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

Pan American Health OrganizationWorld Health Organization

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.

Pandemic CrisesPandemic 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.

COE Multi-sector

COE HEALTH

EPIDEMIOLOGYSHELTER ATTENTION

AND CONTROLEDAN HEALTH

MENTAL HEALTH

MATERNAL YOUTH

COMMUNICATIONS AND

INFORMATION

LOGISTICS

EXTERNAL COOPERATION

PUBLICRELATIONS

PRE AND HOSPITAL

ATTENTION

INFRASTRUCTURE AND ENVIRONMENT

FOOD AND NUTRITION

SAFETY

Characteristics of Sanitary Crises

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

• Countries face many risk problems and one of Countries face many risk problems and one of the risks today is the possibility of an influenza the risks today is the possibility of an influenza pandemic.pandemic.

• A balance must be kept between the most A balance must be kept between the most important priorities in terms of development as important priorities in terms of development as well as risks.well as risks.

• Each month more than 1 million people die from Each month more than 1 million people die from transmissible diseases and in a short period of transmissible diseases and in a short period of time AIDS will be the greatest human pandemic time AIDS will be the greatest human pandemic with 45 million infected people and 22 million with 45 million infected people and 22 million deaths.deaths.

Avoid distracting resourcesAvoid distracting resources

Build a general response capacity:

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.

National PlayersNational 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

Contacts outside of the Country

COUNTRY AFFECTED

BY THE CRISIS

INTERNATIONALCOMMUNITY

FOREIGNRELATIONS

PRESIDENCY

HEALTHMINISTRY

CIVIL DEFENCE

RED CROSS/ NGO’s

MUNICIPALITIES

HOSPITALS

International PlayersInternational Players

OPS/OMS

IFRC

ICRC

MSF

OXFAM

CARE

CRS

PADF

MERCOSUROCHA

WFP

UNHCR

UNFPA

UNICEF

CDERA

CAN/CAPRADESICA/CEPREDENAC

OAS

CIDAUSAID

DFID

ECHO

ORAS/CONHU

IDB

IADB

IICA

WB

Cruz Roja

CDC

Bird InfluenzaBird Influenza

Human cases of Avian InfluenzaHuman cases of Avian Influenza

The current priority is to The current priority is to control the bird influenzacontrol the bird influenza

Beginning of the pandemicBeginning 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.

Multi sector ResponseMulti 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.

DisseminationDissemination

• 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.

Scenario at the beginning of the Pandemic

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.

Mechanisms for national responseMechanisms 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.

Other ActionsOther 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.

ConclusionsConclusions

• 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.