Early Lessons from the Asia-Pacific Region - Adapting Disaster Risk Management Systems for Health-Related Emergencies: World Bank ...

 
Early Lessons from the Asia-Pacific Region - Adapting Disaster Risk Management Systems for Health-Related Emergencies: World Bank ...
Public Disclosure Authorized

                               Adapting Disaster Risk
                               Management Systems
                               for Health-Related
                               Emergencies:
Public Disclosure Authorized

                               Early Lessons from
                               the Asia-Pacific Region

                               October 2020
Public Disclosure Authorized
Public Disclosure Authorized
Early Lessons from the Asia-Pacific Region - Adapting Disaster Risk Management Systems for Health-Related Emergencies: World Bank ...
Photo Copyright: ©World Bank / Henitsoa Rafalia
Early Lessons from the Asia-Pacific Region - Adapting Disaster Risk Management Systems for Health-Related Emergencies: World Bank ...
Adapting Disaster Risk Management Systems
for Health-Related Emergencies: Early Lessons
from the Asia-Pacific Region

Table of Contents

1.     Summary                                            1

2.     Managing the crisis:                               3
       States of Emergency and the role
       of NDMOs during COVID-19

3.     Handling public information:                       16
       COVID-19 awareness, early warning systems

4.     Enhancing emergency management                     22
       Multiple risks during health related emergencies

5.     Recommendations to enhance                         28
       disaster risk management systems
Early Lessons from the Asia-Pacific Region - Adapting Disaster Risk Management Systems for Health-Related Emergencies: World Bank ...
01                                   Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region

1   1.
    Summary                                                caused by a coronavirus.1 Countries around the world moved swiftly to declare states
                                                           of emergency, closing ports of entry and activating crisis management systems.

                                                           This technical note2

                                                           that are responding to public health emergencies resulting from the COVID-19
                                                           pandemic. Selecting these countries, which represent a variety of intragovernmental
                                                           arrangements in the disaster risk management and public health sectors, also made
                                                                                                                                                       3

                                                           has an established disaster management system (also referred to as its emergency
Abbreviations/                                             management or civil defense/protection system) and a public health system.
acronyms:

                                                           a public health emergency and to its subsequent escalation to a pandemic. By
COVID-19 – Coronavirus
disease 2019

CDC – Center for Disease
Control and Prevention
                                                           systems are applied or activated to manage health-related emergencies, focusing on
                                                           four main aspects:
EWS – Early Warning System

MoH – Ministry of Health
                                                           01                  State of emergency declaration: this includes its type, content, and
NDMO – National Disaster                                                       relevant binding legislation, and can apply to a declaration from
Management Organization
                                                                               either (or both) the legal regime for public health or the disaster/
/ Emergency Management
Agency or Service                                                              emergency management agency.

                                                           02                  National Disaster Management Organization (NDMO): the roles
                                                                               and responsibilities of a country’s NDMO (including disaster
                                                                               risk management and civil protection services) in responding to
                                                                               COVID-19 outbreaks and other health related emergencies at both
                                                                               national and sub-national levels.
1

See https://www.who.int/dg/
speeches/detail/who-director-                              03                  Risk reduction, preparedness, and awareness: the effectiveness
general-s-opening-remarks-at-the-
media-briefing-on-covid-19---11-
                                                                               of COVID-19 outbreak tracing, the availability of health risk
march-2020                                                                     information, the strength of community awareness campaigns, the
2                                                                              prevalence of monitoring, and the success of warning services,
This technical note was prepared by
a World Bank technical team led by
Jolanta Kryspin-Watson, Jian Vun,                                              system (multi hazard or otherwise).
and Mizan Bisri, with inputs from
Silviana Puspita, Rifa Atsari, Juwita
Sari, M. Halik Rizki, Devan Kreisberg,
and Nuriza Saputra.                                        04                  Multiplicity of disasters: preparedness for near-future disasters
                                                                               due to natural hazards during the COVID-19 pandemic situation,
It was prepared with financial support
from the Global Facility for Disaster                                          handling of multiple disasters with compounding effects, and
Reduction and Recovery (GFDRR).                                                management of mobility and travel restrictions during emergency
3
                                                                               response and post disaster recovery activities.
The countries that were selected for
review represent a variety of different

had more information available in the
public domain than other countries.
Early Lessons from the Asia-Pacific Region - Adapting Disaster Risk Management Systems for Health-Related Emergencies: World Bank ...
Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region                      02

This note summarizes how the selected countries                                    the resultant technical recommendations, could
have applied disaster management systems                                           be valuable for client countries as they prepare
and practices to COVID-19 response, following a                                    for future emergencies that create compounding
multi-hazard approach for both natural and other                                   effects during the ongoing COVID-19 response and
hazards. Some countries were able to draw on key                                   recovery period, as well as for other health related
                                                                                   emergencies that could arise.
with health-related emergencies – for instance,
the need to have already established a legal basis                                 This summary of the countries’ responses is
for intragovernmental cooperation in responding                                    followed by three sections covering the four aspects
to such events. Having a legal framework in
place allows governments to swiftly make critical                                  guidance for policymakers to enhance disaster
decisions, such as declaring a state of emergency                                  risk management (DRM) systems and platforms to
and enacting travel and mobility restrictions. The                                 better address health related emergencies. It offers
lessons learned during the present emergency, and

01        Review disaster risk management legislation, strategies, and policies. Enhance
          interagency coordination; better integrate public health considerations into DRM legislation
          and policy (and vice versa). Adapt multi-hazard approaches in DRM strategies and plans.

02        Update national risk analyses and impact-based scenarios via a multi-hazard approach. Governments
          can more effectively target particularly vulnerable communities by incorporating epidemiological forecast
          models into decision support platforms to identify priority vulnerable areas and to update multi-hazard
          risk modelling.

03        Monitor feedback on COVID-19 risk and crisis communication, administer performance audits, and
          improve MHEWS platforms. This can inform more holistic multi-hazard risk and crisis communication
          strategies, and suggest approaches for future MHEWS designs that include public health risks.

04        Build on existing early warning systems for natural hazards. Develop road maps for MHEWS open data
          platforms that integrate health surveillance and natural hazard information, incorporate alerts for health-
          related emergencies, and function with strong interagency coordination between Ministries of Health and
          National Disaster Management Organizations (NDMOs).

05        Enhance community-based disaster preparedness programs. Community-based programs could
          include preparedness for health-related emergencies – and help with case tracing, relief distribution,
          and maintenance of public safety.

06        Adapt emergency management systems. Update contingency plans and evacuation procedures,
          and ensure there is no disruption to supply chains for relief and recovery goods and services.
Early Lessons from the Asia-Pacific Region - Adapting Disaster Risk Management Systems for Health-Related Emergencies: World Bank ...
2
03             Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region

          2
         Managing the crisis: States
         of Emergency and the role of
         NDMOs during COVID-19

                                                                    T
                                                                             he COVID-19 pandemic prompted many
                                                                             countries to declare a state of emergency
                                                                             and mandate travel and mobility
                                                                    restrictions in an effort to limit and contain local
                                                                    outbreaks. The restrictions affected various aspects
                                                                    of economic and social life.

