The document discusses pandemic management at the district level, emphasizing the rise of zoonotic diseases and historical pandemics like HIV/AIDS and COVID-19. It outlines the phases of a pandemic and the importance of mitigation strategies, such as social distancing and public education, to reduce transmission rates. Additionally, it highlights the need for preparedness, effective communication, and improved health infrastructure to manage future pandemic threats.

1. PANDEMIC
MANAGEMENT AT
DISTRICT LEVEL
MADE BY – Shrikrishna kesharwani
(181109005)
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SUBJEC
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3. • Disease, any harmful deviation from the normal structural or functional state of an
organism, generally associated with certain signs and symptoms and differing in nature
from physical injury. A diseased organism commonly exhibits signs or symptoms
indicative of its abnormal state.
WHAT IS A DISEASE ?
ZOONOTIC
DISEASES
• Animals can sometimes carry harmful germs that can spread to people and cause illness
– these are known as zoonotic diseases or zoonosis. Zoonotic diseases are caused by
harmful germs like viruses, bacterial, parasites, and fungi. These germs can cause many
different types of illnesses in people and animals, ranging from mild to serious illness
and even death.
• It can be airborne, vector borne, food borne, waterborne, or transfer through direct or
indirect contact from the animal.
• If you look at the history of epidemics and pandemics most of the diseases which were
the cause of the pandemic were originated from animals.

4. Current pandemics
HIV/AIDS
COVID-19
Although the WHO uses the term "global epidemic" to
describe HIV , as HIV is no longer an uncontrollable outbreak
outside of Africa, some authors use the term
"pandemic". HIV originated in Africa, and spread to the
United States via Haiti between 1966 and 1972.AIDS is
currently a pandemic in Africa, with infection rates as high as
25% in some regions southern and eastern Africa.
SARS-CoV-2, a new strain of coronavirus, was first detected
in the city of Wuhan, Hubei Province, China, in late
December 2019. It has caused a cluster of cases of an acute
respiratory disease, which is referred to as coronavirus
disease 2019 (COVID-19). More than 200 countries and
territories have been affected by COVID-19, with major
outbreaks occurring in Brazil, Russia, India, Mexico, Peru,
South Africa, Western Europe, and the United States. On 11
March 2020, the World Health Organization characterized
the spread of COVID-19 as a pandemic, marking the first
global pandemic since the 2009 swine flu pandemic

5. The WHO’s pandemic alert system ranges from Phase 1 (a low risk) to Phase 6 (a full pandemic):
• Phase 1: A virus in animals has caused no known infections in humans.
• Phase 2: An animal virus has caused infection in humans.
• Phase 3: There are scattered cases or small clusters of disease in humans. If the illness is spreading from human to
to human, it’s not broad enough to cause community-level outbreaks.
• Phase 4: The disease is spreading from person to person with confirmed outbreaks at the community level.
• Phase 5: The disease is spreading between humans in more than one country of one of the WHO regions.
• Phase 6: At least one more country, in a different region from Phase 5, has community-level outbreaks.
Interpandemic Pandemic Alert Pandemic
Phase I Phase 2 Phase 3 Phase 4 Phase 5 Phase 6
Phases of a Pandemic
Mitigation and Preparedness Response

6. History of
Pandemics/Epidemics

7. Timeline {2019- continued }- covid 19
• The Black Death. Experts think the plague, sparked by bacteria called Yersinia pestis, is to blame for the illness that tore through
Europe in 1347-51. An estimated 25 million people died.
• The influenza pandemic of 1918. At least 50 million people around the world died of flu during the outbreak of 1918-19. It’s often
called the “Spanish flu,” not because the virus started there but because Spain was one of the first countries to announce cases.
• Smallpox. The smallpox pandemic stretched over hundreds of years. Experts estimate that it killed as many as 300 million people
in the 20th century alone. Thanks to widespread vaccine use, it was declared eradicated in 1980.
• HIV and AIDS. The human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), and related illnesses have
killed about 32 million people around the world.
Notable
Past
Pandemics
in
the
world

