By BROOKS TIGNER
BRUSSELS – What are the lessons learnt for the EU from Ebola, H1N1 influenza and other recent pandemic outbreaks? How adequate are national plans across Europe and how well do they work together?
These are other health-policy aspects of outbreaks were the focus of the final conference of an EU-funded security research project that revealed some disturbing deficiencies in the world of pandemic preparation and response. For example, there is the stark fact that most national pandemic plans across the globe are not readily accessible to the international health community and, more alarming, most are not updated, says the project team.
Meeting here on 15 March for its final conference, the project known as PANDEM (“Pandemic Risk and emergency Management”) gave an overview of the work carried out by its seven-member consortium and some of the recommendations it will soon turn over to the Commission. Launched in September 2015 for 18 months with a budget of EUR 1.8 million, the PANDEM team’s remit was to study and come up with recommendations regarding the legal, ethical and technical aspects of pandemic planning in terms of detection, surveillance, diagnostics, response, communications and governance. All will set the stage for a subsequent technological demonstrator to be funded by the Commission, starting in 2018.
One conclusion of PANDEM’s analysis of national plans in Europe and elsewhere is that “few plans are accessible, few have been updated since [the H1N1 influenza pandemic of] 2009 and few offer versions in commonly accessible languages,” Richard Coker, PANDEM member and a researcher at the London School of Tropical Medicine & Hygiene, told the conference. Moreover, he said public health law capacity “is very limited while medical law is very prominent. This needs addressing in most countries as well.”
As for surveillance, his project colleague, Anders Tegnell of Sweden’s Public Health Agency said “we think this is weak and still too fragmented across the EU. The current systems fail to work together to produce a much needed overview, making it difficult to provide a mapping at EU-level.”
Pandemic planning in the future also has to cover not just natural outbreaks but man-made ones too, whether accidental or deliberate, argued PANDEM team member Máire Connolly of Ireland’s National University in Galway. “The number of BSL [bio safety level] laboratories is increasing and thus so is the risk of accidental infection and the risk of bio-terrorism. The techniques and knowledge out there are much higher than they were 10 years ago,” she said.
Over and above the technical challenges to improved pandemic planning are the intangible ones of managing the public’s response, which points straight to communications. PANDEM member Darina O’Flanagan, consultant for the World Health Organisation, identified one of its more pernicious aspects today.
“How do we confront fake news? We need a system for countering this by coming up with effecting counter-messaging. And the answers are not obvious when the public’s trust in the authority of official experts is so low,” observed O’Flanagan.
The PANDEM consortium will soon hand over its recommendations to the Commission. While many of the details will be classified as “Restricted” for reasons of security, Connolly gave an outline of what they will encompass.
Noting, for example, that a new approach to governance is among the top priorities – “It is crucial for dealing with a pandemic that each MS knows what its neighbour’s pandemic policy is” – she said the consortium will propose strong legal and policy recommendations for the following:
- a model legal framework for pandemic response
- boosting trust in government and public health institutions
- a resource modelling and decision-support tool
- practical risk communication principles
- communications based on social and behavioural science
In more concrete terms, she said the objectives are to enhance the analysis of data by developing visual analytic tools for multiple users. This would enable health officials, for example, to better model when a pandemic would arrive in Europe, predict its severity in terms of cases, measure and track its societal impact at local and regional level and examine the likely effectiveness of countermeasures.
“We’re trying to reduce the load on the human brain during emergencies,” said Connolly, adding that “the civil aviation sector has a very well developed crisis response model so it would probably makes sense to work with them further down the road on the demonstration.”
It will be important that the demonstrator’s design is not pre-cooked to guarantee a “successful” outcome based on whatever recommendations that come from PANDEM. Indeed, so many things can, and do, go wrong during large-scale crises that one could almost argue that demonstrators – above all in the health sector – should set out from the start to forcefully illustrate all the things that will likely fail – and not the things that go right.
Why? Because decision-makers and politicians love to take credit (usually undeserved) for success stories but not the failures. Stressing the grave political consequences of failure during pandemics would be one way to drive home to decision-makers the necessity of properly updating and funding their regional and national pandemic plans and infrastructure.