                                                                    Some countries, like the Republic of Korea,
                                                                    Singapore, Vietnam, and Taiwan, China, have
                                                                    learned from past experiences with SARS and
                                                                    MERS. They were able to better respond to
                                                                    COVID-19 by applying these lessons, which
                                                                    included: having their public health system
                                                                    establish a legal basis for responding to

     "
                                                                    health related emergencies, improving disease
                                                                    surveillance, revising disease outbreak alert
         Some countries,
                                                                    systems and response protocols, and ensuring that
         like Singapore, the                                        medical and emergency response stockpiles were
         Republic of Korea, and                                     sufficient and replenished. In addition, having a
         Vietnam, have learned                                      legal basis for cooperation already in place helped
                                                                    governments coordinate line ministries; outline
         from past experiences                                      clear priorities, mandates, and responsibilities;
         with SARS and MERS,                                        and respond swiftly with travel and mobility
         and were able to                                           restrictions.

         better respond to
                                                                    Some of the countries observed in this note
         COVID-19 by applying

                             "
                                                                    integrated emergency declarations made by
         these lessons.                                             both disaster management and public health
                                                                    agencies; others relied on standalone executive
Early Lessons from the Asia-Pacific Region - Adapting Disaster Risk Management Systems for Health-Related Emergencies: World Bank ...
Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region                             04

order declarations or instructions specific to COVID-19.                               Republic of Korea, and Vietnam – is that it often
Similarly, countries chose differing institutional
arrangements when structuring their interagency                                        across ministries and agencies, particularly if there is
response to the pandemic. This technical note explains                                 strong leadership and vision.
three modalities of intragovernmental coordination
that emerged in the responses to COVID-19: 1) the                                      In the Republic of Korea, when the national infectious
state directly heading an interagency task force (i.e.,                                disease crisis level rose to “serious” on February 23,
leadership by a President or Prime Minister, or another                                2020, the government assembled the Central Disaster
direct line of leadership); 2) the Ministry of Health                                  and Safety Countermeasures Headquarters (CDSCHQ)
(MoH) leading or coordinating the response; and 3) the                                 – which is headed by the Prime Minister – to increase
NDMO leading or coordinating the response. There are                                   efforts on a government-wide response to COVID 19.
also countries that have applied a mixture of the above                                The Central Disease Control Headquarters (KCDC)
approaches.                                                                            and the Central Disaster Management Headquarters
                                                                                       (Ministry of Health and Welfare) assisted in the
Four countries applied Type 1 coordination, with the                                                                          4

President or Prime Minister (or their vice or deputy)                                  summarizes the response system in the Republic of
coordinating the response directly. The advantage                                      Korea following the Level IV Crisis alert.
of this approach – taken by Japan, Myanmar, the

         Crisis Alert                                                       Response System
            Level

                                                                                                                               Local
                                                                     Central                                                Governments

                                                                      Central Disaster and
                                                              Safety Counter measure Headquar ters                   Local Disaster and Safety
                                                                                                                         Countermea sure
                                                                       (Minister of the inter ior and
                                                                                                                           Headquar ters
                                                                        Safety or Prime Minister)
                                                                                                                    (local governments nationwide)
                                        Central
                                        Diseas e
           Level IV                     Control
        (highest level)               Headquarters
                                         (KCDC)               Central Disaster          Pan-government                       Local Disease
                                                               Management               Countermea sures                   Control Task Force
                                                               Headqua rters          Suppor t Headquar ters
                                                                                                                            (local governments
                                                               (Ministr y of Health        (Ministr y of the
                                                                  and Welfare)           Interior and Safety)                   nationwide)

    Figure 1   Republic of Korea’s Government’s Response System. (Source: Republic of Korea’s Central Disaster
               and Safety Countermeasures Headquarters.)

4
    http://ncov.mohw.go.kr/en/
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05                               Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region

In Japan, the parliament enacted the Act on Special                                contingency plans in the event of another emergency
                                                                                   during the COVID-19 outbreak.9
Diseases Preparedness and Response in March 2020
to provide the Prime Minister, relevant ministries,                                In Myanmar, the COVID-19 taskforce response is led by
and prefecture governments with greater authority to                               the Vice President and supported by multiple ministries,
respond to the situation. This response was similar
                             5
                                                                                   including the Ministry of Health and other high-level
to the measures that Japan took in 2012 following the                              government ministers, such as the Union Minister
                                                                                   for Defence, the Union Minister for Border Affairs,
                                                                                   the Union Minister for Home Affairs, and the Union
Among other measures, the Act provided government                                  Minister for Labour, Immigration and Population.10 The
leaders the power to request the closure of certain                                COVID-19 taskforce is responsible for a wide range
types of businesses and public facilities, the                                     of functions, including the investigation, detection,
distribution of relief items, and the distribution of                              and handling of persons infected with COVID-19, and
mandatory and optional cash assistance. Following  6
                                                                                   the coordination of various governmental and non-
this, from April 2020 onwards, states of emergency                                 governmental organizations responding to COVID-19
have been declared in several prefectures. With Special
                                                    7
                                                                                   cases. The NDMO focuses on prevention, containment,
Measures in place, Japan’s Ministry of Health, Labour,                             and response plans for COVID-19 in its regular disaster
and Welfare (MHLW) led the medical and primary                                     preparedness activities.11
response to COVID-19. The State Minister for Disaster
                                                                                   Vietnam mounted a highly coordinated COVID-19
supported the State of Emergency Legislation. Other                                response, largely thanks to its One Health Approach,
key actors include the prefecture governments and                                  which calls for increased multidisciplinary and
the Ministry of Economy, Trade and Industry (METI).                                intersectoral cooperation and communication. This
In principle, the MHLW leads the medical response to                               integrated approach aims to address diseases that
COVID-19 as the Acting Head of the Novel Coronavirus                               emerge at the human–animal–ecosystem interface,
Response Headquarters (the head being the Prime
Minister). This includes maintaining an information                                animal and human health. One Health coordination in
system to track cases of COVID-19. However, the                                    Vietnam includes the Ministry of Agriculture and Rural
MHLW-operated system has no direct feed to the                                     Development (MARD), the MoH, and WHO Vietnam.12
country’s natural disaster information platform, which is
managed by the Japan Meteorological Agency (JMA).8                                 became an early adopter of One Health and is now a
Considering the pandemic, relevant agencies and                                    global leader in this approach.13 It has been one of
ministries have also revised their business continuity
planning and their early action scenarios to create                                Vietnam.14

5                                                                                                11