8. HISTORY OF PANDEMIC / EPIDEMIC IN
INDIA
After 1900

10. Why are emerging infectious diseases on the rise?
• Climate change has already made conditions more favorable to the spread of some infectious
diseases, including Lyme disease, waterborne diseases such as Vibrio parahaemolyticus which
causes vomiting and diarrhea, and mosquito-borne diseases such as malaria and dengue fever.
Future risks are not easy to foretell, but climate change hits hard on several fronts that matter
to when and where pathogens appear, including temperature and rainfall patterns. To help
limit the risk of infectious diseases, we should do all we can to vastly reduce greenhouse gas
emissions and limit global warming to 1.5 degrees.
• We have seen a trend of greater emergence of infectious diseases in recent decades. Most of
these diseases have entered into people from animals, especially wild animals. This trend has
many causes. We have massive concentrations of domesticated animals around the world,
some of which can be home to pathogens, like the flu, that can make people sick. We also have
massive concentrations of people in cities where diseases transmitted by sneezing may find
fertile ground. And we have the ability to travel around the globe in less than a day and share
germs widely.
Source- https://www.hsph.harvard.edu/c-change/subtopics/coronavirus-and-climate-change/

11. • But a look at the origins of COVID reveals that other forces may
be in play. In the past century we have escalated our demands
upon nature, such that today, we are losing species at a rate
unknown since the dinosaurs, along with half of life on earth,
went extinct 65 million years ago. This rapid dismantling of life on
earth owes primarily to habitat loss, which occurs mostly from
growing crops and raising livestock for people. With fewer places
to live and fewer food sources to feed on, animals find food and
shelter where people are, and that can lead to disease spread.
• Another major cause of species loss is climate change, which can
also change where animals and plants live and affect where
diseases may occur. Historically, we have grown as a species in
partnership with the plants and animals we live with. So, when
we change the rules of the game by drastically changing the
climate and life on earth, we have to expect that it will affect our
health.
Source- https://www.hsph.harvard.edu/c-change/subtopics/coronavirus-and-climate-change/
Antibiotic resistance
Climate change
Overpopulation
Encroaching into
wild lands
Concerns about
future pandemics

12. Impacts of pandemic
• Pandemics can cause significant, widespread increases in morbidity and
mortality and have disproportionately higher mortality impacts on LMICs.
• Pandemics can cause economic damage through multiple channels, including
short-term fiscal shocks and longer-term negative shocks to economic
growth.
• Individual behavioral changes, such as fear-induced aversion to workplaces
and other public gathering places, are a primary cause of negative shocks to
economic growth during pandemics.
• Some pandemic mitigation measures can cause significant social and
economic disruption.
• In countries with weak institutions and legacies of political instability,
pandemics can increase political stresses and tensions. In these contexts,
outbreak response measures such as quarantines have sparked violence and
tension between states and citizens.
Source- https://www.ncbi.nlm.nih.gov/books/NBK525302/
Health Impacts
Economic Impacts
Social and Political Impacts

14. Managing a Pandemic
Once a pandemic is identified it is vital to take the appropriate action to contain, manage and reduce the
spread of the virus. The key message at this stage is to reduce the transmission rate - the number of
individuals infected by each single infected individual. If on average across a population the transmission
rate is greater than one the number of cases will continue to increase. Measures that reduce the
transmission rate to less than one will result in a decline in the total number of infections.
Once a significant level of infection is present within a population then reducing this rate of spread
becomes vital. Actions targeted at reducing the transmission rate are termed Mitigation and can involve:
• Social distancing (cancel events, closing institutions, work from home etc.)
• Education of the public - to promote actions such as hand washing and avoiding groups etc.
• Economic measures - to provide relief to individuals and businesses and to increase compliance with
social distancing related policies
All these measures aim to limit the population exposed to infection and to reduce the transmission rate
between them. This results in a flattening of the curve of cases over time (see figures below) and so
reducing the peak in the number of cases needing medical care. This maintains the ability of the
healthcare system to provide quality care to those affected and reduce the mortality rate as far as
possible. The greater the stress on the healthcare system the higher the likely mortality rate, as
resources are unable to meet the demand and healthcare workers themselves exceed their capacity to
provide care. Flattening the curve also extends the time scale of the epidemic so that any
potential vaccine can at some future point be used to rapidly increase immunity within the population.
Source- https://www.physio-pedia.com/Endemics,_Epidemics_and_Pandemics

