Preparedness and response planning WP6

Why this work is important?

States parties have made efforts to encourage sectors other than health to contribute to assessments, planning and interventions aimed at strengthening preparedness and response capacities under the IHR (2005).

Nevertheless, effective multisectoral collaboration remains a challenge in most, if not all, countries. 

Read the action plan to improve public health preparedness and response in the WHO European Region 2018–2023 (PDF 6,555KB).

 

The European Economic and Social Committee (EESC)stresses that all elements of civil society must be involved both in planning to ensure preparedness for crisis situations, and in communication should a crisis occur. An approach that limits coordination to healthcare professionals and civil protection experts is no longer in keeping with the way society operates,
with the media having a significant role in disseminating information to the public.

https://www.eesc.europa.eu/en/our-work/opinions-information-reports/opinions/eesc-opinion-serious-cross-border-threats-health, 28/03/2012

Expected outcomes

1. Support in the development of an integrated multisectoral preparedness and response plan which Member States can incorporate into their national Preparedness and Response plans

2. Lessons learned from COVID-19 with particular focus on understanding the decision-making process and multisectoral collaboration.

3. E-learnings and tabletop exercise protocols and pilots on multi-sectoral collaboration developed, tested and evaluated

4. Best practices guidelines on multi-sectoral collaboration, for (all hazard) integrated Preparedness and Response planning are provided to all participating countries. These are based on the lessons learned from COVID-19 and can be used for continuous learning through implemented e-learnings and tabletop exercises.

Get involved!

Are you a public health professional and/or laboratory expert that has knowledge of the development of your country’s national SARS-CoV-2 testing strategy? Please contribute to this European study with your own personal experiences and opinions by completing the YOUR NATIONAL SARS-COV-2 TESTING POLICY (formdesk.com) survey. It takes about 20 minutes to complete.

Key terms

The interpretation adopted by Work Package (WP) 6 for the terms:

• All hazards approach: “A concept acknowledging that, while hazards vary in source (natural, technological, societal), they often challenge health systems in similar ways. Therefore, risk reduction, emergency preparedness, response actions and community recovery activities are usually implemented along the same, all hazards model, regardless of the cause” (WHO EURO).
• Tools and instruments: Any written or visual (legally binding or non-legally binding) aid used in Public Health Emergency Preparedness and Response (PHEPR).  Examples include, but are not limited to, legally binding documents, policy statements, policy frameworks, directives, decisions, strategies, resolutions, regulations, conventions, charters, reports, codes, agreements, standards, guidelines, protocols, declarations, manuals, action plans, mind maps, decision-making roadmaps, toolkits, algorithms).
• Intersectoral Operability:  i.e., between public health, clinical, biological, chemical and animal and Environment Health, and Civil Protection sectors.

Outputs, activities and deliverables

15 November 2019 One Health Security Conference.  Scene setting presentation for developing and testing cross-sectoral preparedness and response plans and WP6 work plan.  Presented by Corien Swaan, National Institute for Public Health and Environment (RIVM). Watch the video of Preparedness and response planning (WP6) presentation at the Finnish Institute for Health and Welfare’s (THL) website. See the presentation slides: Preparedness and response planning (WP6) (SlideShare)

28-29 April 2020 Online Workshop: Understanding multisectoral preparedness and response on Multisectoral Collaboration to collect relevant tools and instruments for identifying core elements of an integrated, multi-sectoral preparedness and response plan that were not identified during the literature review. Covid-19 had impacted on the results of WP6.  These were discussed during the meeting and necessary changes and refinements to the scope of SHARP JA activity were subsequently actioned that better served the pandemic scenario.  With circa 40 participants, a mutual understanding and agreement of key terms, tools, instruments and core elements was achieved. Read the Understanding multisectoral preparedness and response workshop report (PDF 179 KB)

May 2020 Review of integrated evidence-based planning and evaluation tools for multisectoral integration in preparedness and response used for chemical, environmental and biological threat. This review aimed to identify (i) the sectors that have been described to partake in multisectoral collaboration during public health emergencies, (ii) when multisectoral collaboration take place, and (iii) the tools and instruments used to encourage and/or facilitate collaboration. Read the literature review D6.1 (PDF 1,023 KB)

Rapid SARS-CoV-2 whole-genome sequencing and analysis for informed public health decision-making in the Netherlands article published in Nature Medicine, July 2020. With an acknowledgement to SHARP JA for the team contributing from RIVM, the paper urges countries to share sequence information to combine efforts in understanding the spread of SARS-CoV-2 for enhanced response planning. Mentioned by 5 news outlets and 2 policy sources, the research has been cited 249 times.

