Recovery, Renewal, Resilience

We identify the core barriers to co-production during the pandemic: Pace, distance and complexity, and provide a broad framework which can be designed into a project's main policy framework to facilitate co-production in preparedness and response.

Follow the source link below to TMB Issue 33 to read this briefing in full (p.3-6).

Since the start of the pandemic there has reportedly been an increase in extremist narratives from a variety of groups. People (including vulnerable people who have been severely socially or economically impacted by the pandemic) are at risk of extremism which creates future security challenges. Organisations should remain vigilant about new and emerging threats to public safety and develop response plans that incorporate risks of extremist behaviour. Consider:

• Local assessments of old and new manifestations of local extremism which may have been exacerbated or triggered by the pandemic. Consider the form it takes, (potential) harm caused, and scale of mitigation or response strategies needed
• Developing interventions for those most susceptible to extremist narratives, this may include new groups e.g. a rise in far right groups, and conspiracy theory groups committing arson on 5G towers as they believe them to be the cause of COVID-19
• Assessing groups which have become more at risk since COVID-19 and increased public protections measures and support for these groups e.g. East Asian and South East Asian (since COVID, hate crimes towards this group has increased by 21%)
• Developing COVID-19 cohesion strategy to help bring different communities together to prevent extremist narratives from having significant reach and influence
• Working with researchers and practitioners to build a better understanding of 'what works' in relation to counter extremism online and offline. This should include consideration of dangerous conspiracy theories, and their classification based on the harm they cause

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)

We propose key considerations for local governments when managing wide-ranging change, such as that induced by a complex, rapid and uncertain events like COVID-19. Identifying and understanding the types of change and the extent to which change can be proactive rather than reactive, can help to support the development of resilience in local authorities and their communities.

To read this briefing in full, follow the source link below to TMB Issue 19 (p.2-6).

Part 3: Building on TMB 16 and 17, we present a detailed view of how to assess the performance of the system of resilience before/during/after COVID-19. This briefing presents a comprehensive Annex of aspects against which performance can be considered.

To read this briefing in full, follow the source link below to TMB Issue 18 (p.2-7).

The all-of society impact of COVID-19 has required many organisations to adapt their operating procedures and deliver alternative activities, including frontline emergency services such as the Police, Fire Brigade, Ambulance and Search and Rescue organisations. We provide examples of first responder adaptation during COVID-19 to demonstrate how frontline services have modified their operations to help tackle the crisis.

Alternative activities undertaken by emergency services

• Supporting health and social care: In California (USA), the National Guard deployed rapid medical strike teams to assist overwhelmed health/nursing facilities[1]. Strike teams involved 8-10 people (e.g. included doctors, nurses, physical therapists, respiratory therapists, behavioural health professionals). Strike teams worked across 25 nursing homes – staying on-site for 3-6 days to establish stability of care, disinfected facilities, and staffed mobile COVID-19 testing sites2.
• House-to-house testing: In Guayaquil (Ecuador)municipal taskforces (involving firefighters, medics, and city workers) went house-to-house looking for potential cases[2] . Similarly, in Cambridge (USA), Fire Department paramedics were enlisted to go door-to-door in public housing developments that predominantly housed the elderly and younger disabled tenants to offer Covid-19 tests to residents[3]
• Disinfecting public spaces: In Pune (India) , sanitary workers disinfected and fumigated public areas[4]
• Managing sanitation services: In Ganjam (India), the fire brigade supported the COVID-19 effort by heading the country’s sanitation programme[5]
• Delivering food/medication parcels to vulnerable people: In West Bengal (India), all police stations were made responsible for delivering food and medication to those who are vulnerable and sheltering to avoid food scarcity - the programme was monitored by the State’s District Magistrates and Police Superintendents[6]. In Georgia (USA), a similar scheme involved police officers delivering groceries/medicine to vulnerable people who had placed/paid for orders[7]
• Distributing $100 gift cards: In Smyrna (USA), police handed out $100 gift cards from a community grocery assistance fund to help vulnerable residents purchase essential items[8]
• Counteracting misinformation: In Göttingen (Germany), clashes with tower block residents under enforced lockdown were caused by communication problems between authorities and residents. Translators, working through first responding services, communicated important public health information to relevant residents in German and Romanian via text messaging[9]

