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Posts Tagged ‘response’

In 2019 the WHO released the document “Health Emergency and Disaster Risk Management Framework” (Health-EDRM)[1]. At that time no one had heard of SARS-CoV-2 while, at the same time, it was a premonition of things to come.

A recent paper by Emily Ying Yang Chan et al[2] points out the need to reinforce a bottom-up approach to Health-EDRM in line with my previous post “Citizens’ role in hazard management[3].

A quick review of the Health-EDRM document (see Bullet 5.9) shows how the authors understood the role of the community in an emergency: “Participation of communities in risk assessments to identify local hazards and vulnerabilities can identify actions to reduce health risks prior to an emergency occurring. … The local population will also play the lead role in recovery and reconstruction efforts.”

It is clear that a year and a half after the explosion of Covid-19, “the local population” has been at best a passive actor in the fight against the pandemic. Its participation in the prevention, preparedness, readiness, response, and recovery continuum has been marginal.

I argue in the above-mentioned post, “Citizens’ role in hazard management”, that the involvement of the population should be based on its ability to identify a hazard before it becomes a real risk. For that it is necessary to involve the population by developing diffusion tools covering an array of specific hazards. To my knowledge, nothing existed in this area for a pandemic and, what is even worst, nothing is being done.

If anything has to be learnt from the development of the pandemic, it is that none of the actors were prepared to fight it effectively. But the population was taken completely by surprise, going from normal day to day business to complete lockdown. The population collaborated passively throughout this situation. The problem remains that, having an almost complete lack of knowledge of what the full consequences of the pandemic are, a large percentage of the population has embraced the so called “freedom” with open arms.

The whole structure of population involvement has fallen into pieces. Embracing with open arms the new “freedom” is the exact opposite of what involvement of the population in fighting the pandemic should mean. A large percentage of the population is, with “open arms”, exercising its “freedom” to help spread the SARS-CoV-2.


[1] https://www.who.int/hac/techguidance/preparedness/health-emergency-and-disaster-risk-management-framework-eng.pdf accessed 23/07/21

[2] https://doi.org/10.1016/S0140-6736(21)01233-2  accessed 23/07/21

[3] https://cgarciamanagement.wordpress.com/2021/07/22/citizens-role-in-hazard-management/ accessed 23/07/21

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It was late July 2003 in the city of Auxerre in Burgundy. Authorities had been warning of very high temperatures for August, exceeding 40ºC during the day and no less than 20ºC at night.

M. Collardelle is in his early seventies. He is a healthy person with no more ailments than the usual for his age. He lives downtown, not far from the river, in a two storey-house with a nice small garden around it. With that setting, M. Collardelle does not worry about temperatures; he knows that the river and the garden will make life a lot more pleasant for him than for those who live in apartment houses on the outskirts of the city.

He had just received a telephone call from his only child who is vacationing in Spain with her husband and kids. They had a nice conversation and, to reassure his daughter, he reminded her that he had fought in the Algerian War, where he had endured much more than those forecasted 40ºC. They said goodbye, with M Collardelle telling his daughter not to call again. They would be back in France on the 15th.

So, the first of August arrived and with it, the dreaded 40ºC. And the second was the same and so forth and so on; and M. Collardelle realized that he was not in his twenties but some 45 years older, and he could not cope with the heat. He just sat in his armchair, with the windows open in hope of some respite, but what came from outside was more heat. He didn’t even have the energy to go to the kitchen to fetch a glass of water.

The 15th of August his daughter rang the bell, and as there was no answer, she opened the door and found her lifeless father in his beloved armchair. M. Collardelle had joined the more than 70.000 people who died from the heat wave that summer. 70.000 dead that would never have occurred if proper measures had been in place.

Hazards become real risks when the flow of early-warning-surveillance-preparedness- reaction breaks down for some reason. In the case at hand, it is clear that the early-warning system in place was not enough and that the flow never started; no surveillance, preparedness, or reaction were put in place.

Since 2003 things have improved; the European Climate Adaptation Platform[i] is a good example of how much things have changed. Today most countries have Heat-Health Action Plans to ensure that something like that will never happen again. Nevertheless, most plans focus on the activities that institutions at national, regional, and local levels have to carry out in case of an emergency. The diffusion and communication with citizens is mostly one way, from the institution to the public, at most an open line for people to report back, but with no real engagement or tracing whatsoever.

A comprehensive system for preventing a hazard from becoming a real problem is lacking. To start with, most plans are limited to a specific hazard or to a particular respondent. Very rarely is there a comprehensive focus on a situation that, in many cases, involves the occurrence of various simultaneous hazards.

It is also symptomatic that crisis management is only put in place once the crisis has reached a certain level. Those moments, from the occurrence of the event till the recognition by the relevant authorities that the event is in place, are mostly wasted. In fact, there is a lack of co-responsibility on the part of the citizenry in the response to an event.


[i] http://climate-adapt.eea.europa.eu/about accessed 12.07.21

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For once, an international body has recognized that something has to be done to avoid another COVID-19 disaster. The European Commission is promoting the design and launching of a new agency: the European Health Emergency Preparedness and Response Authority (HERA). The HERA will be tasked with the risk assessment, risk management, and risk communication of future health emergencies.

Five pillars constitute the core of HERA:

  1. Supporting technological innovation.
  2. Fostering coordination among EU and non-EU countries as well as with related international organizations.
  3. Establishing monitoring, preparedness, and response mechanisms.
  4. Instituting a robust EU and WHO surveillance system.
  5. Building specific competence for health and non-health personnel.

All five pillars, together with the promotion of research and innovation for a preparedness agenda and enhancing partnerships with non-EU countries, should put the EU and, by extension, the rest of the world in a better situation than the one it was in a year ago.

We can bet that, if in a few years’ time, no new pandemic has developed, many people will start pointing out how the EU is a machine that wastes money on useless agencies whose only objective is to maintain the good life of many eurocrats. That will be good for two reasons. First, it will mean that we have been spared a new devastating pandemic; second it will probably mean that the mechanisms designed by HERA have worked and we have avoided a new pandemic.

Let’s hope that HERA will have to be faced only with the above kind of criticism, and that its design is as good as we all hope for. Another devastating pandemic like COVID-19 will surely cripple the fabric of the world more than the recent financial and health crises.

Note: this post has been inspired by the paper by Villa, S et al. HERA: a new era for health emergency preparedness in Europe? The Lancet. Published Online May 17, 2021 https://doi.org/10.1016/S0140-6736(21)01107-7

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