissioning Group is urging people to be wary of the 80mph winds set to hit the region tomorrow and to take notice of the weather warnings.

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Endemic- yellow fever
Pandemic- covid 19
Epidemic- smallpox

Pandemics have significant social and political impacts such as clashes between nations, population displacement, and increased social tension and discrimination.

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The results showed that lack of infrastructure brings poor standard living, economic deficit and improves poverty, poverty will have an effect on people health, a long with poor standard living.

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Wildfires increase air pollution in surrounding areas and can affect regional air quality. The effects of smoke from wildfires can range from eye and respiratory tract irritation to more serious disorders, including reduced lung function, bronchitis, exacerbation of asthma and heart failure, and premature death.

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The UK's public finances have been hugely affected by the economic shock of the coronavirus pandemic.

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transport failures and strikes cause people to miss hospital appointments

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Southern England heatwave
34 degrees
Burning issues, fires

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older roads with constant traffic can slow emergency services down and may delay urgent care needed for others

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Flooding affects human health through drowning, heart attacks, injuries, infections, exposure to chemical hazards and mental health consequences. Disruption of services, including health services, safe water, sanitation and transportation ways, plays a major role in vulnerability

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Epidemic - Lasser fever - Nigeria - January 2022

https://www.who.int/emergencies/disease-outbreak-news/item/lassa-fever---nigeria

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In Nigeria, from 3 to 30 January 2022, 211 laboratory confirmed Lassa fever cases including 40 deaths (case fatality ratio: 19%) have been cumulatively reported in 14 of the 36 Nigerian states and the Federal Capital Territory across the country (Figure 1). Three states account for 82% of confirmed cases: Ondo (63), Edo (57) and Bauchi (53). The other states affected are Benue (11), Ebonyi (5), Oyo (5), Taraba (5), Kogi (4), Enugu (2), Kaduna (2), Cross River (1), Delta (1), Katsina (1) and Plateau (1) (Figure 2).

Of the 211 laboratory confirmed cases, five cases have been reported among health workers in two states, Edo (3) and Benue (2).

Figure 1. Weekly number of reported confirmed Lassa Fever cases and deaths in Nigeria during the epidemiological weeks one (commencing 2 January) through four (commencing 23 January) in 2022.

In contrast, noticeably less Lassa fever cases with less geographical spread were reported for the same period (epidemiological weeks 1- 4) in 2021 (54 confirmed cases, including 12 deaths, from 8 States).

Lassa fever is endemic in Nigeria and the annual peak of Lassa fever cases is typically observed during the dry season (December-April). Thus, the number of infections is expected to rise further until the end of the dry season.

While endemic in Nigeria, cases are much higher than the previous epidemic seasons. This could be attributed to reduced response capacity in surveillance and laboratory testing. It is necessary to continue to monitor the annual peaks of Lassa fever in order to contextualize incidence and inform the effective management of Lassa fever.

Figure 2. Confirmed cases of Lassa fever by States reported in Nigeria from 3 - 30 January 2022

Coordination: The Nigeria Centre for Disease Control (NCDC) has activated the National Emergency Operations Centre alert mode for effective multi-sectoral, multi-disciplinary coordination of the response. Similarly, state public health operation centres were activated in affected states. National rapid response teams (NRRT) have been deployed to the Federal Capital Territory and Bauchi, Benue, Ebonyi, Edo, Nasarawa, Ondo, Oyo and Taraba States.

Case Management and Infection Prevention and Control (IPC): Case management, and infection prevention and control (IPC) guidelines have been disseminated. Public and health-care worker advisories have been distributed. Case management and IPC training for treatment centre health-care workers have been conducted.

Surveillance: Enhanced surveillance activities for Lassa fever are ongoing in all states including increased case finding. Reported data is used to generate situational updates by the NCDC and inform further response plans.

Clinical management: Confirmed cases are being treated at identified treatment centres across the states. Medical response commodities have been distributed to states and treatment centres.

Laboratory capacity: The seven national Lassa fever laboratories within the NCDC network that can perform molecular tests are working with full capacity to ensure timely processing of samples.

Community engagement: Risk communications and community engagement activities have been scaled up through television, radio, print, social media and other strategies.

Vector and environmental control: The Federal Ministry of Environment is implementing a Lassa fever environmental response campaign in affected states.

