Training and Disaster Preparedness Emergency Management

EMERGENCY MANAGEMENT

Emergency Management: Training and Disaster Preparedness

Introduction

From the onset, it would be prudent to note that human societies have become increasingly complex as well as vastly connected. It therefore follows disasters and emergencies that are human induced and those that happen to be natural could wreck more widespread havoc today than was the case a few decades ago. This is more so the case in relation to disease outbreaks. Towards this end, the relevance of disaster preparedness cannot be overstated. This text concerns itself with disaster preparedness and more specifically focuses on the relevance of a wide range of factors in preparedness efforts. It should be noted that disease outbreaks have in this case been selected as an ideal disaster in contemporary settings. This is more so the case given that at present, we are in the middle of a pandemic that has affected millions of people from across the world – with fatalities estimated to be in excess of 5 million persons. It therefore follows that insights garnered from this particular discussion could be used to further or shape present discussions about better strategies in relation disaster preparedness in disease outbreak scenarios.

New Approach

Disaster preparedness, in the words of Reilly and Markenson (2019), “consists of a set of measures undertaken by governments, organizations, communities or individuals to better respond and cope with the immediate aftermath of a disaster, whether it be human-made or caused by natural hazards” (211). As the authors in this case further point out, the focus on this front happens to be decreasing the number of casualties if, and when, the disaster actually takes place. Other goals and objectives of disaster preparedness include, but they are not limited to; prevention of wastage in terms of resource deployment in times of disaster, prevention of loss of livelihood, etc.

There are various disaster preparedness models and frameworks that have been suggested in the past. Most of these, as Khan, O’Sullivan, Brown, Tracey, Gibson, Henry and Schwartz (2018) indicate have been developed in the US. For this reason, the authors are of the opinion that the said frameworks might not work as effectively in “other settings with substantially different health systems and governance structures” (Khan, O’Sullivan, Brown, Tracey, Gibson, Henry and Schwartz, 2018, p. 71). For this reason, a new approach that has universal application should be explored. Having in place an effective and practical model or framework is crucial to minimize the impact of disaster. An ideal approach, as available literature indicates, ought to bring on board diverse aspects of preparedness. Thus, it should accurately define what preparedness means or entails.

It is also important to note that as Desborough, Dykgraaf, Philips, Wright, Maddox, Davis, and Kid (2021) point out, there are numerous lessons that we could learn from the COVID-19 pandemic about not only disaster response, but also preparedness. Both of these disaster cycle phases were largely suboptimal in some scenarios. It is on the strength of this assertion that I submit that there is a need for a new approach to address a wide range of aspects related to disaster preparedness in relation to disease outbreaks. The approach should embrace the fact that preparedness efforts are deployed prior to the occurrence of a disaster and should be founded or rooted upon not only the identification of the disaster deemed likely, but also the informed assessment of the likelihood of the said disaster occurring. The approach selected in this case is not only concise, but also all-inclusive in the sense that it takes into consideration the relevance of stakeholders in preparedness efforts. The key steps of the said approach have been discussed in greater detail below;

1. Risk Identification

This could be accomplished via the application of situational awareness concepts – which in simpler terms could be referred to as knowledge about the potential risks. This is especially important so as to ensure that resources are directed at only those risks that have a high likelihood of occurring. In the realm of disease outbreaks (i.e. pandemic outbreaks) Lee, Cleare, and Russell (2010) point out that risk awareness relates to the outlook with regard to infectious disease threats that are ongoing or potential. This could be accomplished via engagement in diverse surveillance undertakings. Thus, the key focus on this front could be the identification of ‘if’ and ‘where’ outbreaks could occur, as well as ‘why’ they are likely to occur.

