Recovery, Renewal, Resilience

Concurrent emergencies such as disruption to water supply or contamination of water resources can have serious impacts on healthcare facilities and the health of individuals, which may be amplified during a pandemic. Water outages or contaminated water can disrupt clinical procedures, e.g. maintaining a sterile environment in hospitals. Protecting water supply is also crucial during a pandemic, as poor hygiene is a catalyst for the rapid spread of infectious disease. Consider:

• Early scenario planning to consider different types of water shortages alongside the pandemic, and assess potential impacts on health facilities and public health
• The need to establish new systems to provide immediate support to communities in the event of water supply disruption or contamination during COVID-19:
  • Evaluate emergency response measures (e.g. mass water distribution) to determine if they are COVID-safe, and make necessary amendments if required
  • Plan for the need to construct and install handwashing stations in affected communities, to prevent rapid spread of the virus
• The potential for water stagnation to occur in buildings that have been unoccupied over the last year, which may lead to contamination
  • Identify buildings that have been unoccupied and plan for maintenance contractors to test and repair water systems before allowing the building to re-open

Vulnerable people and people with disabilities are most at risk during disasters. The impacts of COVID-19 have exacerbated the risk to vulnerable people and people with disabilities, and has exacerbated the risks for marginalised groups of people. Consider assessing:

• How well evacuation plans incorporate vulnerable people and people with disabilities. This should include consideration of compounding impacts on at risk groups from COVID-19, and new vulnerable groups such as those with new underlying health conditions from contracting the virus
• The inclusiveness of disaster preparedness activities e.g. the accessibility of hygiene facilities, and accessibility of early warning messaging for those with disabilities, in poverty or with limited access to information
• The availability of alternative evacuation accommodation (rather than mass shelters) for particularly vulnerable people, where specialised care can be provided

Compound disaster pose a serious risk during the pandemic, which requires a dual focus on the constant threat of COVID-19 to people’s health and to economies, and on natural disasters. The compound nature of natural disasters and COVID-19 intensifies the scale and broadens the scope of human, social, economic and environmental impacts[1]. Disasters have continued to rise year on year. In 2019, EM-DAT recorded 396 natural disasters globally, that led to 11,755 deaths, affected 95 million people, and resulted in 103 billion US$ in economic losses across the world. Floods were the deadliest type of disaster accounting for 43.5% of deaths, followed by extreme temperatures at 25% (mainly due to heat waves in Europe) and storms at 21.5%. Storms affected the highest number of people, accounting for 35% of the total people affected[2].

This trend has continued, 2020 is on course to be the hottest year on record[3] - impacts of this have been witnessed in parts of Africa and the Middle East where crops have been devastated by locust swarms that begun breeding several months earlier than normal due to weather conditions[4]. Of the 132 unique extreme weather events that have occurred in 2020 (as of late September), 92 have overlapped with the COVID-19 pandemic[5].

Learning from two cases: Vanuatu and Bangladesh

A recent example of a large scale disaster during COVID-19 is the category 5 Tropical Cyclone (TC) Harold that struck Vanuatu on 5 April 2020, affecting over 130,000 people (approx. 43% of the population) and resulting in three deaths. TC Harold caused significant damage to schools, medical facilities, homes, agricultural crops, telecommunications and the local boat fleet[6]. More vulnerable groups such as women were reportedly dealing with multiple concurrent crises, namely drought, scarcity of portable water, volcanic ash, acid rain and sulphur gas as there are also several active volcanoes[7].

While Australia did provide humanitarian aid, strict protocols were implemented when delivering supplies to minimise any chance of transmission to Vanuatu[8], and to date there are no, nor have been any cases of COVID-19 in Vanuatu[9]. However, much of the humanitarian support was offered remotely which demonstrates a shift in how aid is provides e.g. aerial surveillance to assess the scale of impact, logistics support to release relief items that were locally pre-positioned.

The cyclone that hit Bangladesh in May 2020 presents the opposite scenario. The impacts of cyclone Amphan were lessened by decades of disaster risk reduction strategies and a weakening of the storm as it made landfall, which meant the death toll was in the dozens rather than thousands[10]. However, the large number of COVID-19 cases in Bangladesh had serious ramifications for ‘normal’ disaster response. Coastal communities in the path of the cyclone had to make choices between braving the cyclone’s impacts as it hit land, and risking COVID-19 infection as 2.2 million people in Bangladesh were evacuated to shelters[11].

The combination of these cases – heavy impact on people and resources from a natural disaster, combined with high COVID-19 infection rates – demonstrate the worst case for which emergency planners and the humanitarian community need to plan. Going forward, disaster affected countries will be impacted by limitations faced globally, as countries contend with COVID-19 and the impacts this has on their own health systems and economies, and the impacts of this on offers of humanitarian aid. Additionally, logistical support, made more complex by travel restrictions and pressures on global supply chains for resources also needs to be considered, for example:[12]

• Impacts of restricting travel on providing and receiving support, including legislation to override COVID-19 restrictions for assistance
• Implications for efficient response if 14 day isolation periods are required e.g. if dispatching urgent search and rescue teams; how do you choose between saving people from a collapsed building or (re)infecting a community with COVID-19?
• Availability of reliable partnerships for international support including financing, mutual aid and personnel when many countries’ own health systems and economies are under huge strain
• Availability of appropriate protective equipment for all personnel deployed to support a humanitarian effort, including those working in-country
• Pressures on internal mobilization of resources, including the health system which is required for first response to both COVID and disasters
• Risk of infection during evacuations while travelling to and from evacuation centres and residing there

