What To Do To Strengthen a Health System Before, During and After a Public Health Crisis (Part 2)
“It is all about more effective public health program management….”
There is always a simpler and more effective solution to public health problems. Our job as global health professionals is to find it. Last week I told you about what needs to happen before and epidemic, and today I will talk about the main steps that need to take place during an epidemic (I will talk about what to do after an epidemic next week). Whatever you do, keep it simple. Epidemics are complex situations and we must not add to its complexity but simply deliver effective solutions.
During an epidemic:
1. First you must confirm the diagnosis of the disease and declare the epidemic (an epidemic being any “unusual” increase in the number of cases above what is “expected” for that time of the year and location). It is not the number of cases that make an epidemic. It is the unusual increase that shows something has changed in the way the disease is transmitted and a new public health measure will be required to stop the epidemic. The ideal situation is to discover the epidemic at “patient zero” or as close as possible to that patient, so you can stop the epidemic before it affects more people.
2. Inform the authorities at the international and regional health organizations of the epidemic.
3. Establish the Central Epidemic Control Command (CECC), where all decisions are made and all assistance is coordinated. Depending on the epidemic and type of disease, the CECC may include the media reps, Department of Education and even the police and army to prevent people from moving from one place to another or crossing borders to prevent spreading the disease.
4. Information to the public about the disease must be sent out by all means of communication; its way of transmission, how to prevent it, and what to do in case symptoms are present. In some cases, mass immunization would be necessary, as was the case in previous preemptive treatments such as with meningitis and anthrax. If that is the case, the public must be informed of where to go, and when. Preventing panic usually caused by misinformation is essential. Panic can cause more damage than the disease itself.
5. Ensure the continuous provision of care for other diseases in facilities not used for epidemic disease treatment. During the recent Ebola epidemic, more people died of other disease because they were afraid to seek care.
6. If foreign assistance is required, it must be coordinated and all must report to the CECC coordinator and the Director. This avoids duplication and chaos. In order to be effective, all foreign assistance must be part of a concerted strategy designed to stop transmission, prevent, detect, and treat cases, and keep the public informed.
7. Whatever is done, it must build on existing resources, structures and systems and protect the health staff and the public.
If you are interested in learning more about Epidemic Prevention and Control, you might want to sign up for the next EPC online training program that starts in September 7, 2015. In this program, I will teach you all these simple steps, how to apply the International Health Regulation, and how to design or improve your EPC program. I will also coach you as you apply all this to an organization, a facility, a program or even a whole country. Reserve your place by writing to info@realizingglobalhealth.com.
If you want to learn more about improving aid effectiveness to develop resilient health systems, I invite you to join me at the next free RGH webinar entitled “Aid Effectiveness in Global Health: Getting Back to Basics in Global Health”.
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