Models could be developed to explore possible pandemics – with data in this case being sourced from a wide range of sources including, but not limited to; healthcare institutions, government agencies, and the relevant NGOs. Situational awareness is instrumental as it would be inappropriate to prepare for an influenza subtype, only to be faced with a viral hemorrhagic fever. It should, however, be noted that this should not be taken as a cue to ignore other possible risks. Indeed, an all hazards approach would be most ideal on this front (Lee, Cleare, and Russell, 2010). However, given that resources are largely finite, the relevance of focusing on the most likely disaster scenarios cannot be overstated. An approach which in my opinion could come in handy in this endeavor is the utilization of a risk matrix. This is more so the case given that a risk matrix could be instrumental in attempts to highlight not only the likelihood of disease outbreak, but also the impact that such an outbreak could have. Both the likelihood of outbreak and impact could be categorized as; low, moderate, and high.

2. Vulnerability Assessment

This relates to the ability of healthcare facilities to effectively manage likely disease outbreak scenarios. This is more so the case with reference to operational, resource, as well as manpower potential. It also relates to how well systems are interconnected as well as the effectiveness of communication mechanisms in place. It is important to note that as Wapling and Sellwood (2016) point out, “poor public health infrastructure is the main limitation and strategic disadvantage against pandemics, as it increases the chances of the risk of exposure to vulnerability” (99). Inadequate infrastructure could effectively derail response to a disease outbreak. It is for these reasons that vulnerability assessment happens to be instrumental as it could come in handy in efforts to put in place measures to reign in some of the challenges or concerns highlighted.

In seeking to explain this particular issue, it would be prudent to take into consideration the impact of COVID-19 on two countries – China and India. This is a macro-view perspective of disease outbreak and preparedness efforts. Whereas China was able to use or deploy its efficient public health infrastructure to respond to the COVID-19 pandemic, India’s inadequate infrastructure largely served as a huge drawback in its efforts to control the spread of the virus. I am of the opinion that had vulnerability assessments been undertaken in the latter case, the number of fatalities would have been significantly reduced. West Africa has also in the past had it rough in as far as epidemic containment measures are concerned as a consequence of failure to identify (and fix) response gaps. Indeed, countries in the said region have since been called upon by the World Health Organization amongst other global agencies “to create resilient integrated systems that can be responsive and proactive to any future threat” (Khan, O’Sullivan, Brown, Tracey, Gibson, Henry and Schwartz, 2018, p. 33).

3. Engagement of Stakeholders

Disaster preparedness efforts ought to ideally bring onboard a wide range of stakeholders – i.e. those who would likely have a significant input in such undertakings as well as those who are likely to be impacted by the said efforts. It therefore follows that some of the external stakeholders that could be engaged in this case are inclusive of, but they are not limited to; local communities, disaster management organizations, diverse health authorities, government agencies at all levels (especially state and local governments), other healthcare institutions, etc. Internal stakeholders could be inclusive of the organizational management, departmental heads, hospital staff, and hospital emergency committees. Disaster response plans would be largely ineffective if their formulation is done in a vacuum. For this reason, there is need to ensure that all the relevant stakeholders are brought on board.

4. Communication

Reilly and Markenson (2019) point out that when it comes the management of disease outbreaks, risk communications are instrumental. In this particular case, risk communication could be two-way; i.e. communication to/from the facility and communication within the facility. When it comes to communication to/from the facility, there is need to see to it that there is seamless communication between healthcare entities, the relevant public healthcare authorities and other relevant external stakeholders. For instance, healthcare facilities could engage in deliberate surveillance efforts so as to capture the relevant data, in this case about disease outbreak, and pass it on to the relevant agencies. This could be accomplished via the close monitoring of percentage of ED visits linked to cases of suspected outbreak. On the other hand, in relation to communication within the facility, it should be noted that this relates to communication within the facility’s various departments. In this case, the focus should be on ensuring that there are clear lines of communication for effective communication so that coordination as well as response efforts can be facilitated in an effective manner in case of disease outbreak.