See https://japan.kantei.go.jp/98_abe/statement/202003/_00001.html                               See https://www.globalnewlightofmyanmar.com/
6
                                                                                                 against-COVID-19/
See https://www.mhlw.go.jp/content/10900000/000620733.pdf
                                                                                                 12
7
                                                                                                 See https://www.pbs.org/wgbh/nova/article/
See https://japan.kantei.go.jp/ongoingtopics/_00020.html                                         one-health-vietnam/
8
                                                                                                 13
                                                                                    -
54f9a8dddebca003631b8                                                                            See http://onehealth.org.vn/upload/upload/Partner-
                                                                                                 ship%20Framework%20ONE%20HEALTH%201.3.16.pdf
9
                                                                                                 14
See https://www.pbs.org/wgbh/nova/article/one-health-vietnam/
                                                                                                 See https://www.ilri.org/news/COVID-19-demonstrat-
10
                                                                                                 ing-need-one-health-approach%E2%80%94-approach-
See https://eurocham-myanmar.org/uploads/5d142-notification-%2853-2020%29-                       ilri-has-long-championedFramework%20ONE%20
formation-of-COVID-19-control--emergency-response-committee---eng.pdf                            HEALTH%201.3.16.pdf
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Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region                                 06

                                                                                  disease emergence or re-emergence; (ii) detecting
Type 1 coordination mechanism. The government                                     and responding rapidly and appropriately to cases
established the National Committee for Corona                                     of new and emerging high-impact diseases in both
Prevention on January 30, 2020, the same day that                                 animals and humans; and (iii) enhancing preparations
the WHO declared the outbreak to be a Public Health                               for the health-related and non-health consequences
Emergency of International Concern. Two days                                      of any severe pandemics. These recommendations
later, on February 1, Vietnam announced a national                                strengthened responses and improved preventative
emergency for COVID-19. The National Committee
                              15
                                                                                  measures through Vietnam’s One Health Approach,
directs the mobilization of resources, coordinating                               and guided the government’s response to COVID-19.
between ministries, ministry-level and governmental
agencies, and People’s Committees of provinces and                                Six of the analyzed countries have
cities. It is led by the Deputy Prime Minister, while the
Deputy Ministers of Health are positioned as Deputy                               implemented Type 2 coordination,
Heads within the group. Other ministries and agencies                             i.e., a COVID-19 response led or
are also participating, supporting the implementation
of plans launched by the Ministry of Health.
                                                                                  coordinated by their Ministries of
                                                                                  Health with support from other
In recent years, the MoH of Vietnam has invested
                                                                                  ministries.
heavily in preparedness for health-related
emergencies. It started with the National Integrated
                                                                                  These countries are Cambodia, Fiji, India, Papua New
Operational Program for Avian and Human Influenza
                                                                                  Guinea, the Philippines, and Singapore.
(OPI) 2006–2010,16 which was then updated by the
Vietnam Integrated National Operational Program
                                                                                  In Fiji, the Ministry of Health and Medical Services
on Avian Influenza, Pandemic Preparedness and
                                                                                  established and led the Incident Management Team
Emerging Infectious Diseases (AIPED) 2011–201517
                                                                                  in response to COVID-19, with support from other
to cover other potentially serious emerging and
                                                                                  ministries. The NDMO provides direct support to the
re-emerging diseases. The objective of the AIPED
                                                                                  MoH through community awareness and prevention
was to reduce the risk to humans and animals from
                                                                                  measures. In the Philippines, the National Disaster
the H5N1 avian influenza, but additional guidance
                                                                                  Risk Reduction and Management Council (NDRRMC)
outlined how to reduce risk from other emerging
                                                                                  provides support to the public health–led response as
infectious diseases, such as the COVID-19 pandemic.
                                                                                  part of a national-level interagency task force, as does
The AIPED clearly outlined the following steps for
                                                                                  the National Disaster Management Authority (NDMA)
managing outbreaks of emerging infectious diseases:
                                                                                  in Papua New Guinea. In Cambodia and India, the
(i) controlling infectious diseases at the source
                                                                                  response is led unequivocally by the MoH.
and implementing appropriate measures to prevent

                                                         17
15
                                                         The program describes mechanisms that could be used to achieve the program objectives,
See https://www.vir.com.vn/vietnam-announces-
national-emergency-over-coronavirus-73535.html           non-government agencies to work together, improving on recent developments, sustaining
                                                         partnerships, and meeting international core requirements for preparedness for and response
16                                                       to emerging infectious diseases and pandemics; ii) providing a structure for domestic and
See “National Integrated Operational                     international resource mobilization to enhance and sustain critical functions, to address gaps
Program for Avian and Human Influenza                    and to facilitate donor coordination to support the activities and the integrated program; iii)
(OPI) 2006-2010,” Ministry of Agriculture                building the evidence base for public health policy, risk communication, and public health action
and Rural Development (MARD), Socialist                  to address emerging infectious diseases; iv) applying a One Health approach that recognizes the
Republic of Vietnam, May 2006. http://                   risks arising at the interface between animal health (both domestic and wild animal species),
animaldiseaseintelligence.com/wordpress/                 human health and ecosystem health, noting that the majority of new human diseases globally
wp-content/uploads/2011/12/AIPED.pdf                     over the past 60 years have originated in animals. A copy of the document can be found here.
Early Lessons from the Asia-Pacific Region - Adapting Disaster Risk Management Systems for Health-Related Emergencies: World Bank ...
07                              Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region

In Singapore, as well, the MoH is leading the                                                 Operations of Civil Emergency Response Plan.19 On
public health response to COVID-19 and, with the                                              February 7, 2020, the Singaporean Ministry of Health
Ministry of National Development, is co-chairing                                              elevated the DORSCON level of the country to orange
the taskforce for overall COVID-19 response and                                               (the second-highest out of four levels), indicating
                                                                                              major disruptions to general public businesses and
support to MoH-led medical operations. The                                                    activities, the institution of public control measures,
MoH leads and maintains coordination with other                                               and the activation of a government response plan.
ministries, and produces the primary updates on the                                           Such measures are commonly known as “circuit
COVID-19 response situation.18 Singapore’s public
health system is strongly linked with the country’s                                           response in Singapore.20 Singaporean ministries also
emergency management framework, including                                                     have prepared business continuity and contingency
through the Disease Outbreak Response System                                                  plans corresponding to the DORSCON Alert Levels.
Condition (DORSCON) and Singapore’s Declaration of

DORSCON ALERT LEVELS                                                                          (Disease Outbreak Response System Condition)

                                GREEN                               YELLOW                                ORANGE                                   RED

     NATURE OF         Disease is mild
                       OR
                                                         Disease is severe and
                                                         spreads easily from person
                                                                                                Disease is severe AND spreads
                                                                                                easily from person to person,
                                                                                                                                   Disease is severe AND is spreading
                                                                                                                                   widely
     DISEASE           Disease is severe but
                                                         to person but is occurring             but disease has not spread
                                                         outside Singapore.                     widely in Singapore and is being
                       does not spread easily                                                   contained (e.g. SARS
                       from person to person             OR                                     experience in Singapore)
                       (e.g. MERS. H7N9)                 Disease is spreading in Singapore
                                                         but is (a) Typically mild i.e only
                                                         slightly more severe than seasonal
                                                         influenza. Could be severe in
                                                         vulnerable groups. (e.g. H1N1
                                                         pandemic) OR (b) being contained

     IMPACT ON         Minimal disruption e.g. border
                       screening, travel advice
                                                         Minimal disruption e.g. additional
                                                         measures at border and/or
                                                                                                Moderate disruption e.g.
                                                                                                quarantine, temperature
                                                                                                                                   Major disruption e.g. school closures,
                                                                                                                                   work from home orders, significant
     DAILY LIFE                                          healthcare settings expected,          screening, visitor restrictions    number of deaths.
                                                         higher work and school                 at hospitals
                                                         absenteeism likely