Consider the demand for alternative activities from emergency services

To determine how, when and where emergency services can support alternative activities, consider:

• The demand for alternative support:
  • Identify current needs where additional capacity to deliver activities is required
  • Identify future areas where demand is foreseeable, and where additional capacity may need to be built e.g. through retraining
• How responders can support alternative activities[10]:
  • Identify potential capacity in responder organisations, or how this capacity can be created, protected, and prioritised, and how long this capacity may be available[11]
  • Obtain strategic-level agreement on the direction, scope and parameters of the alternative activities
  • Gather information to understand activities e.g. from partner databases, existing measures, knowledgeable people
  • Assess the impact of redeploying staff to other activities and the effects of this on their ability, and the organisation’s ability to cope[12]
• Preparing redeployed resources:
  • Identify and source training and safety measures required to redeploy staff to alternative activities (including health and wellbeing of staff and the public)[13]
  • Capability of the resources, including:
    • Transactional activities i.e. single short-term actions
    • Transformational activities i.e. complex, interconnected, longer-term actions needing strategic partnerships

Consider the benefits to the emergency services from delivering alternative activities

The involvement of emergency services in alternative activities has the potential to increase services’ visibility in communities which can help build community trust and engagement[14], reduce misinformation and non-compliance to COVID-19, and bolster local multi-agency partnerships for a more efficient and effective response and recovery[15].

On benefits, consider:

• Working with partners to capitalise on increased contact with marginalised and vulnerable communities e.g. from door-to-door visits. This may include:
  • Addressing additional social or health issues, fire safety, safeguarding, or referral to other services
  • Community engagement activities and visible street presence through renewing the Neighbourhood Watch Scheme and police Safer Neighbourhood Teams[16]
• Developing joint local/national approaches to provide alternative response to support COVID-19 activities. This may include:
  • Emergency services delivering essential items like food and medicines to vulnerable people, driving ambulances, assisting ambulance staff, attending homes of people who have fallen but are not injured[17],[18]
  • Increase multi-agency coordination with civil organisations should be central in the design and review measures for COVID-19 response and recovery[19]
• How to capitalise on increased community engagement and volunteerism to help disseminate public health information. Consider working with volunteer and civil society organisations that are close to communities and know their specific needs to:
  • Increase capacity for response and recovery considering short and long-term requirements of the need, and of volunteers
  • Translate and disseminate timely information in relevant languages and tackle misinformation[20]
  • Build relationships in the community to encourage adherence to COVD-19 behaviours, especially with people who have not had previous contact with emergency services
  • Enhance community engagement and information sharing to combat misinformation and non-compliance about COVID-19 working with Crime and Disorder Reduction Partnerships (CDRPs)18
    

[1] https://www.cpr.org/2020/08/06/national-guard-helps-fill-long-term-care-staff-shortages-in-california/

[2] https://www.theguardian.com/world/2020/apr/22/ecuador-guayaquil-mayor-

[3] https://www.cambridgeday.com/2020/05/16/plans-to-test-most-vulnerable-for-covid-19-evolve-enlisting-fire-paramedics-to-visit-public-housing/

[4] http://cdri.world/casestudy/response_to_covid19_by_pune.pdf

[5] https://www.newindianexpress.com/states/odisha/2020/aug/07/ganjam-to-conduct-home-survey-again-as-cases-rise-2180291.html

[6] https://www.hindustantimes.com/india-news/covid-19-lockdown-police-stations-will-take-responsibility-to-deliver-food-at-doorsteps-says-mamata-banerjee/story-YOYnHAdwmTHAZzzcTLYYuI.html

[7] https://cobbcountycourier.com/2020/04/smyrna-police-deliver-food-and-medicine-to-seniors/

[8] https://cobbcountycourier.com/2020/04/smyrna-police-deliver-food-and-medicine-to-seniors/

[9] https://www.bbc.co.uk/news/world-europe-53131941

[10] The Manchester Briefing on COVID-19. Fifteenth briefing: Week beginning 13th July 2020. ambs.ac.uk/covidrecovery

