unit 6.1: emergency & bioterrorism preparedness

Emergency Preparedness (WHO)

* A continuous process in which **action, funding, partnerships and political commitment** at all levels must be sustained
* It relies on all **stakeholders** working together effectively to plan, invest in and implement priority actions
* The **knowledge and capacities and organizational systems** developed by governments, response and recovery organizations, communities and individuals to effectively **anticipate, respond to, and recover from the impacts** of likely, imminent, emerging, or current emergencies

Disaster Preparedness (International Federation of Red Cross/Crescent)

* measures taken to prepare for and reduce the effects of disasters
* to predict and, where possible, prevent disasters, mitigate their impact on vulnerable populations, and respond to and effectively cope with their consequences

Disaster Preparedness

### Disaster & Emergency Preparedness

* provides a **platform** to design __effective, realistic and coordinated planning, reduces duplication of efforts and increase the overall effectiveness__ of National Societies, household and community members disaster preparedness and response efforts
* activities embedded with **risk reduction measures** can __prevent disaster situations and also result in saving maximum lives and livelihoods__ during any disaster situation, enabling the affected population to get back to normalcy within a short time period
* continuous and integrated process resulting from a wide range of **risk reduction activities** and resources rather than from a distinct sectoral activity by itself.
* requires the **contributions** of many different areas—ranging from training and logistics, to health care, recovery, livelihood to institutional development.

Strategic Framework for Emergency Preparedness

* Common, efficient, coordinated multi-sectoral approach
* unifying framework which identifies the **principles and elements of effective country health emergency preparedness**
* adopts the major **lessons of previous initiatives** and lays out the planning and implementation process by which __countries can determine their priorities__ and develop or strengthen their operational capacities
* capitalizes on the **strengths of current initiatives** and pushes for more integrated action at a time when there is both increased political will and increased funding available to support preparedness efforts.
* advocates for **prioritizing financial and other resources** for community and country emergency preparedness, and for **mobilizing and sustaining increased domestic and international investment**
* includes local and national outbreaks of infectious diseases that have the **potential to cross borders**
* epidemics and pandemics
* other types of emergencies caused by natural, technological and societal hazards that can have a significant impact on people’s health and on society

Operational readiness to respond to emergencies

The government should be able to respond and address emergencies

Resilient health system

despite challenges it must continue to function

One Health at the human-animal-environment interface

has three components: human, animal, and environmental health. When there is a typhoon, you have to consider the animals and the area

A whole-of-government, whole-of-society approach

all resources of the government and society should be used

coordination, communication, and collaboration

How do you achieve One Health?

* emergency preparedness
* plans for emergency preparedness
* response and recovery
* coordination mechanisms

key areas for emergency preparedness framework

National Disaster Risk Reduction and Management Council (NDRRMC)

* agency responsible for **disaster management**


* Old name: National Disaster Coordinating Council (NDCC)

Office of National \[Civil\] Defense (DND)

Department of NDRRMC

Climate Change Commission

agency responsible for the **control and implementation of program** that involves the effects of __climate change__

National Nutrition Council (NNC)

Agency responsible for **maintaining nutrition** during disaster

Department of Finance

in charge of contingency funding, logistics, funds, etc.

Coordination

### Emergency Preparedness Framework

must coordinate with all departments of the government

Exercise of power

### Emergency Preparedness Framework

you must exercise authority over these departments

Financing

### Emergency Preparedness Framework

they must have sufficient funds

assess your risk and capacity

### Emergency Preparedness Framework

what are the potential risks and what is your capability in addressing them

Planning

### Emergency Preparedness Framework

use the information as a basis of planning

Implementing

### Emergency Preparedness Framework

once you have a plan, implement it

Evaluating and Correcting

### Emergency Preparedness Framework

implemented plan must be evaluated and corrected if necessary

Bioterrorism

Biological agents are used to cause **terror**

Biological agents

### Bioterrorism

* organisms or toxins that can **kill or disable people, livestock, and crops**
* can be spread by spraying them into the air, person-to-person contact, infecting animals that carry the disease to humans and by contaminating food and water.

