Emergency and Disaster Systems in a pandemic phase as a response of the Health services

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Emergency and Disaster Systems in a pandemic
phase as a response of the Health services
Pan American Health Organization World Health
Organization
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• Multiple epidemics have caused great human death
  rates throughout history.
• These epidemics have had and will continue to
  have a very different impact on society, a
  critical point being the difficulty in the
  management of the crisis that countries face with
  any catastrophe.
• The number of cases in a pandemic can be less
  relevant than the presence of the disease in
  itself. The six deaths by anthrax in the United
  States and the 44 deaths by SARS in Canada caused
  enormous social and economic repercussions which
  shows that we are not very prepared for the
  management of such crisis.

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Pandemic Crises

• Require a multi sector and inter disciplinary
  focus
• Health is only a part of the entire context, the
  fundamental problem is the integral health of the
  population.

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COE Multi-sector
COE HEALTH
INFRASTRUCTURE AND ENVIRONMENT
FOOD AND NUTRITIONSAFETY
PRE AND HOSPITAL ATTENTION
LOGISTICS
MATERNAL YOUTH
COMMUNICATIONS AND INFORMATION
MENTAL HEALTH
PUBLIC RELATIONS
EXTERNAL COOPERATION
SHELTER ATTENTIONAND CONTROL
EPIDEMIOLOGY
EDAN HEALTH
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Characteristics of Sanitary Crises

• Fear
• Decision making influence
• Rumor investigation
• Health personnel and public health
• Safety
• Health is not in charge of the situation!
• Specific technical aspects
• Possibility of unknown agents
• Economy
• Economic criteria tends to prevail

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Avoid distracting resources

• Countries face many risk problems and one of the
  risks today is the possibility of an influenza
  pandemic.
• A balance must be kept between the most important
  priorities in terms of development as well as
  risks.
• Each month more than 1 million people die from
  transmissible diseases and in a short period of
  time AIDS will be the greatest human pandemic
  with 45 million infected people and 22 million
  deaths.

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Build a general response capacity

• It is impossible to be prepared for all
  scenarios.
• It is necessary to work with all the players
  within and outside of the health sector,
  especially with parties related to individual and
  massive emergencies.
• Coordinate with the responsible national
  institutions responsible for the prevention and
  attention of disasters.

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National Players

• Within the same country, other spokespersons
  compete for the lead role as well as national and
  international attention
• Agricultural Sector
• Health Sector
• Civil Protection
• Presidency of the Republic

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Contacts outside of the Country
FOREIGNRELATIONS
PRESIDENCY
INTERNATIONAL COMMUNITY
COUNTRY AFFECTEDBY THE CRISIS
HEALTHMINISTRY
CIVIL DEFENCE
RED CROSS/ NGOs
MUNICIPALITIES
HOSPITALS
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International Players
WB
UNHCR
CARE
ECHO
CDC
USAID
CIDA
OCHA
MERCOSUR
CDERA
Cruz Roja
OXFAM
IADB
PADF
OPS/OMS
DFID
WFP
IICA
CRS
OAS
IDB
ICRC
UNFPA
SICA/CEPREDENAC
CAN/CAPRADE
MSF
UNICEF
IFRC
ORAS/CONHU
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Bird Influenza
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Human cases of Avian Influenza
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The current priority is to control the bird
influenza
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Beginning of the pandemic

• The first cases generate a crisis.
• There will be an economic impact before it
  becomes a sanitary emergency.

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Potential Impact of Avian Influenza in LAC

• Population at risk
• 600 million people in LAC
• 194 million people living in rural areas
• 5 billion domestic birds in LAC
• Economy
• Poultry production (around US 18,5 billion
  dollars).
• Egg production (around US 5 billion dollars).
• Imposition of barriers to commerce.
• Food Safety
• Poultry comprises 40 of the animal protein
  
  consumed in the Region.
• Employment in poultry production chain
  
  
• Environment (carcass disposal)
• Tourism
• The tourism sector in the Caribbean contributes
  to
  31 for the
  Gross Domestic Product and employs 500,000 people.

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Multi sector Response

• The influenza pandemic will require a multi
  sector response
• Mobilization of many public and private
  institutions
• National and local mechanisms exist for the
  response to emergency and disasters.
• The health sector must lead the response to the
  influenza pandemic.
• Countries and hospitals with proven plans will be
  in a better place to make decisions and take
  actions quickly.

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Dissemination

• Delaying the initiation of the pandemic is
  essential to get more time for the
  institutionalization of the response mechanisms.
• Once the pandemic virus is disseminate, it will
  affect all the public and private services.

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Scenario at the beginning of the Pandemic

• Absence and then competence of the first
  available vaccines.
• Health services will be saturated by the public
  searching for medical attention.
• Many hospitals will need to adapt their services
  including the flow of patients, hospitalization,
  emergency, intensive care, etc.
• The government will have to decide whether to
  close or not places where people are concentrated
  such as schools, markets, stadiums, malls and
  other places and buildings.
• Disorder due to fear and disease in the security
  forces, schools, economic sector, health
  personnel, etc,
• Scarcity or lack of antivirals. This could create
  conflicts in theirdistribution.

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Mechanisms for national response

• Implementation of the contingency plan.
• Activate the Committee and Emergency Operations
  Center.
• Mobilize multi sector capacity for a fast
  preparation and initiation of the response
• Mobilize emergency response equipment.
• Mobilize financial resources for the pandemic
  response.
• Implement procedures and logistics mechanisms.

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Other Actions

• Risk Communication
• Extension of the health services capacity.
• Distribution and prescription of antivirals.
• Vaccination of high risk populations.
• Non-pharmaceutical interventions
• Quarantine and distancing mechanisms.
• Travel and business restrictions.
• Recommendations for international transportation.

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Conclusions

• It is possible that the people not participating
  in the seminars, simulations, planning, etc, are
  the ones that will really make the decisions.
• Authorities in other sectors will be essential at
  the beginning, during and after the pandemic.
• No emergency or disaster takes place in
  accordance with what is planned.
• The sending of human and logistics resources will
  require a well planned mobilization.
• Each week in the delay and containment is
  important in order to reduce the economic and
  social impact.
• New problems will require new resources.