[11] https://www.nga.org/wp-content/uploads/2020/05/NGA-Memo_Concurrent-Emergencies_FINAL.pdf

[12] https://www.cipd.co.uk/knowledge/strategy/resourcing/transferable-skills-redeploying-during-COVID-19

[13] https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0666_Redeploying-your-secondary-care-medical-workforce-safely-v-2_14July.pdf

[14] https://www.app.college.police.uk/app-content/engagement-and-communication/engaging-with-communities/

[15] https://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=25788&LangID=E

[16] https://policyexchange.org.uk/wp-content/uploads/Policing-a-Pandemic.pdf

[17] https://www.nationalfirechiefs.org.uk/News/Page-2/covid-19-firefighters-to-deliver-food-and-medicines-drive-ambulances-and-retrieve-bodies/249304

[18] https://www.westyorksfire.gov.uk/news/fire-service-staff-volunteer-to-help-people-get-back-on-their-feet-during-coronavirus-pandemic/

[19] https://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=25788&LangID=E

[20] https://www.theguardian.com/australia-news/2020/jul/06/melbourne-towers-residents-translated-covid-19-information-sheet-into-10-different-languages-in-24-hours

Part 2: We build on TMB 16 and consider how to apply the VSM's 5 systems to understand and debrief on experiences of COVID-19 in a structured, systems manner.

To read this briefing in full, follow the source link below (p.2-6).

Part 1: We begin by exploring how the experience of COVID-19 prompts consideration of what national and local (ambitious) renewal of systems to develop resilience to crises and major emergencies could look like. We present a model of 5 systems: operational delivery; coordination; management; intelligence; and policy. This briefing elevates thinking from the performance of individual organisations into considering the performance of the system as a whole.

To read this briefing in full, follow the source link below to TMB Issue 16 (p.2-7).

To plan for local outbreaks of the pandemic, local government in England were required to develop and publicise their Local Outbreak Plan on how they will manage any sporadic surges of the virus in their local area. To structure these outbreak control plans, UK public health authorities identified seven connected themes to cover: care homes and schools; high risk places and communities; methods for local mobile testing units; contact tracing and infection control in complex settings; integrating local and national data; supporting vulnerable people to self-isolate; establishing governance structures. Other countries (e.g. Ireland and New Zealand) have also required the development of outbreak control plans, especially for outbreaks in care homes.Consider how to:

• Review how other organisations have planned for outbreaks and learn from the contents of those plans
• Develop an outbreak control plan for how to manage a spike in COVID-19 case
• Use others' plans to confirm the contents of your plans and/or expand those contents
• How to exercise those plans and how to share the learning from those exercises with other organisations
• Developing bespoke outbreak control plans for specific sectors e.g. care homes

Recently, European Union countries have begun enforced lockdowns in smaller regions in response to new outbreaks of COVID-19, rather than bringing the entire country to a halt. 'Smart lockdowns' have been undertaken in Germany, Portugal, Italy, and the UK where local governments have declared local lockdown where cases of COVID-19 could not be contained.

Special consideration should be given to the identified causes of spikes in transmission. Localised COVID-19 outbreaks in Europe and the USA share a number of similarities. In most cases, overcrowded living conditions, poor working conditions, cultural practices, and/or limited socio-economic capital point to increased risk of infection and transmission. In Warendorf (Germany) and Cleckheaton (England), outbreaks were attributed to abattoirs and meat factories , which often employ migrant workers in poor working conditions on low-paid contracts. While the outbreak in Cleckheaton does not seem to have spread into the community, the fallout from the abattoir in Germany resulted in the lockdown of the city of Warendorf. Similar patterns are being witnessed in the USA, where workers from meat processing plants in Georgia, Arkansas and Mississippi, who are predominantly migrant workers or people of colour, have died from the virus or have become infected.

Conversely, in Marche (Italy) and Lisbon (Portugal) outbreaks originated in migrant communities that were living in overcrowded quarters or experiencing unsafe working conditions. Similarly, this week in Leicester (England), a local lockdown has been enforced. Possible reasons for the spike in cases shares stark similarities to the local lockdowns that have gone on elsewhere.