15. PANDEMIC
MITIGATION :
PREPAREDNESS AND
RESPONSE

16. PRE-PANDEMIC PREAREDNESS MEASURES-
1. Situational Awareness- in the context of pandemic
preparedness—can be defined as having an accurate, up-to-
date view of potential or ongoing infectious disease threats
(including through traditional surveillance in humans and
animals) and the resources (human, financial, informational,
and institutional) available to manage those threats. Situational
awareness is a crucial activity at all stages of a pandemic,
including pre pandemic, spark, and spread periods. It requires
the support of health care resources (such as hospitals,
doctors, and nurses), diagnostic infrastructure, and
communications systems. It also requires the population to
have access to and trust in the health care system.
2. Preventing and Extinguishing Pandemic Sparks- Although most
pandemic preparedness activities focus on reducing morbidity
and mortality after a pandemic has spread widely, certain
activities may prevent and contain pandemic sparks before
they become a wider threat. At the core of pandemic
prevention is the concept of One Health, an approach that
considers human health, animal health, and the environment
to be fundamentally interconnected. Activities that focus on
understanding and controlling zoonotic pathogens may prevent
spillover events and subsequent pandemics.
3. Improving health infrastructure- It is very important to have
good health infrastructure in every urban and rural area, and it
has to be equipped with modern infrastructure including the
isolation wards and adequate oxygen supply.
4. Develop guidelines for pandemic situations- it is important to
develop guidelines for pandemic situations so that during
pandemic there will be less chaos.

17. DURING PANDEMIC MITIGATION MEASURES-
1. Risk Communications- Risk communications can play
a significant role in the control of an emerging
epidemic or pandemic by providing information that
people can use to take protective and preventive
action. The dissemination of basic information (such
as how the pathogen is transmitted, guidance on
managing patient care, high-risk practices, and
protective behavioral measures) can rapidly and
significantly reduce the transmission of disease.
2. Reducing Pandemic Spread- Once a pandemic has
begun in earnest, public health efforts often focus on
minimizing its spread. Limiting the spread of a
pandemic can help to reduce the number of total
people who are infected and thus also mitigate some
of the indirect health and economic effects.
Strategies to minimize pandemic spread include the
following:
• Curtailing interactions between infected and uninfected
populations: for example, through patient isolation,
quarantine, social distancing practices, and school
closures
• Reducing infectiousness of symptomatic patients: for
example, through antiviral and antibiotic treatment and
infection control practices
• Reducing susceptibility of uninfected individuals: for
example, through vaccines.

18. 3. Curtailing Interactions between Infected and Uninfected Populations- The methods for
curtailing interactions between infected and uninfected populations include patient
isolation, quarantine, social distancing practices, school closures, use of personal
protective equipment, and travel restrictions.
4.-Reducing Infectiousness and Susceptibility- Vaccines, antibiotics, and antiviral drugs
can play a critical role in mitigating a pandemic by reducing the infectiousness of
symptomatic patients and the susceptibility of uninfected individuals.
5.- Care and Treatment to Reduce the Severity of Pandemic Illness-
During a pandemic, health authorities work to reduce the severity of illness through
patient care and treatment, which can help decrease the likelihood of severe outcomes
such as hospitalizations and deaths. Treatments may range from nonspecific, supportive
care to disease-specific drugs. During the pre pandemic period, plans to implement these
measures should be developed and tested through simulation exercises.
6.-Potential for Scaling Up-The term scaling up refers to the expansion of health
intervention coverage. In the context of pandemic preparedness, successfully scaling up
requires health systems to expand services to accommodate rapid increases in the number
of suspected cases. Scaling up is facilitated by surge capacity (the ability to draw on
additional clinical personnel, logisticians, and financial and other resources) as well as
preexisting operational relationships and plans linking government, nongovernmental
organizations, and the private sector. Ultimately, scaling up consists of having both local
surge capacity and the absorptive capacity to accept outside assistance.