     ADVICE TO         • Be socially responsible;
                         if you are sick, stay at home
                                                         • Be socially responsible: if
                                                           you are sick, stay at home
                                                                                                • Be socially responsible:
                                                                                                  if you are sick, stay at home
                                                                                                                                   • Be socially responsible: if
                                                                                                                                     you are sick, stay at home
     PUBLIC
                       • Maintain good                   • Maintain good personal               • Maintain good personal           • Maintain good personal
                         personal hygiene                  hygiene                                hygiene                            hygiene

                       • Look out for health             • Look out for health                  • Look out for health              • Look out for health advisories
                         advisories                        advisories                             advisories
                                                                                                                                   • Comply with control measures
                                                                                                • Comply with control
                                                                                                  measures                         • Practise social distancing:
                                                                                                                                     avoid crowded areas

Figure 2   Disease Outbreak Response System Condition (DORSCON) Alert Levels in Singapore. (Source: Ministry of Health Singapore.)

18                                       19                                                                                                 20

See https://www.moh.gov.sg/              The ‘Disease Outbreak Response System Condition’ (DORSCON) is a color-coded                        See https://www.gov.sg/
COVID-19                                 framework that shows the current disease situation. The framework provides the                     article/COVID-19-updates-
                                         general guidelines on what needs to be done to prevent and reduce the impact of                    and-announcements
                                         infections. https://www.gov.sg/article/what-do-the-different-dorscon-levels-mean
Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region                                                08

Five countries are employing Type 3 coordination,                                     technical advice and resource support.22 The NDMO
using their NDMO as the lead agency for COVID-19                                      is responsible for leading the National Coronavirus
response. They include Indonesia, New Zealand,                                        Taskforce; the taskforce itself includes the MoH and
Samoa, Tonga, and Vanuatu.                                                            its partners, which focus on COVID-19 prevention and
                                                                                      preparedness activities.
There are several reasons why NDMOs might be
the preferred lead agency during health-related                                       The government has also established the Recovery
emergencies.                                                                          Operations Center (ROC) under the Prime Minister’s
handling a variety of emergencies deriving not only
from natural disasters but also from various other                                    for both COVID-19 and Tropical Cyclone Harold, which
hazards, including epidemics and pandemics. For                                       affected Vanuatu during the pandemic in early April
                                    Vanuatu understands                               2020. The ROC will assist in the effective transition
that the country's high travel volume and tourism                                     from the NDMO’s response phase to the post-disaster
                                                                                      recovery from both emergencies.
Therefore, its NDMO also manages this kind of
hazard, in coordination with the Ministry of Health,                                  Similarly, in Tonga, the National Emergency
which is responsible for the monitoring, detection,
and treatment of any outbreaks.21 Second, several                                     the coordination of resources during a disaster
countries already require NDMOs and relevant                                          or emergency, either natural or non-natural, which
ministries and agencies to operate under one                                          includes COVID-19 response. This function is being
umbrella when it comes to disaster response so                                        performed in conjunction with the Central Control
that coordination is more effective. In Vanuatu,                                      Group, with the coordination activities based within
such coordination occurs through the National                                         the National Emergency Operations Centre (NEOC).
Disaster Committee. The NDMO works intensively                                        The NEOC was activated on March 20, 2020, as a
with relevant ministries and agencies (including the                                  result of Tonga’s State of Emergency declaration for
                                                                                      COVID-19.

                                                                                   Photo: People crossed the flooded street in Jakarta - Indonesia / Dani Daniar / Shutterstock

21                                                                                                                                22

See Government of The Republic of Vanuatu (2010). National Disaster Plan, from https://reliefweb.int/sites/                       Ibid.
reliefweb.int/files/resources/Vanuatu_Final%20Review%20National%20Disaster%20Plan_2010.pdf
09                                Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region

                                                                                    Samoa has also activated its National Emergency

     "
                                                                                    Operation Centre (NEOC), which is part of the
           Each pattern of                                                          country’s National Emergency Response Plan as
           intergovernmental                                                        per the National Disaster Management Plan under
                                                                                    the National Disaster and Emergency Act 2007. The
           coordination for COVID-19
                                                                                    NEOC is the focal point of the country’s response
           has its own value. An NDMO-                                              activities, facilitating collaboration and operational
           led or -coordinated response                                             coordination amongst all stakeholders, with
           can enable rapid adjustment                                              advice and technical guidance from the Ministry of
                                                                                    Health for the duration of the emergency period.
           of preparedness measures                                                 The Ministry of Health is also responsible for
           alongside other types of                                                 implementing awareness programs for COVID-19
           risks in response to the                                                 prevention.

           COVID-19 pandemic.
                                                        "                           In New Zealand, there are three main legislative acts
                                                                                    giving the government authority to take necessary

                                                                                    1956, the Civil Defense Emergency Management Act
                                                                                    2002, and the Epidemic Preparedness Act 2006. All
                                                                                    these acts reference each other and can be invoked
                                                                                    independently. The Health Act 1956 (HA 1956)
                                                                                    gives broad powers to the Minister of Health and

                                                                                    The Health Act was also amended as of March 11,

                                                                                    disease and a quarantinable infectious disease.23

                                                                                    powers to carry out necessary prevention measures,

                                                                                    instituting social distancing orders.

                                                                                    The Epidemic Preparedness Act 2006 enables
                                                                                    government agencies to try and prevent the outbreak
                                                                                    of epidemics in New Zealand. The Act only applies
                                                                                    to a “quarantinable disease” – and, as a result of the
                                                                                    amendment to the Health Act noted above, COVID-19

                                                                                    Act 2006 to be enforced, the government must

                                                                                     23

                                                                                     See https://COVID19.govt.nz/resources/key-documents-and-
     Photo: Sanitizing streets in Telangana India / Sujeeth Potla / Unsplash
Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region                                          10

                                                  Photo: Medical tents assembled at Emergency entrance of Kiang Wu Hospital, Macau / Macau Photo Agency / Unsplash

issue a notice in the gazette,24                                                     of the Civil Defence Emergency Management Act
government notice board. The Prime Minister may                                      2002 (CDEM Act) and the National Civil Defence
issue an epidemic notice if it is recommended by the                                 Emergency Management Plan Order 2015 – to
Director-General of Health, with the agreement of                                    manage the COVID-19 emergency and prevent its
                                                                                                                                  26
                                                                                                                                       are being used
that an outbreak of a disease is "likely to disrupt                                  where necessary to slow the spread of COVID-19 by
or continue to disrupt the central government and                                    reducing and managing its impacts. The act grants
business activity in New Zealand (or stated parts
                                                                                     conservation and supply of fuel and other essential
Prime Minister issued the Epidemic Preparedness                                      supplies – to help manage wider impacts, and the
(COVID-19) Notice 2020, which came into effect on                                    authority to close roads, proscribe activities that may
March 25, 2020. This notice activated a range of
provisions in both the Social Security Act (beginning
March 25) and the Immigration Act (beginning April
2) intended to deal with the practical effects of the                                emergency, the Director and National Controller Civil
COVID-19 outbreak.                                                                   Defence Emergency Management issued a “Direction
                                                                                     to CDEM Groups and Group Controllers for the
The declaration of a state of national emergency25                                   duration of the COVID-19 response and recovery” to
gave the Director and National Controller the                                        help localize the control of operations.
means – in accordance with section 9 and Part 5