Lassa fever is a viral haemorrhagic fever that is primarily transmitted to humans via contact with food or household items contaminated with urine or faeces from Mastomys rats. Though to a lesser extent, secondary human-to-human transmission can also occur through direct contact with the blood, secretions, organs or other body fluids of infected persons, especially in health-care settings.

As aforementioned, the peak of Lassa fever cases in humans typically occurs in the dry season (December-April) and follows the reproduction cycle of the Mastomys rats in the wet season (May - November). Given that 90-95% of human infections are due to indirect exposure (through food or household items contaminated by infected rats' excreta) or direct contact with infected Mastomys rats, the very high density and high circulation of Lassa fever virus in the rat population poses a risk for further human infection during the dry season.

Approximately 80% of Lassa virus infections in humans are either asymptomatic or mild, however, infection in the remaining 20% manifests as a febrile illness of variable severity associated with multiple organ dysfunctions with or without haemorrhage. The overall case fatality ratio among all infected people is approximately 1% but is significantly higher among patients hospitalized with severe illness (around 15%).

Timely diagnosis results in more rapid isolation of patients and provision of treatment, while also reducing the risk of person-to-person transmission in health care settings. Early supportive care with rehydration and symptomatic treatment improves survival of patients.

The current overall risk is considered high at national level. While Lassa fever is endemic in Nigeria and the country has developed an increased capacity for the prevention and control of Lassa fever outbreaks, including strengthened surveillance, diagnostic and treatment capacity, several factors contribute to the current elevated risk level. These include an increase in the number of confirmed cases compared to previous epidemic seasons, gaps in surveillance and varying degrees of subnational response capacity, delays in sample shipment for laboratory testing, a decrease of case management capacity due to conversion of dedicated Lassa fever facilities into COVID-19 health-care facilities and suboptimal IPC procedures. These factors combined warrant the need for further improvement and support of the country's capacity to detect and respond to Lassa fever outbreaks. In addition, the five confirmed cases among health workers, which included two workers caring for the same patient in the emergency ward, further emphasizes the urgent need to strengthen IPC measures.

The overall regional and global risk is considered low due to minimal cross-border transmission from Nigeria to neighbouring countries. Lassa fever is known to be endemic in West African countries, primarily in Sierra Leone, Guinea, Liberia and Nigeria, but may exist in other countries in the same region.

Mastomys rats are the main reservoir for Lassa virus and so abundant in endemic areas in West Africa that it is not possible to eliminate them from the environment. Prevention of Lassa fever relies on promoting good "community hygiene" to discourage rodents from entering homes. Effective measures include storing grain and other foodstuffs in rodent-proof containers, disposing of waste far from the home, maintaining clean households and considering keeping cats. Precaution should be taken when handling Mastomys rats. All animal products should be thoroughly cooked.

Those caring for affected persons should be careful and avoid contact with blood and body fluids.

In health-care settings, health workers and volunteers should apply standard infection prevention and control (IPC) measures when caring for individuals, regardless of their presumed diagnosis. These include basic hand hygiene, respiratory hygiene, use of personal protective equipment (to block splashes or other contact with infected materials) and safe injection practices.

Health workers caring for those with suspected or confirmed Lassa fever should apply extra infection control measures to prevent contact with the person's blood, body fluids and contaminated surfaces or materials such as clothing and bedding. When in close contact (within 1 meter) of individuals with Lassa fever, health workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).

Personnel working in laboratories are also at risk. Samples taken from suspected Lassa fever cases for diagnostics should be handled by trained staff and processed in suitably equipped laboratories under maximum biological containment conditions.

WHO continues to advise all countries endemic for Lassa fever on the need to enhance early detection and treatment of cases to reduce the case fatality rate.

WHO advises against any restrictions on travel or trade to or from Nigeria and the affected areas based on the currently available information.

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In Nigeria, from 3 to 30 January 2022, 211 laboratory confirmed Lassa fever cases including 40 deaths (case fatality ratio: 19%) have been cumulatively reported in 14 of the 36 Nigerian states and the Federal Capital Territory across the country (Figure 1). Three states account for 82% of confirmed cases: Ondo (63), Edo (57) and Bauchi (53).

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https://news.dorsetcouncil.gov.uk/2022/02/17/protection-of-life-priority-during-storm-eunice/

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The council has made the difficult decision to advise all schools to close and has suspended many services for Friday as 100mph winds of Storm Eunice are predicted to hit the county.

