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Community resilience in public health management of viral outbreaks

This article explores the concept of community resilience in the context of public health management of viral outbreaks. It discusses various descriptive terminologies related to epidemics and outlines ten key steps for effective outbreak response. The importance of community resilience in controlling and preventing the spread of diseases is emphasized, along with strategies for case management and communication during an outbreak.

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Community resilience in public health management of viral outbreaks

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  1. Community resilience in public health management of viral outbreaks Dr. Abhijeet Jadhav JTCDM- TISS, Mumbai

  2. Epidemic • How to define • Region/ area (which population) • Time (point of start; sudden/ over a time) • Excess (to the background incidence)

  3. Source - Principles of EPIDEMIOLOGY. CDC

  4. Some commonly used descriptive terminologies • Epidemic • Common source epidemic • Single exposure/ point source • Continuous/ multiple exposure • Propagated epidemic • Person to person • Antropod/ vector born • Animal reservoir • Slow/ modern epidemic • Endemic • Pandemic • Syndemic

  5. Incubation period A- Latent period B- Minimal Incubation P. C- Median Incubation P. Primary cases No. of cases C Secondary cases A B Time  Exposure

  6. Outbreak is ‘an epidemic limited to a localized increase in incidence of a disease’ (Last) • Problem is unexpected • Demand for immediate response • Usually needs intensive field work- assessment, prevention, cure • Scope of investigation limited because of time constraint (Goodman and Buechler 1996) • Generally needs official sanction

  7. Viral out-breaks • Frequent • Influenza virus & other • Antigenic shift • Antigenic drift • Prevention- vaccines? • Treatment- antivirals? And symptomatic • Prevention of spread- isolation, quarantine

  8. TEN KEY STEPS • Determine existence of epidemic • Confirm diagnosis • Define case and estimate number • Orient data in time, place, person • Determine who is at risk • Develop explanatory hypothesis • Compare with established facts • Plan and execute systematic study • Prepare written report • Execute control and preventive measures Brownson and Petitti

  9. Basic parameters for decision making • Demographic details • Annual disease incidence rate • Existing policies related to the disease • Standard definitions & protocols by international agencies • biological & Special groups with more vulnerability • Capacity of local institutions

  10. Community Resilience Resilient community needs resilient system…

  11. Resilience for viral outbreaks • Term “Resilience” implies a prolong activity and in disaster management “community Resilience” typically falls in the DRR component. • But for viral outbreaks it is also part of response…

  12. Responding to the outbreak

  13. Controlling the epidemic • Specific points to act • Decrease vulnerability • Controlling the source • Manipulate infection pathway • When treating a case is priority? • Very high infectivity or severity • New disease- no information about the treatment • That is the only option

  14. Further Prevention of disease • Primordial prevention: • prevention of infection + prevention of disease • Removal of risk factor • Primary prevention: • prevention of disease • Through personal protection • Secondary prevention: • early detection + treatment/ containment • Prevention of bad outcomes of disease

  15. Case management • Objectives: • Early case detection • Early treatment • Prevention of worst health outcomes

  16. Case management • Activities for community resilience • Case definition • Help line • Detection • Health care centers • Partnership with privet sector • Improvising the existing facilities

  17. Controlling the spread of disease • Objective- • Reducing the spread of the disease to a ‘significant’ level

  18. Controlling the spread of disease • Activities for community resilience • Isolation • Quarantine • Migration • Preventive measures • Special care of vulnerable

  19. Action plan Before epidemics During epidemics Confirm & delegate the responsibilities Gather latest information to improvise the plan of action Train volunteers Community awareness Provision of supplies Modification of HCS Implementation of preventive & mitigating measures • Agree upon roles & responsibilities • Establish plan of action • Training of the staff for epidemic situations • Protocols in surveillance system • Protocol for contingency arrangements of supplies & referrals

  20. Health communication in viral outbreak

  21. Communication with… • Community (through mass-media) • Media • Health department & pvt. health sector • Stakeholder departments • International bodies • NGOs & welfare societies

  22. Massage should be • Specific • Simple, clear & meaningful • Timely • Updated • Non-ambiguous • Culturally acceptable • Based on perceived needs/ threats

  23. For media communication • Ask media to trust only one portal/ agency for outbreak related information eg- website • It should be updated and checked for technical correctness as well as appropriateness • This is the most effective tool to modify community behavior • Ask media to use effective ways to change the behavior and work with them

  24. Viral outbreak massage themes- for community • Don’t panic • Symptoms of the disease • What to do if one has the symptoms • How to protect ourselves and prevent the disease • Facilities available • Where to contact for further information

  25. Communication with health sectors • Private medical setups • Dedicated helplines • What is the disease • How to diagnose • How to treat & treatment of complications • Referral facilities • Preventive modalities

  26. Communication for help • NGOs, international bodies etc can be approached depending upon their specific areas of expertise • Be clear and specific • Make sure about upper hand of the agency • Consider all possible socio-economical & political consequences • Or many NGOs and other organizations can approach for help. You need to communicate with them very carefully.

  27. Role of CBOs

  28. Why there is need of helping hand • Acute & sudden appearance of problem • Huge scale of intervention • Technicality of intervention • Distribution chain to remote areas • Urgent need of many volunteers • Need of training technical and non-technical training to masses at various sites • Procurement of medical/other supplies and related logistic • Monitoring and evaluation of short term plan

  29. Specific areas of contribution • Training- Health related human recourse (HW, AW, ASHA, para-medic, lab-technicians, doctors, nurses) needs specific training related to intervention and disease. • Volunteers- Some organizations have good hold on community and they can gather good manpower. • Technical knowledge- Some organizations work in community based or other related research and their specific inputs can be valuable in designing the intervention & making it simple

  30. Specific areas of contribution • Regulatory work Some organizations have good experience of working in administrative work with govt in monitoring and evaluation. • Health communication & working with community Some genuine organization are deep rooted and quite experienced in doing this job. • Acquiring materials & logistics Some rich and influential organizations- specially Corporate social responsibility centers can help in funding or material arrangements

  31. Some precautions… • Thorough contracts or MOUs • Same motive of community welfare • Proper understanding of the issues • Consider possible ill-motives • Strict regulation is a must • A priory plan of deliverables and responsibilities (with consequences of failure)

  32. Thank you

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