24                                        26

See https://gazette.govt.nz/              Emergency powers under the CDEM Act 2002 enable the Director of Civil Defence Emergency (and CDEM Group
notice/id/2020-go1368                     Controllers) to, among other things: (i) close or restrict access to roads or public places; (ii) remove or secure
                                          dangerous structures and materials; (iii) provide rescue, first aid, food, shelter, etc.; (iv) conserve essential
25
                                          supplies and regulate traffic; (v) dispose of dead persons and animals; (vi) enter into premises, e.g., to rescue
See https://COVID19.govt.nz/alert-
system/state-of-national-emergency/       equipment, materials and assistance. https://COVID19.govt.nz/alert-system/state-of-national-emergency
11                                  Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region

                                                                                       On May 13, 2020, the New Zealand Parliament
                                                                                       passed the COVID-19 Public Health Response
                                                                                       Bill,27 which establishes standalone legislation
                                                                                       that provides a different legal framework for

                                                                                       (or sooner, if the pandemic is brought under
                                                                                       control before that time). The Act aims to support
                                                                                       a public health response to COVID-19 that

                                                                                          (a) prevents, and limits the risk
                                                                                                of, the outbreak or spread
                                                                                                of COVID-19 (considering
                                                                                                its infectious nature and
                                                                                                potential for asymptomatic
                                                                                                transmission);

                                                                                          (b) avoids, mitigates, or
                                                                                                remedies the actual or
                                                                                                potential adverse effects
                                                                                                of the COVID-19 outbreak
                                                                                                (whether direct or indirect);

                                                                                          (c) is coordinated, orderly,
                                                                                                and proportionate; and

                                                                                          (d) has enforceable measures
                                                                                                that augment the relevant
                                                                                                voluntary measures and
                                                                                                public health and other
                                                                                                guidance supporting the
                                                                                                COVID-19 response.

Photo: (Top) Heatmap by the Center for Systems Science and Engineering (CSSE) / Clay
Banks / Unsplash | (Bottom) Unsplash

27

See http://www.legislation.govt.nz/bill/government/2020/0246/latest/LMS344134.html
Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region                                             12

In addition, New Zealand has adopted an alert system                              management of disasters.” The National Disaster
for COVID-19 that includes four distinct levels. This                             Management Authority (NDMA) is the lead agency for
system enables target populations to prepare and                                  coordinating disaster management, with the Prime
plan for the different kinds of restrictions that will                            Minister as its Chairperson. The Government of India
be in place depending on the level of the alert. Each                             later announced a complete lockdown.
alert level refers to different legislative acts (e.g., the
COVID-19 Public Health Response Bill governs Alert                                In Indonesia, both the disaster management and
Level 2).                                                                         health agencies had previously recognized the risk
                                                                                  of potential disease outbreak, learning from their
In India
25, 2020, of the spread of the novel coronavirus, an                              Disaster Management describes “non-natural disaster”
interministerial meeting was called by the Principal                              as a “non-natural event or a series of non-natural
Secretary to the Prime Minister. In March 2020, the                               events such as technological failure, modernization
government declared a 21-day national lockdown                                    failure, and epidemic.” Before the COVID-19 pandemic,
in 82 districts in 22 states and Union Territories of                             two key regulations had already been enacted: Law
                                                           28
                                                                                  No. 6/2018 on Health Quarantine and MoH Regulation
to combat the spread of COVID-19. This lockdown                                   75/2019 on Health Crisis Response. The MoH had also
                                                                                  invested in preparing health emergency action plans
provisions of the National Disaster Management Act                                and other related measures in cooperation with health-
2005, which was enacted to “provide for the effective
       29
                                                                                  related stakeholders.30

                                                                                     Photo: Medical students in training, Yogyakarta, Indonesia / World Bank / Flickr

28                                                    29                                                          30

See https://www.hindustantimes.com/in-                See https://www.hindustantimes.com/                         See https://www.who.int/docs/default-
dia-news/82-districts-under-lockdown-over-            india-news/covid-19-disaster-act-                           source/searo/indonesia/non-who-
covid-19-what-s-open-and-what-is-shut/                invoked-for-the-1st-time-in-india/story-                    publications/health-crisis-action-plan-
story-c1AEMZXuuXN6FvmrAdRvsJ.html                                                                                 2015-2019-bahasa.pdf?sfvrsn=1b9f18fe_2
13                            Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region

                                                                                emergency response by BNPB and other ministry-
two COVID-19 cases (announced on March 2, 2020),                                level government agencies. However, the NDRF
the Indonesian MoH published national guidelines                                does not guide emergency responses related to
                                                                                pandemics. Hence, BNPB adjusted to accommodate
pandemic.31 The document outlines procedures for                                the establishment of the COVID-19 Task Force with
medical workers handling the disease. The MoH also                              the Head of BNPB as the chairperson. The framework
published an Operational and Mitigation Response
Plan, which describes the coordination line between                             and principles of operation, and designates the
ministries and agencies managing COVID-19. To                                   coordinating authority for each phase (see table 1).
coordinate a government-wide response, the National                             The government determines the alert level. Each level
Disaster Management Authority (BNPB, Indonesia’s                                stipulates the public health and social measures
NDMO) is leading the interagency COVID-19 Task                                  to be taken against COVID-19, including increasing
Force.                                                                          or decreasing limits on human contact, travel, and
                                                                                business operations. Restrictions are cumulative (e.g.,
Before the COVID-19 pandemic, BNPB had developed                                at Alert Level 4, all restrictions at Alert Levels 1, 2, and
a National Disaster Response Framework (NDRF),                                  3 also apply). Different parts of the country may be at
which sets out a Concept of Operations to guide                                 different alert levels.