The Met Office has categorised the impact of the wind in the storm as a severe amber warning which means there could be a danger to life and structural damage to property.

The council has taken the decision to put threat to life above some continuation of services and there will be disruption to residents.

All schools have been advised to close to staff and students.

Services which have been suspended include, and are not limited to, -

Council transport, including school and social care

Closure of day centres

Closure of all household recycling centres (HRCs, or "the tip")

Suspension of bin collections. Do not put your bins out for collection on Friday 18 February. We will attempt to collect rubbish on Saturday 19 February. Food waste will be emptied on your next collection day (Friday 25 February). We hope to collect missed recycling on Saturday 26 February. Garden and commercial waste customers will be contacted separately.

Libraries and council owned buildings will be closed to the public

Roads could be closed at short notice

Durlston Country Park is closed and scheduled performances cancelled

Any further service disruption due to the storm, which is scheduled to hit the Dorset Council area from 5am until 9pm, will be posted here dorsetcouncil.gov.uk/emergencies-severe-weather/disrupted-services

Cllr Graham Carr Jones, Portfolio Holder for Housing, Community Safety and Emergency Planning, said:

"The decision to suspend services has not been taken lightly and the priority is to prevent injury and loss of life.

"The council has taken heed of the warnings from the Met Office, and due to their predictions of extremely strong wind, we have taken the precautionary decisions to suspend services and advise all schools close and children stay at home.

"We have plans in place for scenarios such as this and we feel well prepared. Highways and arboricultural teams will be on stand-by throughout the weekend to deal with highways issues, fallen trees and debris on the roads."

"Residents need to take precautions to make sure they stay safe and well until the storm passes."

Residents are being advised to only travel if absolutely necessary and take measures to stay safe and should not go to watch the sea in coastal or clifftop locations. Flood warnings from the Environment Agency have been issued for Lyme Regis, West Bay, Chiswell and Ferrybridge, Preston Beach Road and Swanage Bay in terms of tidal surge flooding.

Emergency procedures are being put in place to keep homeless and rough sleepers safe, to make welfare checks to the vulnerable and for home care providers.

The Met office said disruption from "extremely strong" winds in Storm Eunice is scheduled between 5am and 9pm on Friday 18 February which may cause significant disruption including flying debris which could result in danger to life, falling branches and trees, damage to buildings and roofs, power lines brought down, road closures, disruption and cancellations to train, bus, ferry and planes in addition to beach material thrown onto sea fronts, coastal roads and properties.

Report a highways issue online at dorsetcouncil.gov.uk/travel/travel-dorset/live-travel-updates.

To speak to customer services call 01305 221000.

We would like to ask for your support to help our colleagues in the health services. You can help in the following ways:

Use NHS services wisely to get the right treatment, in the right place, at the right time. Hospital emergency departments are under extreme pressure. If you're unwell and are unsure about where to go, visit nhs.uk or call 111. All will be done to answer your call as quickly as possible though it may take a little longer due to the current demand. Please be patient and kind when you speak to health teams.

Contact your local pharmacist or GP practice for ongoing or minor health issues.

Only ever call 999 in a medical emergency - this is when someone is seriously ill or injured and their life is at risk.

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Protection of life priority during Storm Eunice - Dorset Council news

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The council has made the difficult decision to advise all schools to close and has suspended many services for Friday as 100mph winds of Storm Eunice are predicted to hit the county. The Met Office has categorised the impact of the wind in the storm as a severe amber warning which means there could be...

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https://metro.co.uk/2022/02/18/storm-eunice-how-to-look-after-your-mental-health-if-the-weather-gives-you-anxiety-16128500/amp/

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As storm Eunice continues to batter the UK, there are people up and down the country who are struggling with an unmanageable fear that is caused by severe weather - known as anemophobia, ancraophobia, and astraphobia.

Tamazin Morley is 53 and lives in Portsmouth, Hampshire. In 2017, she developed PTSD, as a response to suffering past trauma. The illness has meant she hasn't worked for three years, a stark contrast to the life she lived as a high-flying business woman, working in Hong Kong.

For her, there are several triggers for her PTSD - and storms, particularly their threatening and loud noises, are one of them.

'The house is my safe place - and when there's a storm rattling the windows and wind whistling down the fireplace, it doesn't feel safe anymore,' she tells Metro.co.uk.

'I can't sleep or go outside until it stops.'

When the wind and rain are raging outside, her life is put on pause.

