It creates a history and a better undestanding of the events that affected so many people on the East coast. It also compares the two storms to exhibit in both cases there were things we could have done better.
The article highlights public health security and "biosecurity" in the context of large scale efforts/interventions in response to public health threats. Various frameworks have been proposed and implemented to analyze and respond to the new range of pathogenic threats. These take form as research groups, global health initiatives, legislation and emergency preparedness plans. The article proposes looking at biosecurity with an STS multidisciplinary approach (though not explicitly stated as such) and has separated biosecurity into four unique domains. These are emerging infection disease, bioterrorism, cutting-edge life-sciences, and food safety. These all overlap throughout the article. The article further highlights the faults of the "public health" approach and emphasized the trend towards a preparadness model.
Firstly, the bibliography is incrediable thorough and comprehensive. There appears to have been a great deal of research into many aspects of the disaster by these researchers. There were a lot of news articles referenced within the bibliography to captures real events that happened in order to apply those to the greater concept. There were also many anthrological and sociological articles on disasters and their effects within the bibliography, which had been referenced frequently too,
The article cites the merits and failures of the investigations following three disasters. These are the burning of the Capitol Building in 1814, a boiler explosion in 1850, and the Iroquois Theater Fire of 1903.
Vulnerable populations for mental health issues seem to be covered by pay exclusion. Those younger than 21 or 22 are included, which appear to be the most at-risk for mental illness.
The author cites a number of cases in which the law proved difficult to enforce. One example is seen when looking at the difference in residency application acceptance rates between different locales/prefects. The much larger and metropolitan areas would accept down to 47% of the applications, indicating a possibly fair division of candidates reviewed. Other more rural areas would accept over 90% of the applications, showing almost no distiguishment between ailments. The question becomes whether this is reflective on the doctors' judgements of "serious ailment" given location, the political beliefs of the prefect, or simply the lack of caring whether someone emmigrates or not. Another example of the flaws in this law is highlighted by a personal anecdote from a patient. The patient was given a diagnosis when originially coming to France on a personal visa. They were told their condition was quite serious and would require ongoing care. However, when the doctor who diagnosed him was asked to sign for evaluation for the residency permit, the doctor changed his diagnosis to something much less serious. The political thought behind the poicy came into play and interrupted the normal proceedings, tearing doctors between their obligations to the law (and only allow exceptional cases) and to medicine (and err on the side of caution).
The author also highlights the development of this law and its effects in three stages. Pre-1990: Serious illness was a factor in residency completely at the discretion of local government. Immigrants were seen as workers and they served that purpose only. If a worker was sick, they were of no use to society. 1990-1998: Illness was more often factored into the decision making process, but those allowed to stay received no paid employment or social wellfare benefits. Post 1998: Written into law, ill immigrants were allowed to stay with the opportunity for pay and legal status in France.
This was created to support the existing Good Samaritan Policy. The afformentioned policy would not be applicable during biohazard or chemhazard events due to the policy that involve such events. This could cause a delay in treatment that could potentially lead to the deaths of the affected community. In order to allow for treatment without delay the hazard issues would be 'ignored' by the EPA and the responders not prosecuted. They would also receives support from the EPA and FOSC for protecting themselves from any damages lawsuits coming from the potential contamination from the response.
I read through some information about the Bhopal disaster that was referenced, as well as some other articles on Nuclear Emergency Response. I also found some protocol for Radiation Sickness. (Potassium Iodide, Prussian Blue, DTPA, Neupogen)
The author speaks of Dr. Per Bech, a Dutch Psychiatrist, and his co-author Lone Lindberg, and his patient who suffered from mental illness over the course of his life, and how the vignette Bech wrote about this patient had value and relevance for understanding the use of Zoloft.
The World Health Assembly adopted resolution WHA65.4 on the global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level. This resolution called for the creation of a plan detailing services, legislation, strategies and programmes provided for the purpose of treating mental health conditions.