Biological attack

### Bioterrorism

deliberate **release** of germs or other biological substances that can make you sics

chemical weapons

### Bioterrorism

defined as "chemical substances, whether gaseous, liquid or solid, which might be **employed in warfare because of their direct toxic effects** on man, animals and plants"

* expanded to include "not only toxic chemicals but also **ammunition and equipment** for their dispersal"

*Dr. Titos Quibuyen of the Institute of Chemistry of U.P. Diliman*

toxic chemical

### Bioterrorism

"chemical which, **through its chemical effects on living process** may cause death, temporary loss of performance, or permanent injury to people and animal"

High toxicity

### Bioterrorism

**To be used as a weapon, such a substance must satisfy the following requirements:**

not everybody will die, but it must cause death or long term consequences

Not too difficult to handle

### Bioterrorism

terrorists do not want to die themselves during the delivery of the biological weapon

Good shelf life without degradation and corroding packaging

### Bioterrorism

* important in long term planning
* stockpiling the agents to be used

Resistant to atmospheric water, air, and other external factors

### Bioterrorism

* effect must not be degraded when deployed in air or water
* Ability to withstand heat when dispersed

Tokyo Subway **Sarin** Gas Attack

### Bioterrorism

March 20, 1995

* released in 3 different stations
* colorless, odorless, lightweight
* inhalation causes **paralysis** of the body
* **respiratory arrest** because the nerves that causes for your lungs to expand will stop
* purified from pesticide

Anthrax (Amerithrax)

### Bioterrorism

2001

* cutaneous to the skin and may also be pulmonary

PNP: Bureau of Fire

### Bioterrorism Strategic Plan

who should respond in the event of a **civilian** bioterrorism attack

Armed Forces of the Philippines

### Bioterrorism Strategic Plan

who should respond in the event of a bioterrorism attack on the **state** itself

Preparedness & Prevention

### Bioterrorism Strategic Plan

* **Detection, diagnosis, and mitigation of illness and injury** caused by biological and chemical terrorism is a complex process that involves numerous partners and activities
* require **special emergency preparedness** in all cities and states
* provide **self-assessment tools** for terrorism preparedness, including performance standards, attack simulations, and other exercises
* encourage and support **applied research** to develop innovative tools and strategies

Detection & Surveillance

### Bioterrorism Strategic Plan

* __essential__ for **ensuring a prompt response** to a biological or chemical attack, including the provision of prophylactic medicines, chemical antidotes, or vaccines
* integrate **surveillance** for illness and injury resulting from biological and chemical terrorism

Diagnosis & Characterization of Biological & Chemical Agents

### Bioterrorism Strategic Plan

* create a **multilevel laboratory response network for bioterrorism** (LRNB)
* __transfer diagnostic technology to state health laboratories__ and others who will perform initial testing
* create an **in-house rapid-response and advanced technology** (RRAT) laboratory

Response

### Bioterrorism Strategic Plan

* A **comprehensive public health response** to a biological or chemical terrorist event involves __epidemiologic investigation, medical treatment and prophylaxis for affected persons, and the initiation of disease prevention or environmental decontamination measures__

Communication systems

### Bioterrorism Strategic Plan

* ___ with the public through the **news media** will also be essential to limit terrorists' ability to induce public panic and disrupt daily life

1. **state-of-the-art communication system** that will support disease surveillance
2. **rapid notification and information exchange** regarding disease outbreaks that are possibly related to bioterrorism
3. **dissemination of** diagnostic **results** and emergency health **information**
4. **coordination** of emergency response activities

### Bioterrorism Strategic Plan: *Communication*

During the next 5 years, CDC will work with state and local health agencies to develop:

House Bill 4458

### Bioterrorism Preparedness in the PH

proposes the establishment of an integrated **chemical, biological, radiological, nuclear (CBRN) resiliency program** to prevent, control, respond and manage the risk and impact of the global nuclear and biological warfare on the country