She describes herself as feeling constantly on 'high alert' and, when the weather outside is noisy and violent, she finds herself panicking, her thoughts spiralling.

Tamazin says: 'I'm constantly thinking what if the windows break, what if my dogs escape, what if a whole number of terrible things happens.

'When my partner went to work this morning, I made him call me as soon as he arrived as I was so worried about him traveling.'

Tamazin describes turning up the TV full blast, to try to drown the noise out from outside. As she can't sleep, she often finds sitting up during the night, wearing headphones, in an attempt to distract herself.

While many of us may hear news of impending bad weather and hope for a snow day, or interrogate the reason for the names given to storms like Eunice, for people like Tamazin, it's a nightmare.

'I tend to hyperventilate,' she tells Metro.co.uk. 'And because lots of adrenaline is going into my body, it can feel like having a heart attack.'

For those suffering with mental health disorders, violent storms can be triggering, but phobias and anxiety related to storms can be caused by many factors.

Why are some people so affected by stormy weather?

While it's normal to experience a certain amount of worry during wild weather conditions, the fear shouldn't dominate your thoughts, or stop you from being able to go about your business.

But for some people, uncertain situations evoke a sense of panic and worry, leading to them obsessively predict the worst.

Storms can trigger this feeling as we don't have any control over what the weather does - and the truth is, severe weather can cause damage and devastation, so there is a basis for the fear.

'A person may worry or overthink in an attempt to attempt to feel more in control, find potential solutions, and feel like they're prepared for the worst case scenario,' Navit Schechter, CBT therapist and founder of Conscious & Calm explains.

'However, someone who suffers with anxiety is likely to over-estimate the likelihood of something terrible happening as a result of a storm, compared to someone who is more able to tolerate uncertain situations.'

People with anxiety tend to be over-thinkers, ruminators and catastrophisers, agrees Sally Baker, senior therapist.

'So they'll think "oh, it's windy", then the next thought is "I wonder if my garden furniture is safe", and then it's "oh my god, my windows might come in, or my roof might come off,"' she says.

'It's like a seed,' she continues. 'The more you pay attention to it, the more it sprouts - and before you know it, the room is full of catastrophic thoughts.'

Tania Taylor, clinical hypnotherapist and psychotherapist,explains that, for some, it may be learned behaviour - for example, if a child has seen a parent demonstrating a fear response when exposed to a storm, they might then mimic this response.

'It is a survival mechanism,' Tania says. 'But over time, it stops becoming a mimicked response and becomes the natural response to the stimulus or threat.'

For others, Tania explains that this deep fear can be linked to a traumatic event that occurred during a storm. 'For example, a car accident, or a flood, that resulted in serious shock,' she notes.

'At first it might be re-living the experience in your mind, but then can become overwhelming with repeated imagery happening again and again.

'The part of the brain that controls fight or flight (limbic system) isn't able to distinguish very well between imagined images and reality.

'Intellectually, we know that it's not really happening, but the limbic system is much more powerful than our frontal cortex (the part that knows it's imagined), and so it is very difficult to control that fear response.'

This is the case for Laura*, aged 24, London, who suffers from major anxiety during storms as a result of PTSD she developed after her school was struck with lightning, when she was just eight-years-old. As you can imagine, it was a terrifying experience for those involved.

'When the weather is so severe, on a day like today, it brings back all those feelings from when that happened,' she says. 'It really negatively affects my mental health.'

Laura explains that hearing or being in a storm now makes her feel anxious, worried and generally sad. 'I become quite closed off and often revert back to being younger, needing comfort and a feeling of protection.'

Although it happened years ago, Laura explains she hasn't been able to shake the effect it had on her. 'I'm always worried something like it will happen again and this time I won't be as lucky.'

When a storm comes, she finds that getting into bed and being in a comfortable environment helps to calm her down. Wearing earphones, to try and block out the noise and 'take her to a different place' is another technique she uses.

Trauma rather than the storm itself

For those suffering extreme reactions and exacerbated anxiety and deteriorated mental health during storms, it's often not about the storm itself - but can be related to the noise, the unpredictability and the perceived threat that comes with it.

' For people with anxiety disorder or PTSD, the triggers are neither here nor there', explains Sally Baker, senior therapist.

'It's about bringing it back to the core issue which, often, is living with unresolved trauma.