5. Public Awareness/Education

Institutions have a responsibility to ensure that their immediate communities are aware of the best courses of action to embrace in the event of likely disease outbreaks. The creation of the said awareness could assume diverse formats, i.e. via social media, printed posters, public address systems, mass media engagements, etc. The overall goal in this case would be to increase public awareness about the likely outbreak of disease and what measures to take in as far as emergency response and risk reduction is concerned. It is important to note that as Lee, Cleare, and Russell (2010) indicate, “risk communications can play a significant role in the control of an emerging epidemic or pandemic by providing information that people can use to take protective and preventive action” (327).

6. Training

It is important to note that in disaster scenarios, staff members encounter activities that are out of their normal responsibilities as well as roles. For this reason, it is important to ensure that they are capable of performing in scenarios that they are non-routine. Towards this end, hospital staff should be equipped with the necessary skills to manage and respond to disease outbreaks. Ideally, the said training should target all staff. However, there is also need to have a select team of professionals who would coordinate the protocols and procedures related to response. This team should be familiarized with the institutional emergency response plan and take an active role in drills (which should ideally be facility-wide) meant to promote preparedness.

Process Mapping of New Approach

Inter-Agency Collaboration

As has been pointed out elsewhere in this discussion, disaster response plans would be largely ineffective if their formulation is done in a vacuum. For this reason, the relevance of bringing on board other relevant players cannot be overstated on this front. According to Kortepeter, Kwon, Christopher, Hewlett, and Cieslak (2017), disease outbreaks have the potential to be widespread – and could as a matter of fact breach community or state boarders and become a national concern. It is with this in mind that the authors are in this case categorical that “having ongoing communication and cooperation between agencies, long before an emerging threat surfaces, is paramount for preparedness and effective response” (Kortepeter, Kwon, Christopher, Hewlett, and Cieslak, 2017, p. 21). The benefit of a move of this nature as the authors in this case further observe is that a largely proactive approach is embraced, other than a reactive approach.

Communication and Media Relations

As has already been indicated elsewhere in this text, communication could in this take diverse formats. There are various preparedness undertakings that ought to be undertaken in as far as communication is concerned. With regard to internal communication, there is need to ensure that the facility has in place a robust mechanism that seeks to ensure that facility visitors, patients as well as staff are provided with all the relevant information if and when appropriate. Further, all facility employees should be familiar with the two-way communication protocols in place in, i.e. in relation to conveyance of information between staff and hospital administration or management. When it comes to external communication, there is need to come up with a clear definition and categorization of the content, nature and kind of information that should be disseminated to the general public. This is especially important in efforts to ensure that disease transmission risks, for instance, are minimized. It is important to note that the communication processes and standards identified in this case should not go against the clear guidelines as well as policies of the relevant government health agencies. Media relations should also be addressed comprehensively. This is more so the case when it comes to the ideal channels of communication, and the most viable formats of engaging the media. However, in as far as media relations are concerned, Jennings, Aras, and Barrett (2016) suggest a good rule of thumb. In the words of the authors, there is need to ensure that the format of engagement selected ensures that communication remains “both factual and empathetic, addressing unfolding events and underlying fears through the lens of community experiences, histories, and perceptions” (286).

Logistical Issues

One of the key objectives of logistics in this realm is the provision of the required resources to ensure that disaster management and/or response efforts are not derailed. Thus, one crucial component of the disaster response plan should be logistics. However, this particular component should be based on the outcomes of the risk assessment. There is need to conduct an evaluation of the facility’s prevailing logistics system with an intention of identifying aspects of the same that need to be addressed or granted the relevant attention. This could be in relation to resource deployment mechanisms, equipment and supplies acquisition, etc. It is also important to note that in this case, there may be need to reach out to suppliers and formulate a Memorandum of Understanding in which case there is a commitment to avail the relevant items, equipment, and tools that are instrumental in disease spread control or prevention efforts. Further, strategies could be put in place to address potential personnel shortages as a consequence of any unexpected surge in the number of persons who require medical attention. This may also call for considerations to me made on how to acquire additional skilled staff if/and when they are needed. All these considerations, and especially the latter, should be made following the relevant risk assessments as well as vulnerability assessment.