Despite these challenges there are measures which can help countries better prepare for compound COVID-19 disasters. Consider how to:

• Reconceptualise all disaster response as simultaneous COVID-19 response and mitigation of virus transmission
• Develop strategies that incorporate both climate change adaptation and reducing global health threats, by building COVID-19 into disaster risk reduction strategies. Use pre-existing resources such as the Disaster Resilience Scorecard for Cities, and it’s related Public Health Addendum[13], or the UN’s Build Back Better approach[14]
• Partner with disaster risk reduction and emergency planning organisations to integrate health management and disaster management
• Integrate data on COVID-19 and disasters to inform early warning systems, and invest resources into upgrading and expanding systems to manage complex situations
• Deliver preparedness messaging about disasters and other diseases, alongside COVID-19 advice, to keep issues at the forefront of people’s minds and to ensure communities have up-to-date information about mitigating risks posed to them, and the support services available[15]
• Build an understanding based on expertise and skills guided by science, while also building capacity in communities to better understand the hazards of a double disaster and plan collective action[16]
• Keep messaging simple. COVID-19 messaging is already fraught with confusion and misinformation, detailing the risks from other hazards may doubly confuse people if not done in a simple way

The influences of climate change has resulted in disasters which have become seasonal, reoccurring and protracted. This, combined with COVID-19 results in compound disasters that are continually unravelling, which blurs the lines between response, recovery, preparedness, and prevention[17]. It is therefore important to consider humanitarian assistance for a world that is facing two chronic challenges; COVID-19 and climate change.

References:

[1] https://www.sheltercluster.org/sites/default/files/docs/tc_harold_and_covid-19_vanuatu_recovery_strategy_v3_130820.pdf

[2] https://www.cred.be/publications

[3] https://www.theguardian.com/environment/2020/apr/27/meteorologists-say-2020-on-course-to-be-hottest-year-since-records-began

[4] http://www.fao.org/ag/locusts/en/info/info/index.html

[5] https://media.ifrc.org/ifrc/press-release/least-51-6-million-people-doubly-hit-climate-related-disasters-covid-19-new-analysis-ifrc-reveals/

[6] https://www.dfat.gov.au/geo/vanuatu/development-assistance/Pages/supporting-cyclone-recovery-reconstruction-vanuatu

[7] https://actionaid.org.au/wp-content/uploads/2018/08/STPC-AdvocacyReport2020-FINAL-pages.pdf

[8] https://www.dfat.gov.au/crisis-hub/Pages/tropical-cyclone-harold

[9] https://covid19.gov.vu/

[10] https://www.wri.org/blog/2020/05/south-asia-confronts-double-disaster-cyclone-and-covid-19?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+WRI_News_and_Views+%28WRI+Insights+Blog%2C+News%2C+and+Publications+%7C+World+Resources+Institute%29

[11] https://www.wri.org/blog/2020/05/south-asia-confronts-double-disaster-cyclone-and-covid-19?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+WRI_News_and_Views+%28WRI+Insights+Blog%2C+News%2C+and+Publications+%7C+World+Resources+Institute%29

[12] http://nautil.us/blog/a-warning-from-history-about-simultaneous-disasters

[13]https://www.unisdr.org/campaign/resilientcities/assets/toolkit/documents/Disaster%20Resilience%20Scorecard_Public%20Health%20Addendum%20Ver1%20Final_July%202018.pdf

[14] https://www.unisdr.org/files/53213_bbb.pdf

[15] https://www.bnhcrc.com.au/hazardnotes/79

[16] https://www.wri.org/blog/2020/05/south-asia-confronts-double-disaster-cyclone-and-covid-19?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+WRI_News_and_Views+%28WRI+Insights+Blog%2C+News%2C+and+Publications+%7C+World+Resources+Institute%29

[17]https://www.sheltercluster.org/sites/default/files/docs/tc_harold_and_covid19_vanuatu_recovery_strategy_v3_130820.pdf

Planning for the mass gathering of people after a disaster amid COVID-19 is essential to mitigate the transmission of disease. Mass gatherings may occur at health facilities, evacuation shelters, or distribution centres supporting the immediate needs of those affected by a disaster. Consider adapting plans for mass gatherings at sites such as health facilities to accommodate COVID-19 safety measures including:

• Identify facilities for phased relocation of hospitalised patients to manage the influx of new patients considering risks of COVID transmission
• Outline capacity arrangements for on-site emergency care, and special care options for people with pre-existing conditions who are at increased risk of the virus
• Identify resources for further disease outbreaks to counter the increased burden of additional infections and strains on resources (e.g. PPE) that are needed to mitigate COVID-19 transmissions
• Revise estimates of requirements for shelters and transportation for mass movement of people. Increase estimates by at least a 3-times to account for physical distancing
• Maintain an inventory of available dwellings (e.g.school buildings, community halls, places of worship) that will allow enough space for socially distance emergency accommodation
• Plan for distribution centres that distribute basic necessities such as food and medicine. Consider capitalising on community engagement at these sites to continue pandemic risk communication

In the context of COVID-19 to ensure preparedness. Consider the development of Standard Operating Procedures to address this risk.