'This is your physical system reacting. Your "fight or flight" mode is already "over-cranked" and hyper-vigilant, therefore, it doesn't take much to trigger that mode into a full-blown panic attack.

'Ultimately, in this case, the work has to be to resolve the trauma - which is the root of the problem.'

What to do if you're struggling with your mental health in the storm
Unplug from the news cycle
Part of the issue, for those who know they are triggered by storms, can be the anticipation the build up created by the constant news cycle, social media discourse, reports of incidents, and extreme weather warnings.

Sally explains that this can put people on edge, with their fears cranked up to a level that won't take much to explode.

'Physically, in our bodies, anticipation builds fear - our heart rate increases, our pupils dilate,' she says. 'Your breathing becomes shallow.

'Unplug from the news cycle.'
Create distraction
Your thoughts - and the fear that something terrible could happen - are what create the feelings of anxiety.

'Distracting yourself, for example by doing a crossword, playing Wordle, watching television or having a conversation with someone, will prevent your thoughts from dwelling on what "could" happen,' explains Navit.

'This can help you feel less anxious.'

Another practical tip is to turn up the TV, or listen to the radio to physically block out what 's going on outside.
Control your breathing
Tania suggests a method called 'rectangular breathing', which can also work as a good distraction, as well as being physically calming.

'Find a rectangular shaped object,' Tania says. 'A window, door, road sign, book, your phone.' Tamazin uses her TV.

'Then, breathe in following the short line, moving from top left, to top right. Hold for a count of one at each corner.

'Breathe out following the line from top right, to bottom right, holding at the corner, and so on. Next introduce counting of your breath.

'Try to exhale for one count more than you inhale. As you progress, try to slow your breathing down a little at a time by adding an extra count into your inhale, and exhale.

'So, if you start inhaling to a count of two, you will exhale to a count of three. By the end, you may be inhaling to a count of five, and exhaling to a count of six.

'Only ever hold to a count of one at each corner of the rectangular shape.'
Interrupt your negative thoughts
When your thoughts are spiralling during a storm, it can be helpful to have a technique to interrupt the negativity.

'If you're getting wound up, you can make a noise like "uhh-uhh", like a wrong noise in a game show, to help remind yourself that you've had an unhelpful thought,' Sally suggests.

'It's just one way of managing your thinking and stopping the spiral cycle.'
Focus on what you can control, not what you can't
Bring your attention into your home and the things you can control - and away from what's happening outside, suggests Navit.

'Once anything that needs to be tied down outside has been tied down, for example, there's nothing more we can do - and thinking about what could happen will only create more anxiety and worry,' she notes.

Instead, bring your focus into your immediate space and what you can control, such as spending time with your children, doing your work, or tidying up.
Talk to someone
If your fear is causing an extreme reaction, it might be time to talk to someone.

'It's more common than you think,' says Tania. 'And talking therapies - which are free on the NHS, or available at private firms like mine, can help you live through storms without unbearable anxiety.'
To chat about mental health in an open, non-judgmental space, join our Mentally Yours Facebook group. Follow us on Twitter at @MentallyYrs.
MORE : 'I berate myself internally': Why we overanalyse our behaviour after socialising - and how to stop

MORE : Children say they want lessons on coping with stress and anxiety in schools

MORE : Louise Thompson reveals she 'cried 20 times this week' as she details 'jagged' PTSD road to recovery

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'I'm terrified': How to cope if your mental health is affected by storms

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As storm Eunice continues to batter the UK, there are people up and down the country who are struggling with an unmanageable fear that is caused by severe weather - known as anemophobia, ancraophobia, and astraphobia. Tamazin Morley is 53 and lives in Portsmouth, Hampshire.

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Prevents professionals from getting into work, meaning less patients are seen to and the hospital becomes understaffed

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First responders, such as fire and ambulance services, will likely struggle to reach urgent cases in a timely manner during flooding in England, researchers from Loughborough University have found. (2021)

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Mad cow disease (CJD)- epidemic
It’s is incurable disease, which meant it had a higher affect on the NHS, in the 1980/1990s , causing shortage of food, meaning health care wasn’t supplied well

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Four people

Millions experienced severe disruption as record-breaking winds from Storm Eunice caused death and injury, huge structural damage, transport chaos and widespread power cuts. Four people were confirmed to have died in the UK and Ireland by Friday evening.19 Feb 2022

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Climate change is also expected to increase the magnitude and frequency of flood events which will make responding to emergencies more difficult.