During Spring 2021, Understanding the factors that contribute to the similarities and differences in SARS-CoV-2 testing strategies across Europe – interviews of professionals in several countries took place. Plus focus group discussions were organised with citizens in 8 countries on Understanding the citizen’s role during preparedness for, and response to, the Covid-19 pandemic.

16 – 19 November 2021 Poster presentation:  Identifying the sectors described in public health emergency preparedness & response literature: A systematic review.  Presented at the ESCAIDE Conference 2021, available to 2500 online participants form the infectious disease public health community, it highlighted the challenge that, despite a push for multisectoral collaboration, only four sectors are frequently mentioned in literature describing collaboration during public health emergencies. View the poster: Identifying the sectors described in public health emergency preparedness & response literature: A systematic review (PDF 536 KB)

10 – 12 November 2021 How to upscale in capacity in different aspects of preparedness and response workshop at 14th European Public Health Conference 2021: Public health futures in a changing world.  Available to 2,048 delegates, including public health professionals, researchers, education specialists, training professionals, students, policy makers and representatives from international and European organisations, like the European Commission, WHO, ECDC and the European Observatory. European (public) health networks. The workshop presented scientific research on how European countries have attempted to deal with capacity shortages in the period of the first SARS-CoV-2 pandemic wave and subsequent period. Each presentation focused on a specific capacity or domain of the COVID-19 pandemic. Read the  workshop abstract (PDF 174KB). The workshop captured inventories on the minimum level of expertise necessary in core capacities in contact tracing, testing strategies and operational readiness at points of entry in Europe. Clarity was built on the gaps, feasibility and barriers for participating countries when developing a multisectoral preparedness and response plans, with particular focus on low GNI countries. 

6 and 7 September 2022 Expert meeting on lessons learnt from multisectoral collaboration during the COVID-19 pandemic, Malta (MS22). Collating from SHARP JA partners the lessons learned from COVID-19 – with particular focus on understanding multi-sectoral collaboration during both the decision-making processes and decision-implementation processes. Gaining an overview of lessons learnt and reaching consensus of the priority areas for future work. Read more on the expert meeting. 30 experts across 17 member states provided their insight and experiences to identify exchangeable best practices, and priority areas for future work. The event was a pleasant combination of both in-depth discussions, exchange of knowledge and experiences, as well as networking. Event participation satisfaction surveys indicate a positive experience with 99% of respondents feeling the meeting was somewhat or highly effective in facilitating productive conversation about the future of response planning.

28 September 2022. Following further analysis by WP6, preliminary results were shared during the ECDC workshop on Lessons learned during the COVID-19 pandemic. WP6 hopes the information provided will help future preparedness and response planning in individual member states and relevant international organisations.

11 November 2022, further preliminary results of research on lessons learnt from multisectoral collaboration during the COVID-19 pandemic, were presented during the European Public Health Conference 2022.

24 November 2022, Work package 6 put out a call for partner countries to send their current national and/or important subnational public health emergency preparedness and response plans for advice and direction on collaboration with other roles/sectors. The plans in their national language should be emailed to sharp@rivm.nl by 30 December 2022. In return, RIVM experts will:

• Compare the plan with existing other European public health emergency plans
• Identify (common) roles in public health emergencies
• Work toward developing a new categorization of roles and sectors in public health preparedness and response planning
• Then share the findings to help improve your future planning.

22 November 2022 Following Sandra Kamga’s exhaustive literature review to map involvement of different stakeholders throughout the preparedness and response cycle the conclusion was there’s a need for improvement. Kengne Kamga LS, Voordouw ACG, de Vries MC, et al Identifying the sectors involved in the European public health emergency preparedness and response: a systematic review BMJ Open 2022;12: e062624. doi: 10.1136/bmjopen-2022-062624. The paper has been downloaded 1074 times.