Table 1    Adjusted National Disaster Response Framework in Indonesia to Concept of
           Operations for COVID 19 Response (Source: Indonesian Ministry of Health)

     Statement of                                                                Operations principle                     Coordinator /
     phase (threshold)                                                                                                    Commander

                  (General)              Zero COVID-19 cases                     Strengthening detection,                 National: MoH
                  Preparedness           in Indonesia                            surveillance, prevention                 Sub-national:
                                                                                                                          Head of local
                                                                                                                          government

                  Emergency              Early and sporadic                      Case detection,                          National: MoH
                  Preparedness           COVID-19 cases                          contact tracing, and                     Sub-national:
                                                                                 case isolation                           Head of local
                                                                                                                          government

                  Emergency              At minimum, two clusters                Case detection, contact                  National: MoH
                  Response               of COVID-19 in Indonesia                tracing, case isolation,                 Sub-national:
                                                                                 pandemic mitigation,                     Head of local
                                                                                 physical distancing, and                 government
                                                                                 business continuity plan

                  Rehabilitation         No new case after two                   Response de-escalation,                  Head of local
                                         incubation periods,                     stringent surveillance, and              government
                                         counted from the last                   functional rehabilitation

31

Revised on March 27, 2020: https://www.kemkes.go.id/article/view/20012900002/Kesiapsiagaan-menghadapi-Infeksi-Novel-Coronavirus.html
Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region                                                                                                       14

                                                                                                                          and Singapore). This early declaration enabled quick
                                                                                                                          resource mobilization for public health responses
emergency (SoE) related to COVID-19 for most of the                                                                       (including case tracing and tests) and swift decision-
countries studied in this note. In accordance with their                                                                  making on social mobility restrictions (e.g., lockdown,
respective approaches to managing the crisis, countries                                                                   large-scale social restrictions, or quarantine) while
declared the SoE through the public health authority
(e.g., Republic of Korea, Singapore, and Vietnam) or the                                                                  countries (e.g., India) have even declared nationwide
disaster management authority (e.g., India, Indonesia,                                                                    lockdowns without SoE declarations. In Indonesia,
                                                                                                                          following the SoE declaration, while social mobility
3 illustrates, countries with public health agencies                                                                      restrictions were in place during the weeks of March
leading the crisis declared the public health emergency                                                                   and April, relevant Indonesian ministries developed and
earlier, around the beginning of February 2020 and                                                                                                                                     32

                                                                                                   COUNTRIES
                           Cambodia                                  Indonesia                               Myanmar                                 Phillipines                            Singapore
                           Fiji                                      Japan                                   New Zealand                             Korea, Rep                             Vietnam

4500
              WHO declared COVID-19 as
              Public Health Eemergency of
              International Concern
4000
                                                                                                                                                                                                                  Indonesia

                                                     JP National
                                                            SoE
3500

                                                     SG start
                                              Circuit Breaker
3000

                                              NZ SoE
                                          declaration
2500                                                                                  SG end
                                             PH SoE                          Circuit Breaker
                                         declaration

2000
                                                                                                                                                                                                                  Phillipines
                                       KR SoE
                                       (Alert Level #4)

1500            SG
                Dorscon
                Alert #3
                (max. 4)
                                                                                                                                                                                                                  Myanmar
1000
      VN
 declared
      SoE
500                                                                                                                                                                                                               Japan

                                                                                                                                                                                                                  Korea, Rep
     0                                                                                                                                                                                                                      time
         W4   W1   W2       W3    W4    W1     W2     W3   W4   W1      W2    W3   W4   W1    W2   W3   W4    W1     W2   W3   W4   W1     W2   W3    W4   W1      W2   W3   W4   W1   W2     W3   W4   W1   W2
 January      February                  March                   April                   May                   June                  July                   August                 September             October

Figure 3

32

See complete list here: https://COVID19.go.id/p/protokol?page=1
Adapting Disaster Risk Management Systems

BOX 1                                                               for Health-Related Emergencies: Early
                                                                    Lessons from the Asia-Pacific Region

Continuity and
Digitalization of
Public Services
during COVID-19
The COVID-19 pandemic has prompted many countries to rethink how
they communicate with their citizens and explore how to continue
providing services for the community despite the need to limit mobility
and interpersonal contact. In sectors such as government services,
education, the media, communication systems, and the economy,
digital solutions have allowed some day-to-day activities to continue
during the lockdown. For instance, Vietnam took the opportunity                             33

to accelerate digital transformation and, under direction from the                          See https://iotbusiness-
                                                                                            platform.com/blog/
Prime Minister, created digital applications and encouraged business                        covid-19-challenges-
activities to continue in the digital environment.33 Vietnam had already                    opportunities-and-the-road-
                                                                                            ahead-for-vietnams-digital-
launched a digital National Public Services Portal in December 2019;                        economy/
by February 2020, nine out of 22 ministries and government agencies,                        34

as well as all 63 provinces or cities, had integrated their respective                      See http://hanoitimes.vn/
                                                                                            vietnams-efforts-towards-e-
public services into the online portal. By May 2020, the portal
                                      34
                                                                                            government-to-help-contain-
included six more government services intended to help businesses                           covid-19-pm-301041.html

and individuals affected by the COVID-19 pandemic.35                                        35

                                                                                            See http://hanoitimes.
                                                                                            vn/more-public-services-
Other countries, like Singapore, also shifted the provision of public                       launched-online-to-support-
                                                                                            people-businesses-hurt-by-
services primarily to digital platforms, scaling down or temporarily                        covid-19-312061.html
closing physical service centers and deferring non-urgent physical
                                                                                            36
service appointments.36 In New Zealand, the focus is on ensuring                            See https://www.psd.gov.sg/
that all agencies providing public services can operate at maximum                          press-room/press-releases/
                                                                                            end-of-circuit-breaker--public-
capacity while complying with applicable public health measures.37                          service-adopts-phased-
                                                                                            approach-to-re-opening-
Each government agency is encouraged to determine its own planning                          physical- service-centres-
to maintain the delivery of public services during the pandemic and                         and-public-facilities

is responsible for deciding how to apply these guidelines. At the
                                                                                            37
same time, governments need to ensure that vulnerable populations,                          See https://www.
including people with disabilities and disaster-affected people, are                        publicservice.govt.nz/
                                                                                            resources/covid-19-
able to easily access digitized public services.                                            workforce-guidelines/
3
16      Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region

      3
     Handling public information:
     COVID-19 awareness, early
     warning systems

                                                            I
                                                                 n order to improve their understanding of
                                                                 COVID-19 risks and implications, the countries
                                                                 analyzed in this note have established a range
                                                            of case tracing, data dashboard, and information
                                                            management platforms. Most of the COVID-19
                                                            platforms analyzed here provide data visualization
                                                            related to the number and location of COVID-19
                                                            cases, rather than projections or forecasting.
                                                            But a commonality between pandemics, cyclones,

                                                                                                        38
                                                                                                             Simply
                                                            tracking COVID-19 infection rates, contact tracing,
                                                            and case hotspots in a country is not enough. It is
                                                            critical to overlay the COVID-19 epidemiological
                                                            models on risk models of other natural hazards.
                                                            The inclusion of seasonal events may enable
                                                            governments to consider worst-case risk scenarios,

                                                            dynamic of COVID-19–related policies – particularly
                                                            decisions to activate and cancel SoEs, large-scale
                                                            social restrictions, or lockdowns – may increase
                                                            the probability that diverse hazards will interact
                                                            with COVID-19 cases and stimulate concurrent and
                                                            cascading crises.

