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)

The outbreak of COVID-19 has resulted in countries closing their borders at short notice, and the suspension or severe curtailing of transport. These measures have implications for those who are not in their country of residence including those working, temporarily living, or holidaying abroad. At the time of the first outbreak, over 200,000 EU citizens were estimated to be stranded outside of the EU, and faced difficulties returning home[1].

As travel restrictions for work and holidays ease amidst the ongoing pandemic, but as the possibility of overnight changes to such easements, there is an increased need to consider how repatriations may be managed. This includes COVID-safe travel arrangements for returning citizens, the safety of staff, and the effective test and trace of those returning home. Facilitating the swift and safe repatriation of people via evacuation flights or ground transport requires multiple state and non-state actors. Significant attention has been given to the amazing efforts of commercial and chartered flights in repatriating citizens, but less focus has been paid to the important role that emergency services can play in supporting repatriation efforts.

In the US, air ambulance teams were deployed to support 39 flights, repatriating over 2,000 individuals. Air ambulance teams were able to supplement flights and reduced over reliance on commercial flights for repatriations (a critique of the UK response[2]). This required monumental effort from emergency service providers. After medical screening or treatment at specific facilities, emergency services (such as police) helped to escort people to their homes to ensure they had accurate public health information and that they understood they should self-isolate.

Authorities should consider how to work with emergency services to develop plans for COVID-19 travel scenarios, to better understand how to capitalise on and protect the capacity and resources of emergency services. Consider how to:

• Develop emergency plans that include a host of emergency service personnel who have technical expertise, and know their communities. Plans should[3]:
  • Be trained and practiced
  • Regularly incorporate best practices gained from previous lessons learned
• Build capacity in emergency services to support COVID-19 operations through increased staffing and resources
• Anticipate and plan for adequate rest periods for emergency service staff before they go back on call during an emergency period
• Protect emergency service staff. Pay special attention to safe removal and disposal of PPE to avoid contamination, including use of a trained observer[4] / “spotter”[5] who:
  • is vigilant in spotting defects in equipment;
  • is proactive in identifying upcoming risks;
  • follows the provided checklist, but focuses on the big picture;
  • is informative, supportive and well-paced in issuing instructions or advice;
  • always practices hand hygiene immediately after providing assistance

Consideration can also be given to what happens to repatriated citizens when they arrive in their country of origin. In Victoria (Australia), research determined that 99% of COVID-19 cases since the end of May could be traced to two hotels housing returning travellers in quarantine[6]. Lesson learnt from this case suggest the need to:

• Ensure clear and appropriate advice for any personnel involved in repatriation and subsequent quarantine of citizens
• Ensure training modules for personnel specifically relates to issues of repatriation and subsequent quarantine and is not generalised. Ensure training materials are overseen by experts and are up-to-date
• Strategically use law enforcement (and army personnel) to provide assistance to a locale when mandatory quarantine is required
• Be aware that some citizens being asked to quarantine may have competing priorities such as the need to provide financially.
• Consider how to understand these needs and provide localised assistance to ensure quarantine is not broken

References:

[1] https://www.europarl.europa.eu/RegData/etudes/BRIE/2020/649359/EPRS_BRI(2020)649359_EN.pdf

[2] https://www.bbc.co.uk/news/uk-politics-53561756

[3] https://ancile.tech/how-to-manage-repatriation-in-a-world-crisis/

[4] https://www.cdc.gov/vhf/ebola/hcp/ppe-training/trained-observer/observer_01.html

[5] https://www.airmedicaljournal.com/article/S1067-991X(20)30076-6/fulltext

[6] https://www.theguardian.com/australia-news/2020/aug/18/hotel-quarantine-linked-to-99-of-victorias-covid-cases-inquiry-told

To read this case study in its original format follow the source link below to TMB Issue 21 (p.20-21)

In the USA, the impacts of natural disasters are being felt more frequently and earlier than expected. As a result, emergency planning for potential evacuation is of increasing importance. Consider: Locale specific, local guidance on evacuating safely during the pandemic:

• Reviewing agreements and plans with neighbouring regions to provide mutual aid resources
• Adequate stocks of personal protective equipment for staff, and to distribute to evacuees and residents at risk of evacuation
• Adequate stocks of COVID-19 testing kits to evacuation centres to avoid spread of the virus during evacuation
• Capacity to perform temperature checks on all arrivals at shelters
• Ensure residents are prepared to make plans for alternative arrangements during an evacuation such as staying with friends/family, or in hotels, rather than relying on communal shelters (which should be the last option)
• Ensure residents have adequately prepared for an evacuation and understand they should bring their own personal bedding and care items to mitigate transmission