8 December 2022, call for partner countries to send their current national and/or important sub national public health emergency preparedness and response plans promoted at the International tabletop exercise on  Points of Entry: contact tracing, control measures and cross-sectoral collaboration. Athens. 118 people registered from 24 countries.

January 2023, publication of the literature review (6.3.1) by Instituto de Salud Carlos III,  partner in work package 6 of the SHARP Joint Action.  The review analysed the success and fail factors relating to three public health events that affected EU countries between 2010 and 2014 – one biological in origin, one chemical, and one environmental.   Some useful lessons were highlighted in case studies, including:

• utilisation of existing international cooperation structures
• the success of multidisciplinary and intersectoral approaches
• usefulness of risk assessments and preparedness plans that detailed relevant authorities’ roles, responsibilities and the clear operating procedures

Read more. View a presentation on the review from María  del Carmen Varela Martínez, Instituto de Salud Carlos III shared with health protection specialists and policymakers from across 14 countries at the Inter-Sectoral Preparedness and Response Planning Essentials workshop, Latvia in March 2023.

20 – 21 March 2023, Workshop presentation of WP6 deliverables and how to implement them in national preparedness and response plans, Riga, Latvia. Full details and links to presentation videos.

Currently in development

• Ongoing survey among all countries to gather lessons learned about multi-sectoral collaboration during Covid-19. The questionnaire takes 30-45 minutes to complete. Access the questionnaire and the appendix list of sectors based on the European Commission’s list of sectors and economic activities.
• WP6 is developing a tabletop exercise (TTX) to enhance awareness on which sectors are currently involved and which should be involved in the initial period of public health emergency response (M23).  It’s designed to inspire public health professionals to think about multisectoral collaboration in their existing national, (in)formal preparedness and response plans. All hazards e-learning tool (MS21) is currently being piloted in the Netherlands 20 October – 9 December 2022. In preparation for the pilot workshop, the RIVM recommends participants register for the ESCMID online course, “Training for an outbreak response: design your own table top (PDF 2,048KB)” to create a draft TTX for their own national context. WP8 lead, IPHS also includes a a course on simulation exercises in the SHARP Joint Action online learning platform.
• Your feedback is very important to us.  Email:  sharp@rivm.nl for any information, or suggestions you might have. 

Work Package 6 partners and people

Lead: National Institute of Public Health and the Environment (RIVM), Netherlands

The National Coordination Centre for Communicable Disease Control (LCI) of RIVM has a large body of knowledge and expertise on preparedness and response. Learn more at the LCI richtlijnen (rivm.nl) website.

The Centre for Infectious Diseases Research, Diagnostics and Laboratory Surveillance (IDS) is responsible for availability of complete and well-arranged diagnostic capacity in the Netherlands. Learn more about IDS at the Centrum Infectieziekteonderzoek, Diagnostiek en laboratorium Surveillance (RIVM) website.

RIVM is collaborative partner across many EU projects, e.g. AIRSAN, RAGIDA, REACT, SHIPSAN, AsiaFluCap; the WHO Collaborative Center for Infectious Disease Preparedness and IHR monitoring and evaluation. RIVM’s role as a WP lead in the Healthy Gateways Joint Action on Points of Entry ensured the collaboration and integration of the two joint actions.

Co-leads: 

Instituto de Salud Carlos III (ISCIII), Spain

The Institute of Health Carlos III (ISCIII) is the main public research entity in funding, managing and carrying out biomedical research in Spain for over 20 years. In addition it offers scientific and health technical services to the National Health System (SNS). ISCIII actively participates in research EU projects and joint actions. Through the National Centre of Epidemiology or the National Centre of Microbiology, ISCIII has participated in projects such as SHIPSAN ACT, Healthy Gateways, MediPIET, TERROR, QUANDHIP and EMERGE. Learn more at ISCII’s website.

