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Diagnostic Testing Strategies for Health Care Delivery During the Great Bangkok Flood and Other Weather Disasters

Kost, Gerald J. MD, PhD, MS, FACB*†; Katip, Pratheep MT; Vinitwatanakhun, Chuchart MD§

Point of Care: The Journal of Near-Patient Testing & Technology: December 2012 - Volume 11 - Issue 4 - p 191–199
doi: 10.1097/POC.0b013e318265f255
Original Articles

Objectives Our objectives were (a) to define resiliency strategies for catastrophic floods; (b) to report how these strategies that evolved during the Great Bangkok Flood; (c) to anticipate crisis care during weather disasters and mitigate risk for victims, patients, residents, and professionals; (d) to offer leadership approaches for disaster laboratory medicine, modeled after the Bangkok Medical Center and National Health System Laboratory response to Thai government requests for help; and (e) to identify point-of-care (POC) and laboratory diagnostic requirements during weather disasters, including infectious disease outbreaks summarized historically.

Methods Great Bangkok Flood data were gathered by 2 members (G.J.K., C.V.) of the response Working Group established at the request of the Division of Medical Sciences, Ministry of Public Health. We also conducted follow-up interviews of medical professionals and surveyed the National Health System, which provided emergency diagnostic services.

Results The historical record proves the impact of infectious diseases in weather disasters. Problems encountered during the Bangkok Flood included leptospirosis, presumed cholera at very low penetration, and fungal infections. Widespread prolonged inundation interrupted supply chains motivating future preparedness.

Conclusions Feasibility of POC testing was demonstrated in previous flood episodes (eg, Hurricane Katrina) and again during the Great Bangkok Flood, although on a limited basis. Preparation, training, mobility, and deployment were challenges. In addition, some medical problems require sophisticated analytical methods not yet amenable to testing directly at the site of need. Unmet needs ensure a bright future for innovators who develop new POC solutions and increase the mobility of diagnostic services for weather disasters.

From the *Point-of-Care Technologies Center and the POCT•CTR, Pathologyand Laboratory Medicine, School of Medicine, University of California, Davis, CA; †Faculty and ‡College of Population Studies, Chulalongkorn University; and §National Healthcare Systems Limited, Bangkok Medical Center, Bangkok, Thailand.

Reprints: Gerald J. Kost, MD, PhD, MS, FACB, Point-of-Care Testing Center for Teaching and Research, Pathology and Laboratory Medicine, 3455 Tupper Hall, School of Medicine, University of California, Davis, CA 95616. E-mail:

This study was supported primarily by POCT•CTR (Dr Kost, director) and in part by a National Institute for Biomedical Imaging and Bioengineering (NIBIB) Point-of-Care Technologies Center grant (Dr Kost, principal investigator, National Institutes of Health U54 EB007959). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIBIB or the NIH.

Figures and tables were provided through courtesy and permission of Knowledge Optimization®, Davis, CA.

© 2012 Lippincott Williams & Wilkins, Inc.