FEMA (USA) has made freely available some training materials on a range of topics. The trainings below are not specific to COVID-19 but are helpful to the broader issues of planning for emergencies. These links are to just the slides, but they provide a helpful background and sources for further study. Consider reviewing the materials in the following FEMA courses:

• Animals in Disasters: Awareness and Preparedness
• Animals in Disasters: Community Planning
• An Introduction to Exercises
• Leadership and Influence
• Decision Making and Problem Solving
• Effective Communication
• Developing and Managing Volunteers

Each of these courses have online materials available on the URLs given above - often over 100 slides are freely available.

FEMA (USA) make freely available training materials on a range of topics which are of relevance to the current pandemic. The list of training below is not specific to COVID-19 but is helpful for the broader issues of planning for emergencies and commanding emergency response to incidents. These links are to just the slides, but they provide a helpful background and sources for further study. Consider reviewing the materials in the following FEMA courses:

• Emergency Planning
• Fundamentals of Emergency Management
• Introduction to the Incident Command System
• Basic Incident Command System for Initial Response
• An Introduction to the National Incident Management System
• National Response Framework: An Introduction

Each of these courses have online materials available on the URLs given above - often over 100 slides are freely available.

Spare capacity is expensive when it is not being used so, in many cases, systems are lean and focus on maximising their utilisation, ongoing value for money, efficiency and return on initial investment. However, this reduces ability to rapidly access capacity and to react quickly in emergency situations. During the early stages of COVID-19 in different countries we witnessed the attempt to delay the impact of the virus so that the system could create needed capacity in areas of healthcare. This time was used to create spare capacity by freeing up beds, sourcing equipment and supplies expected to be needed, preparing staff, identifying processes to pause or reduce to redeploy resources to more critical activities, retrain staff in other critical activities. As countries analyse the potential of future waves of the pandemic, consider:

• What important services are/have been stretched to (or exceed) maximum capacity during the response e.g. healthcare (intensive care), schools (number of socially distanced pupils in classrooms)
• Where demand for important services could exceed available capacity during recovery and Renewal e.g. provision of mental health support, financial advice, unemployment services, retraining
• Where spare capacity should be built into the system so that an appropriate response can be rapidly provided to emergencies e.g. ongoing response to COVID-19, concurrent emergencies, future outbreaks of the virus
• How spare capacity can be created, protected, and prioritised for rapid use when needed
• The need for spare capacity on an ongoing basis after the crisis lessens

Reference: Interview with German Fire Department

Existing resilience strategies should be amended in real-time to include long and short-term actions to combat the effects of COVID-19. This should include consideration of pre-existing vulnerabilities such as local socio-economic conditions, and environmental risk such as heatwaves and floods. Consider evaluating all indicators of all resilience programmes to weave COVID-19 impacts and indicators into sustainable resilience planning. This helps accommodate COVID-19 into existing long-term city plans, rather than trying to build resilience purely around COVID concerns

This lesson was contributed to by Chief Resilience Officers in the USA and Colombia, during project data collection.

Including:

• Advising citizens to remain prepared for a future lockdown - provide information to citizens about 'preparedness kits' that they may still want to keep available. This kit can include non-perishable foods, hygiene and cleaning products, basic medical supplies, and entertainment items. Consider providing information on items to purchase based on age or gender
• Advising citizens not to panic buy - if advising citizens to develop 'preparedness kits', provide clear information about how many items are reasonable per household, explain why over-stockpiling is not needed and detrimental
• Advising citizens about lockdown procedures - if advising citizens to develop 'preparedness kits', provide clear information to reiterate lockdown procedures such as social distancing, self-isolation, monitoring of systems, access to services during a lockdown

Local government should identify lessons learned and update their DRR plans, procedures and practices with knowledge gained during the Covid-19 response. This should integrate lessons from all sectors to improve DRR practices with information about epidemics that effect all aspects of society, commerce and life. Covid-19 has change thinking that pandemics were limited to the health sector and has moved its prominence into all sectors and to all stakeholder. Cities are now epidemic aware and this social and institutional memory should be recorded and used to inform plans.

Reference: American Red Cross