19. 7.- Risk Transfer Mechanisms- As with any other type of natural disaster, the risk
from pandemics cannot be eliminated. Despite prevention efforts, pandemics will
continue to occur and will at times overwhelm the systems that have been put in
place to mitigate their health, societal, and economic effects. Risk transfer
mechanisms (such as specialized insurance facilities) offer an additional tool to
manage this risk. the development of risk transfer systems requires countries to
build the following capacities, among others:
• Robust surveillance data to identify when an outbreak has reached sufficient
scale to require the release of funds
• Laboratory capacity to confirm the causative agent
• Predefined contingency and response plans to spend the funds effectively upon
their release.
8.-Ensure proper data availability of the pandemic including the virus and its
mutation information.
9.-Ensure fast vaccination of the population after vaccine availability. (prioritize
vaccination of vulnerable population first)
10.- Ensure proper lockdown to stop spreading of virus if the spreading rate is very
fast.
11.- follow all the guidelines provided by the health department.

20. COVID 19 MANAGEMENT CASE STUDIES
-
LINK - https://youtu.be/K3Ob8_bHQ4A
LINK -https://youtu.be/5TZkkCpK-rs
LINK- https://youtu.be/mgrDDyvwfBM
NANDURBAR MODEL
BHILWARA MODEL
INDIAN CASE STUDY
FOR DISTRICT LEVEL
PANDEMIC
MANAGEMENT-
INTERNATIONAL CASE STUDY

21. Post pandemic
• Phase wise reopening schools, markets
and the public places like cinema hall,
parks etc. to restart economic activities.
• Ensuring 100 percent vaccination of the
population with proper protection from
the other variants of the virus.
• Awareness campaigns by the
government for the people for yoga to
improve mental health.
• Learn from the pandemic experience and
try to improve the healthcare
infrastructure and other guidelines to
prepare from future pandemics.

22. CONCLUSIONS
• Preparing for a pandemic is challenging because of a multitude of factors, many of which
are unique among natural disasters. Pandemics are rare events, and the risk of
occurrence is influenced by anthropogenic changes in the natural environment. In
addition, accountability for preparedness is diffuse, and many of the countries at
greatest risk have the most limited capacity to manage and mitigate pandemic risk.
• Unlike most other natural disasters, pandemics do not remain geographically contained,
and damages can be mitigated significantly through prompt intervention. As a result,
there are strong ethical and global health imperatives for building capacity to detect and
respond to pandemic threats, particularly in countries with weak preparedness and high
spark and spread risk.
• Investments to improve pandemic preparedness may have fewer immediate benefits,
particularly relative to other pressing health needs in countries with heavy burdens of
endemic disease. Therefore, characterizing pandemic risk and identifying gaps in
pandemic preparedness are essential for prioritizing and targeting capacity-building
efforts. Thinking about risks in terms of frequency and severity, notably using
probabilistic modeling and EP curves, can quantify the potential pandemic risks facing
each country and clarify the benefit-cost case for investing in pandemic preparedness.

23. REFERENCES-
• (2020). Retrieved from webmd: https://www.webmd.com/cold-and-flu/what-are-
epidemics-pandemics-outbreaks
• Alam, M. A. (2020). Leading in the shadows: understanding administrative leadership in
the context of COVID-19 pandemic management in Bangladesh.
• Alexander R. Vaccaro, C. L. (2020). Practice Management During the COVID-19 Pandemic.
• Breslin, K. B. (2021). The COVID-19 Pandemic: What can we learn from past research in
organizations and management?
• Ralf Krumkampa, A. A. (2020). Evaluation of national pandemic management policies—A
hazard analysis of critical control points approach.
• Sera Whitelaw, M. A. (2020). Applications of digital technology in COVID-19 pandemic
planning and response.
• Shi-Hong Weng, A. Y.-K.-X. (2020). Responding to the Coronavirus Pandemic: A Tale of Two
Cities.
• Vandana Tamrakar1, A. S. (2020). District level correlates of COVID-19 pandemic in India.
• https://www.youtube.com/results?search_query=covid+19+MANAGEMENT+RSTV

24. Thank you