infection diseases emergency and Disasters

1. MTI, Khyber Teaching Hospital, Peshawar
Preparation of Infectious disease
emergencies and Disastors
By
Rehmat Ullah
Nursing Director, MTI KTH, Peshawar

2. MTI, Khyber Teaching Hospital, Peshawar
Important Concepts
 Mitigation is the actions taken before and during an outbreak or
epidemic to decrease the potential impact of the situation
 Zoonotic disease is a disease that can be passed between
animals and humans
 Quarantine is the separation and restriction of movement of
persons who may have been exposed to a communicable
disease but are not yet ill. It is used to stop the spread of a
disease
 Emergency management is the process by which an individual,
facility, and/or community uses mitigation strategies to better
prepare for, respond to, and recover from a disaster or
emergency

3. MTI, Khyber Teaching Hospital, Peshawar
Introduction
 Public health emergencies bring many challenges,
including;
 an urgent need for response, proper case identification,
 use of basic and enhanced infection prevention and control
(IPC) practices,
 data collection, and communication,
 all while essential health services must still be maintained.
 The more a facility can prepare in advance, the better
the ability to respond and adapt to a public health
emergency

4. MTI, Khyber Teaching Hospital, Peshawar
Classification of Public Health
Emergencies
Can be classified as infectious and non-infectious
emergencies.
 Infectious disease emergencies include all events that
involve;
 a biological agent (e.g., bioterrorism event) or
 a disease (a pandemic or an outbreak of an emerging pathogen)
and
 impact a large number of individuals, such as in a pandemic (e.g.,
avian influenza) or
 an outbreak of an emerging infectious disease (e.g., Middle East
Respiratory Syndrome-Corona Virus [MERS-CoV]).
 Non-infectious disease emergencies include;
 all natural and manmade events that do not include an infectious
agent as the source of the incident.

5. MTI, Khyber Teaching Hospital, Peshawar
IPC & Public Health Emergencies
 tend to bring IPC infrastructure into the spotlight
as routes of disease transmission are investigated.
 Many outbreaks in the past have revealed
breakdowns in IPC practices, even in institutions
and countries that were assumed to have strong
practices

6. MTI, Khyber Teaching Hospital, Peshawar
Four Principles of Emergency
Management

7. MTI, Khyber Teaching Hospital, Peshawar
Mitigation
 Mitigation is the actions taken before and during an outbreak or
epidemic to decrease the potential impact of the situation
 Mitigation strategies can help a health care facility decrease the
devastating impact of a potential public health emergency.
 For example, offering timely vaccination if an effective vaccine is
available against the disease, such as
 influenza, polio, measles, or yellow fever, can prevent or mitigate an
outbreak of these diseases. (APIC 2014; FEMA 2015)

8. MTI, Khyber Teaching Hospital, Peshawar
Preparedness
 Increase a facility’s ability to respond when an
emergency occurs.
 They include planning, organizing, training, equipping,
practicing, evaluating, and taking corrective actions
 IPC aspects of preparedness include;
 stockpiling IPC supplies, training staff, and increasing
compliance with recommended IPC practices during
mitigation
 It is essential to test the system and make sure the
facility is clear about who is expected to do what

9. MTI, Khyber Teaching Hospital, Peshawar
key steps in the pre-emergency
preparedness
 Creating a strong disease surveillance system--
Outbreaks, epidemics, and pandemics
 Reinforcing IPC practices
 Coordinating with health ministries or other public
health authorities
 Partnering with the community for education,
involvement, and communication
 Performing drills and tests of the system

10. MTI, Khyber Teaching Hospital, Peshawar
Reinforcing IPC practices

11. MTI, Khyber Teaching Hospital, Peshawar
Response
 Includes activities in reaction to a known or
suspected event
 Response functions and tasks are divided into
three time frames:
1. Immediate response 0–2 hours
2. Intermediate response  2–6/12 hours
3. Extended response  12–24 hours

12. MTI, Khyber Teaching Hospital, Peshawar

13. MTI, Khyber Teaching Hospital, Peshawar

14. MTI, Khyber Teaching Hospital, Peshawar
Recovery
 Once an emergency is declared “over,” the recovery efforts
begin
 The six general principles for recovery actions:
1. Establish short- and long-term goals to return a facility or
community to the pre-event baseline.
2. Evaluate how the emergency management plan was carried out
and identify gaps that occurred during the response.
3. Determine potential solutions to the gaps identified in the
emergency management plan.
4. Update the emergency management plan to reflect lessons
learned.
5. Educate staff on changes in the emergency management plan.
6. Practice the new emergency management plan. (APIC 2014)

15. MTI, Khyber Teaching Hospital, Peshawar
Post-event evaluation
 Questions to consider during the post event evaluation
include:
 Was the facility response appropriate for the emergency?
 Were the emergency preparedness plans implemented as they
were intended to be implemented?
 Were the emergency preparedness plans timely and effective?
 Were the facility’s patients, staff, and HCWs safe?
 Could risks have been further reduced for patients, staff, and the
community?
 Were there any gaps in the system?
 What was done well?
 What could have been done better?

16. MTI, Khyber Teaching Hospital, Peshawar
Outbreak Communication & Information
Dissemination
 WHO has identified five best practices for outbreak
communication (also called “risk communication”):
1. Build trust honest, competent, and in control
2. Announce early first communication about an
outbreak can set the tone for all of the communications
3. Be transparent information is honest, easily
understood, complete, and accurate
4. Respect public concerns listen to the concerns
and fears of the public
5. Plan in advance Emergencies can be chaotic, stressful,
and emotional

17. MTI, Khyber Teaching Hospital, Peshawar
Preparing for a Public Health Emergency
 Dedicate adequate resources to emergency preparedness planning efforts.
 Secure facility leadership support for emergency preparedness plans.
 Designate individuals responsible for making the facility’s emergency
preparedness plans.
 Involve individuals and representatives from various backgrounds in the
emergency preparedness plans.
 Ensure that everyone involved in the emergency preparedness plan knows
what their roles and responsibilities are during a public health emergency.
 Perform a facility risk assessment of emergency preparedness.
 Establish relationships with local ministries of health.
 Develop standard operating procedures for essential functions, including:
 Procedures for outbreak alert and outbreak verification
 The flow of information
 The development and distribution of information to the public
 Staffing management
 Designated roles and responsibilities

18. MTI, Khyber Teaching Hospital, Peshawar
Preparing for a Public Health Emergency
 Designate a spokesperson
 Ensure a Surveillance is in place
 Monitoring hospital admissions, deaths, staff absenteeism, vaccine
usage
 Designate an area to store specimens, protocols for
specimen collection and transportation.
 Ensure basic IPC procedures are followed
 Staff are trained, Equipment is available, designated area
for patient screening, triage, and patient care
 Supply needs (including PPE) have been calculated
 Ensure adequate number of staff and training

19. MTI, Khyber Teaching Hospital, Peshawar
Preparing for a Public Health Emergency
 Determine how vaccine or antivirals can be
obtained
 Develop contingency plans for storage,
distribution, and safe administration of vaccines &
antivirals.
 Management of the deceased
 Assess the effectiveness of plan, Perform drills,
Revise & determine a set interval of time

20. MTI, Khyber Teaching Hospital, Peshawar
THANKS
QUESTIONS