Recovery, Renewal, Resilience

COVID-19 has shed new light on the way in which countries respond to, and recover from emergencies. This includes COVID-19 specific advice and broader lessons about emergency preparedness and management. For example, previous guidance on volunteer management has traditionally assumed a point of convergence at a disaster site, while this still holds true for many emergencies e.g. floods, lessons from COVID-19 demonstrate that volunteer management may also be dispersed, large-scale and without face-to-face contact. Consider how lessons from COVID-19 may help to revise emergency plans:

• Conduct a 'stock take' of current emergency guidance, and consider what may be missing or no longer fit for purpose
• Implement debriefs, peer reviews and impact assessments, drawing on expertise from local government and emergency practitioners, to evaluate how well current guidance worked and where it needs revising
• Consider that emergency planning must remain relevant to specific types of emergencies, but that broader lessons from COVID-19 can help strengthen guidance e.g. issues of inclusion such as gender, ethnicity, sexuality; health and socio-economic disparities and vulnerabilities; volunteering capacity; supply chain stability; green agenda; and partnerships arrangements
• Draw on resources beyond government guidance from global networks e.g. Resilient Cities Network's revised toolkit which builds recovery from COVID-19 into a wider resilience agenda for a safe and equitable world, and resources from International Organization for Standardization (ISO) which is developing new recovery standards in light of COVID-19 lessons (ISO 22393)

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

To prepare for the impact of a natural disaster alongside COVID-19, research should focus on modelling natural hazards beside epidemiological risks. This can inform public health responses to manage, for example, the dual challenges of dealing with the effects of flooding and preventing localised COVID-19 outbreaks). Consider pre-emptive strategies to counter the compounded risks of COVID-19 and natural hazards:

• Identify possible pandemic-natural disaster hybrid scenarios including worst-case scenarios
• Work with multiple organisations to build new hybrid forecast models that combine existing pandemic projection models and natural hazard forecasting
• Consider seasonal weather forecasting models in advance and their impact on transmission and health and response capacity
• Re-design response plans to focus on COVID-19 restrictions e.g. impacts on emergency aid distribution, involvement of volunteers, access to PPE, providing shelter, food distribution
• Exercise the impact of concurrent emergencies to identify key learning and integrate that learning refreshing plans in the light of COVID-19

The avoidable death framework (ADF) considers avoidable deaths from disasters, including pandemics which are amenable (treatable), preventable, or both. Amenable deaths require timely and effective healthcare. Preventable deaths can be avoided through public health interventions such as epidemiology and surveillance, outreach, screening and health teaching.

Amenable death research can analyse:

• Waiting times and the impacts of delays on those who receive and those who give care e.g. the time interval between onset of symptoms and seeking medical interventions; the time interval between the arrival of the patient and commencing treatment
• Effectiveness of the health system including outcomes that are affected by the way the system works e.g. the application of COVID-19 treatment protocol. More amenable (treatable) deaths in a given region would indicate a less effective system

Preventable death research can analyse:

• Effectiveness of health interventions e.g. hand hygiene, respiratory etiquette, social distancing, crowd control and lockdown
• Indirect deaths e.g. hunger, suicide

Consider how amenable and preventable deaths could be further effectively avoided through disaster risk governance which includes:

• Risk communication
• Coordination, collaboration and cooperation between the government and the general public; between governmental departments; and between the government and civil societies/multilateral organisations