Reportedly, in Leicester some garment factories continued to operate throughout the crisis and forced their workers to work despite high levels of infection. Wage exploitation of the largely immigrant workforce, failure to protect workers' rights in Leicester's garment factories (a subject of concern for years), and poor communication of lockdown rules with Leicester's large ethnic minority community have all contributed to a resurgence in the disease.

Secondly, the East of the city, suspected to be the epicenter of the outbreak, has extreme levels of poverty, is densely packed with terraced housing, and has a high proportion of ethnic minority families where multi-generational living is common.

These patterns barely differ from the spike in cases in Singapore in May 2020 in which Singapore's progress on tackling COVID-19 was halted as tens of thousands of migrant workers contracted the disease due to poor living conditions and being neglected by testing schemes as their migrant status and relative poverty meant they were overlooked by the government.

Implementing smart lockdowns requires:

• Outbreak control plans for the COVID-19 partnership to be developed, written, and communicated to wider partners, specifying their role in the outbreak response
• Collaborate closely across the public sector to understand possible at-risk communities e.g. minority groups, migrant workers, those in poor or insecure housing, those in particular occupations
• Identify new cases early through rapid testing and contact tracing and sharing timely data across agencies
• Decide the threshold at which a cluster of new cases become an outbreak
• Decide the threshold at which an outbreak triggers the lockdown of an area, and how the size of that area is determined
• Collaborate closely with the public sector to communicate and enforce local lockdowns e.g. the police, the health and social sector, local leaders
• Ensure there is capacity in local-health care systems to respond to the outbreak
• Collaborate with citizens to ensure good behavioural practices are understood and adhered to e.g. hand washing, social distancing at work and in public areas
• Ensure the parameters of the local lockdown are clear. For example, in a UK "local authority boundaries can run down the middle of a street" which makes it different to differentiate what is appropriate for a city or region, and to understand how a local community identifies with the place and boundaries in which they live

Local outbreaks, whether in migrant worker accommodation, meat factories or impoverished areas of a city, clearly underscore the disproportionate impact of COVID-19 on minority, migrant, and poor communities. Increased engagement with, and attention to ethnic minority groups, marginalised people and impoverished communities is key to staving off local and national resurgences of COVID-19. Strong multi-organisational partnerships are required to account for varying needs and concerns with certain communities including addressing their living and working conditions and the risks this poses to public health.

To read this case study in its original format (including source links and references, follow the source link below.

Consider using the Emergency Planning College Business Continuity (BC) checklist to understand how well BC is incorporated into core areas such as risk management (see BS65000 for further examples). The checklist provides signposting to relevant guidance. Example guidance includes:

Roles, responsibilities and competencies

• Identify BC roles and command and control structures e.g. strategic leads; BC advisor/coordinator; incident management etc
• Promote effective leadership (e.g. ISO22301; ISO22330)
• Document information including plans, procedures, roles and competencies, and the recording of decisions, actions and rationale (e.g. ISO22301: Clause 7.5)

Monitoring and evaluation and decision making

• Effectively monitor impacts and use of trusted, key guidance for BC to inform decisions
• Agree decision-making methodology and governance structures for BC
• Use models such as the Joint Decision Model (JDM) for making decisions for multi-agency response or organisational level
• Agree processes for effectively standing response down, including decision makers and deciding factors (e.g. ISO22301: Clause 8.4.4.3)

Recovery of businesses and Maintenance of BC

• Promote recovery as a chance for innovation of current processes, organizations, communities and behaviours, which is in keeping with 'Continual Improvement' (e.g. ISO22301: Clause 10.2; 'Innovation' in BS65000)
• Advocate the lifecycle of the BC plan and the accuracy of priorities and how lessons are learned from incidents

This briefing builds on The Manchester Briefing (TMB) 8 to discuss more about the effects and impacts of, and opportunities arising from, COVID-19; what these mean for developing recovery strategies and for Local Resilience Forums (LRFs) which plan the response to crisis.

Follow the source link below to TMB Issue 9 to read this briefing in full (p.2-10).

Annex A of this week's 'Briefing A' contains a menu of impact themes and impact areas that could be used to help local government plan an impact assessment (p.7-10). Follow the source link below to view this briefing.