                                                            Some of the COVID-19 platforms discussed here
                                                            are managed and operationalized by the country's

                                                            38

                                                            See https://doi.org/10.1016/j.pdisas.2020.100102
Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region                                          17

NDMO, some by the MoH; and there is considerable                                     in the daily Situation Report of the Inter-Agency
variation in whether a country’s COVID-19 data                                       Task Force for COVID-19.43 This practice builds on
dashboard is linked to its early warning system (EWS)                                NDRRMC’s standard practice for natural disasters, and
platform (whether multi-hazard or standalone).                                       provides consistency in terms of structured crisis-
                                                                                     management reporting.
In Cambodia, the country’s Center for Disease
Control and Prevention (CDC) provides a COVID-19                                     The Government of Vietnam is providing COVID-19
tracking website; however, it does not feed into the
                     39
                                                                                     data to the public that includes the demography,
country’s EWS platform (named EWS1294). Similarly,                                   precise locations, and ages of patients. The MoH
in Myanmar,    40
                    the distribution map of COVID-19                                 launched a website to publish information related to
cases was developed by MoH and is not linked to                                      COVID-1944 on February 9, 2020 – two days before
the EWS platform operated by the Department of                                       the WHO even named the novel coronavirus disease
Disaster Management or to the one managed by the                                     “COVID-19.” Once Vietnam declared that the country
Department of Meteorology. Conversely, in Vietnam,                                   was entering the second phase of COVID-19 response,
although the NDMO’s EWS (VnAWARE) provides                                           the MoH prepared and released a new tool: a mobile
information on COVID-19, it does not integrate with                                  application that facilitates a bottom-up approach to
the monitoring platform provided by the MoH.41                                       tracking the disease. Through the app, communities
                                                                                     can report their health status and follow the contact-
In the Philippines, on the other hand, the Department                                tracing process. This action was also taken just before
of Health–managed COVID-19 tracker feeds into the                                    the WHO declared a global pandemic on March 11,
Emergency Operations Center (EOC) of the National                                    2020. The low number of reported infections and
Disaster Risk Reduction and Management Council                                       deaths in Vietnam may indicate that the government’s
(NDRRMC).42 Data and information from the platform,                                  early efforts to prepare communities and disseminate
along with contributions from other agencies and local                               risk information on COVID-19 may have helped
government units, are then compiled by the NDRRMC                                    contain local transmissions.

                                                               Photo: People riding motorbike and wearing mask in Ho Chi Minh City, Vietnam / Markus Winkler

39                                                   41                                                                43

See https://COVID-19-map.cdcmoh.gov.kh/              See https://ncov.moh.gov.vn/                                      See http://www.ndrrmc.gov.ph/9-
                                                                                                                       ndrrmc-advisory/4036
40                                                   42
                                                                                                                       44
See https://doph.maps.arcgis.com/                    See https://www.doh.gov.ph/COVID-19tracker
                                                                                                                       See https://ncov.moh.gov.vn/
f8fb4ccc3d2d42c7ab0590dbb3fc26b8
18                              Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region

Even when a country’s NDMO is leading the                                          from becoming overburdened; assess the volume
government’s COVID-19 response, case tracing                                       of emergency management items needed more
information is not necessarily integrated into                                     accurately (as a miscalculation could affect logistical
the country’s EWS platform. In New Zealand, the
government has developed a dedicated platform                                      services.47
for COVID-19 information. While the website of the
Ministry of Civil Defence and Emergency Management                                 In many countries, the NDMO’s and MoH’s EWS
(CDEM) contains general information on the status                                  platforms remain independent. In Singapore, the
of local COVID-19 outbreaks, it remains focused on
providing information regarding natural disasters. This                            risk, while MetService Singapore operates the EWS on
means that the four color-coded alert levels in New                                hydrometeorological risk. Nevertheless, both agencies
Zealand (prepare, reduce, restrict, and lockdown) and                              have access to Singapore’s MoH and GovTech
its advisories for each alert level, as well as guidance
on risk assessment and the range of measures to be                                 locations of, and detailed information about, COVID-19
taken by the public at risk, have yet to be subsumed                               cases.
                                          45

                                                                                   In Japan, the State Minister for Disaster Management
In Indonesia, although BNPB is the lead agency of
the Task Force for COVID 19 and manages the data                                   broad disaster risk management policy, strategies,
dashboard on COVID-19 cases and response, it is         46
                                                                                   preparedness, and response to natural hazards.48 As
not yet apparent whether COVID-19 risk information is
considered when updating the country’s multi-hazard                                input to the State of Emergency stipulation under the
risk level – that is, it remains unclear whether the                               new COVID-19 law. Early warning system operations
process goes beyond the current approach of simply                                 remained with the Japan Meteorological Agency
adding risk layers relevant to COVID-19 infections by                              and related bureaus under the Ministry of Land,
analyzing additional data (such as vulnerabilities and                             Infrastructure and Transportation.

indication that COVID-19 case tracing and hotspots
are being integrated into the current EWS platforms                                authority under the law to take effective emergency
with other anticipated future risks or potential                                   measures, as they can take into account the
disasters (e.g., hydrometeorological risks, or disasters                           characteristics of each area and provide careful
caused by geological hazards). Governments could                                                                     49
                                                                                                                          The Government
improve preparedness by integrating early warning                                  Response Headquarters is coordinating as necessary
systems, thereby helping to: prevent medical and                                   with designated prefectures, which will help the
governmental emergency-services operations                                         government inform residents of the difference

45                                                                       48

See https://doi.org/10.1016/j.ijdrr.2020.101674                          According to law, this is limited to heavy rain, typhoons, earthquakes, tsunamis,
                                                                         landslides, volcanic eruptions, flooding, and heavy snow.
46

See https://www.COVID-19.go.id/situasi-virus-corona/                     49

47
                                                                         COVID-19: https://www.bousai.metro.tokyo.lg.jp/_res/projects/default_project/_
See https://doi.org/10.1017/dmp.2020.51                                  page_/001/007/698/2020041510.pdf
Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region                     19

"Tracking COVID-19 infection rates,
  contact tracing, and case hotspots
  in a country is not enough. It is
  critical to overlay the COVID-19
  epidemiological models on risk
  models of other natural hazards.
  The inclusion of seasonal events
  may enable governments to
  consider worst-case risk scenarios.
                                                           "

  between the emergency measures and "lockdown"                                    tested daily at 5:00 p.m. The speakers, located on
  procedures. Designated prefectures will also ask                                 the streets, are linked to a national system that can
  people to refrain from travel across prefectures                                 transmit disaster warnings to local governments
  and call for a calm response to prevent confusion                                throughout the country within seven seconds. This
  (including panic buying of food, medicine, and daily                             same system is currently being used by municipal
  necessities). Government support also included                                   governments, broadcasting public announcements
  establishing an information-management platform                                  that call for residents’ collaboration in ensuring
                                                                                   physical distancing, avoiding crowded spaces,
  tracing, although detailed risk information on
           50

                                                                                   similar messages through internet and smartphone
  early warning system and public information systems                              messaging applications, advising citizens to stay
  for disasters.51 By focusing the response and public                             home.
  communication efforts at the prefectural level, Japan

  other types of disasters, including the systems for                              Cyclone Harold in April 2020 (Fiji, the Solomon
  announcing public information, managing information,                             Islands, Tonga, and Vanuatu) have an EWS in place for
  and dispatching emergency and medical workers.                                   natural hazards. In Samoa, the Samoa Meteorological
                                                                                   Service provides cyclone advisories. The public
  In addition, Japan has a local government disaster                               received COVID-19 information and case updates
  administration wireless broadcast (“goji no chaimu”                              from government websites, radio, TV, and social media
                                                                                   (Facebook and Twitter).