ErasmusMC

The Department of Viroscience at Erasmus MC runs an extensive research program on viral infections of humans and animals, with specific interests in viral zoonoses, pathogenesis and transmission and natural and vaccine-induced immunity. Learn more at the Viroscience Department Erasmus MC website.

Affiliated entity: Austrian Agency for Health and Food Safety (AGES GmbH)

The Austrian Agency for Health and Food Safety (AGES) is the leading expert and research organisation for risk mitigation in Austria to ensure health for humans, animals and plants, food safety, food security and consumer protection. AGES is a limited liability company owned by the Republic of Austria. AGES provides services defined by the Austrian Health and Food Safety Act (GESG), sectoral legislation and the relevant European and international regulations.

The company works impact oriented, risk-based and interdisciplinary regarding the topics public health, animal health, food safety, food security and consumer protection along the food chain, medical and drug safety and radiation protection. Services provided by AGES comprise researches, examinations, integrative risk analysis, risk communication and information dissemination based on bundled, scientifically sound expert knowledge. To achieve these tasks, the company conducts applied science and communicates relevant scientific expertise. AGES experts include partners in national and international networks. AGES monitors, controls, licenses, communicates risk management and develops recommendations for risk minimization for its two shareholders, the Federal Ministry of Agriculture, Forestry, Environment and Water Management and the Federal Ministry of Health.

People

• Prof. Dr. Aura Timen, former Head of the department of the National Coordination Centre for Communicable Disease Control (LCI) in the RIVM. Currently Head of department of Primary and Community Care, Radboud University Medical Centre, Nijmegen University.
• Dr. Corien Swaan, Head of the department for Prevention and Control, within the LCI in the RIVM
• Dr Bettie Voordouw, Medical microbiologist, MPH, PhD, specialization in virology, vaccinology and public health microbiology
• Dr Maaike de Vries, Molecular microbiologist within IDS at the RIVM
• Sandra Kamga is a PhD student at the National Coordination Centre for Communicable Disease Control, at the National
• Institute for Public Health and the Environment, in the Netherlands. She is a medical doctor with additional degrees in political science, media & communication.
• Jorrit Kabel, Senior policy advisor within the LCI at the RIVM
• Prof. Dr. Marion Koopmans, Head of the Department of Virology in the ErasmusMC
• Dr Carmen Varela-Martinez has PhD in Pharmacy, specialist in Microbiology and MS in field epidemiology. She is epidemiologist scientist at the Spanish National Centre of Epidemiology since 2002, coordinating the management of outbreaks of national relevance. She is the ECDC National Focal Point for surveillance. She has participated in different European projects and Joint Actions.
• Raquel Escudero has PhD in Biology. She has been a scientist at the Spanish National Centre of Microbiology (Institute of Health Carlos III) since 1995. She is the head of the Laboratory of Reference and Research on Special Pathogens. She has participated in different European projects including QUANDHIP and EMERGE.
• Isabel Jado is PhD in Biology. She has been working in the Spanish National Centre of Microbiology (CNM) since 1994, she is the Director of the  CNM since 2021. She shared the head of the Laboratory of Reference and Research on Special Pathogens. She has participated in different National and European Projects and Joint Actions.
• Mari Paz Sanchez-Seco, PhD in Biology, is working in the Arbovirus and imported viral diseases laboratory in the National Centre of Microbiology that is the National Reference Laboratory for zoonoses. She is working in the centre as a researcher from 2006 and as the head of the laboratory from 2012. She was part of the scientific advisory board of the ENIVD and the EVDLabNet.
• Ana Vázquez is PhD in Biology, specialist in Virology. She is working at the Spanish National Centre of Microbiology since 2003, in the Arbovirus and imported viral diseases laboratory. She has participated in different European projects.
• Anabel Negredo is PhD in Pharmacy, specialist in high-risk viruses. She is working at the Spanish National Centre of Microbiology since 2003, in the Arbovirus and imported viral diseases laboratory. She has participated in different European projects.
• Sabine Maritschnik, MPH, RDN has a Master of Public Health and is a certified Registered Dietitian Nutritionist from the US. She has been an Epidemiologist at the Austrian Agency for Health and Food Safety since 2008.

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