In view of the possible disruptions in the manufacturing and supply of health products following the coronavirus disease 2019 (COVID-19) pandemic, the Tunisian medicines regulatory authority was mobilized to guarantee patient safety. Teleworking has become the ultimate way of service continuity. The planning was revised according to health priorities. Work procedures were set online. A minimum list of medicines known as "medicines of health and strategic interest" was established. The Directorate of Pharmacy and Medicines (DPM) has been working on updating medicines stock data. A provisional suspension of authorizations for medicines export for 1 mo was decided. A fast-track procedure allowing the validation of alternative sources of raw materials has been put in place. An appeal for a fast track manufacture of hydroalcoholic gel/solutions was launched. A Monitored Emergency Use of Unregistered and Investigational Interventions (MEURI) procedure has been adopted in order to dispense off-label prescriptions of hydroxychloroquine and azithromycin combination. Focus groups were organized in order to set up therapeutic trials exploring possible strategies of COVID-19 treatment, such as serotherapy and BCG vaccine. This proactive and anticipatory policy has made it possible to meet the health challenges dictated by this crisis.

Disease outbreaks have attracted the attention of the public health community to early warning and response systems (EWRS) for communicable diseases and other cross-border threats to health. The European Union (EU) and the World Health Organization (WHO) have published regulations in this area. Decision 1082/2013/EU brought a new approach the management of public health threats in EU member states. Decision 1082/2013/EU brought several innovations, which included establishing a Health Security Committee; preparedness and response planning; joint procurement of medical countermeasures; ad hoc monitoring for biological, chemical, and environmental threats; EWRS; and recognition of an emergency situation and interoperability between various sectors. Turkey, as an acceding country to the EU and a member of the WHO, has been improving its national public health system to meet EU legislations and WHO standards. This article first explains EWRS as defined in Decision 1082/2013/EU and Turkey’s obligations to align its public health laws to the EU acquis. EWRS in Turkey are addressed, particularly their coherence with EU policies regarding preparedness and response, alert notification, and interoperability between health and other sectors. Finally, the challenges and limitations of the current Turkish system are discussed and further improvements are suggested. (Disaster Med Public Health Preparedness. 2016;10:883–892)

Carbon monoxide acute intoxication is a common cause of accidental poisoning in industrialized countries and sometimes it produces a real mass casualty incident. The incident described here occurred in a church in the province of Verona, when a group of people was exposed to carbon monoxide due to a heating system malfunction. Fifty-seven people went to the Emergency Department. The mean carboxyhemoglobin (COHb) level was 10.1±5.7% (range: 3-25%). The clinicians, after medical examination, decided to move 37 patients to hyperbaric chambers for hyperbaric oxygen (HBO) therapy. This is the first case report that highlights and analyses the logistic difficulties of managing a mass carbon monoxide poisoning in different health care settings, with a high influx of patients in an Emergency Department and a complex liaison between emergency services. This article shows how it is possible to manage a complex situation with good outcome. (Disaster Med Public Health Preparedness. 2017;11:251–255)