  50                                                        51

  See https://stopCOVID-19.metro.tokyo.lg.jp/en/            See https://map.bousai.metro.tokyo.lg.jp/en/pc/map.
20                            Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region

In Vanuatu, the COVID-19 taskforce created                                      to the curfew as stated in the SoE order, and a stricter
                                                                                travel advisory was released. On April 3, 2020, the
updates.52 In addition, the government has created                              NDMO released a statement detailing the Scenario 2
a Health Promotions Vanuatu page on Facebook to
disseminate COVID-19 information and updates to                                 cases in Vanuatu) of the country’s COVID-19 response,
the public. The NDMO has taken the lead in overall                              and announced a stimulus package.
coordination of the COVID-19 response since the end
of March 2020, when there were only suspected cases                             On April 1, 2020, during the initial two-week SoE
                                                                                period, the NDMO released a public cyclone alert
and travel restrictions have been in place since then,                          based on the weather outlook of the VMGD Vanuatu
and the NDMO advised the public to practice good                                Meteorological and Geo-hazard Department. The
hygiene and physical distancing while it monitored                              NDMO also announced three other, non-COVID–
the situation with a suspected COVID-19 case cluster.                           related warnings during this period: high potential that
On March 26, 2020, the Prime Minister declared                                  Tropical Cyclone Harold would reach Vanuatu in 24 to
a two-week SoE. To raise public awareness and                                   48 hours; alert level 2 for ash fall from Mt. Yasur on
increase preparedness, the NDMO, with support from
the Emergency Telecommunication Cluster, set up
a toll-free number for the public to call to request                            On April 5, 2020, the NDMO prioritized the response
information regarding COVID-19. Information is also                             to Tropical Cyclone Harold. Some areas received red
disseminated via SMS.                                                           and yellow alerts; people in those provinces were
                                                                                advised to remain alert and listen to Radio Vanuatu
                                                                                to stay updated. Power and water outages occurred
cases in Vanuatu, the NDMO stepped up preventive                                in Santo, and people in the northern areas were
action by installing several hand-washing stations and                          moved to evacuation centers with support from
enforcing strict social-distancing measures. During                             Provincial Emergency Operation Centers. The NDMO
the two-week SoE, the public was advised to adhere                              also released Directive no. 37, which stated that the

52

See https://COVID-19.gov.vu
Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region                      21

regulations restricting social gatherings of more                                status from Scenario 2 to Scenario 1 (SoE declaration
                                                                                 for preparedness and containment measures, but
response would not apply to those seeking shelter in
safe houses or evacuation centers.                                               39, which lifted all domestic restrictions on air and
                                                                                 maritime operations (subject to normal safety and
The NDMO once again prioritized Tropical Cyclone                                 regulatory requirements). This was due to unintended
Harold response above COVID-19 in its April 7                                    ambiguity in responding to Tropical Cyclone Harold
situation report. The NDMO issued an “all clear”                                 against the backdrop of the pandemic – even with
status for northern and central provinces, but still                             no cases of COVID-19 in Vanuatu – which resulted
advised people to listen to Radio Vanuatu for the                                in the quarantining (for seven days) of relief supplies
latest updates; it also released a preliminary report                            from other nations. These much-needed supplies
on the cyclone’s impact on some areas of Vanuatu.                                were therefore not immediately available to disaster-
Regarding COVID-19, the NDMO changed the national                                affected people.

 Figure 4    Epidemiological forecast models for COVID-19 fatalities and infections of selected countries relative to the rate of other
             hazards.53

53

See https://www.essoar.org/doi/10.1002/essoar.10502915.2 and https://covid19-scenarios.org/
4
22      Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region

      4
     Enhancing emergency
     management: Multiple
     risks during health related
     emergencies
                                                            A
                                                                     s we begin to understand how the COVID-19
                                                                     pandemic is multiplying risks and changing

                                                            become clear that we must bolster our preparedness
                                                            for current and future natural hazards and health
                                                            related emergencies, particularly biohazards. It
                                                            is critical to understand that disasters can occur
                                                            at multiple levels simultaneously, and that the
                                                            response to one hazard (such as the COVID-19
                                                            pandemic) can expose further vulnerability problems
                                                            and raise additional concerns for the response to
                                                            another concurrent hazard.54 These concerns include
                                                            whether the government and other related actors
                                                            are preparing or revising their contingency plans
                                                            or other guidelines in response to such situations.
                                                            Disaster preparedness strategies and resourcing plans
                                                            should carefully consider the impact of COVID-19
                                                            on future response operations. Governments should
                                                            adapt implementation modalities to account for those
                                                            impacts, which could include the disruption of critical
                                                            supply chains, the potential localization of response
                                                            efforts due to restricted mobility of humanitarian
                                                            actors, the limited availability of evacuation centers
                                                            with capacity for social distancing, the constrained
                                                            capacity of humanitarian workers or volunteers and
                                                            medical staff to respond to natural disasters in areas
                                                            affected by COVID-19, and health systems’ limited
                                                            supply of personal protective and medical equipment

                                                            COVID-19 cases. 55

                                                            54                                                  55

                                                            See https://onlinelibrary.wiley.com/doi/            Op. cit.
                                                            full/10.1111/1469-8676.12890
Adapting Disaster Risk Management Systems for Health-Related Emergencies: Early Lessons from the Asia-Pacific Region                                23

                                                                                                                              Photo: World Bank / Flickr

For instance, New Zealand’s lockdown means that                                     to Tropical Cyclone Harold to consider the unique
mobilization restrictions are in place. However, the                                characteristics of the COVID-19 setting. Lockdown
                                                                                    notice and curfew was lifted to allow people to
of an emergency, the protocol for natural disasters                                 move to a safe place and prepare for cyclones,
would override the lockdown order. Communities                                      but communities were advised to maintain social
                                                                                    distancing during evacuation. However, there are
take necessary measures for COVID-19 prevention,                                    still some challenges surrounding how to maintain
including maintaining safe distances and personal                                   physical distancing and prevent outbreaks in
hygiene. The Civil Defense Management Authority has
not yet issued a separate protocol to address natural
emergency situations during COVID-19; citizens are to                               kit is not readily available in Tonga, and importing

                                                                                    of tests, travel restrictions, and quarantine policies.

countries that responded to natural disasters during
the current COVID-19 situation.                                                     number of evacuation centers, which has resulted
                                                                                    in overcrowding. Tropical Cyclone Harold damaged

towards Fiji as a Category-4 storm. When it caused                                  usually communities’ preferred option for use as
                                                                                    evacuation centers. The community now has few
Emergency Operations Centre was activated. The                                      options for evacuation centers, and during the
NDMO worked closely with the MoH to ensure that                                     aftermath of the cyclone, the government struggled
physical distancing was practiced in evacuation                                     to keep the occupancy rate of evacuation centers at a
centers. In Tonga, the NDMO adjusted its response                                   safe level. 56

56

See https://www.undrr.org/publication/undrr-asia-pacific-COVID-19-brief-combating-dual-challenges-climate-related-disasters
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