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The threat of pandemics 

What did you do this weekend? How did you fill that 48 hours? The weekly shop maybe, sports sessions for children, household chores, socialising or simply catching up on some rest? Ruth Wozencroft of CRJ Key Network Partner Q-bital Healthcare Solutions explores the omnipresent threat of pandemic diseases and what can be done in advance to mitigate their effects.

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It may sound like science fiction or the plot of a follow up to Hollywood blockbusters such as Outbreak – but a group of international experts has warned that not a single country in the world is truly prepared for a worldwide pandemic, calling government efforts to prepare “grossly insufficient”. Image: lightwise|123rf

In less than the time it took you to enjoy the latest cinema release, catch up on some sleep and watch the kids play football, a flu pandemic, its source unknown, could spread across the world. It could kill up to 80 million people. It would undoubtedly spark panic. National security and the global economy would be affected. And it wouldn’t need a full weekend to do it, either. Experts predict it could take as little as 36 hours.

The first annual report by the Global Preparedness Monitoring Board, an independent group of 15 experts convened by the World Bank and WHO after the first Ebola crisis, describes the threat of a pandemic spreading around the world, potentially killing tens of millions of people, as “a real one”.

They reviewed health care systems already in place across the world and found just 13 countries had the resources to put up a fight against an 'inevitable' pandemic.

The most prepared countries included the UK, the US, Australia, Canada, France and the Netherlands – however, given how fast the outbreak would be likely to spread, experts warn that even these nations may struggle to curb the disease.

There are increasingly dire risks of epidemics, the report said, yet the world remains unprepared. It warned that epidemic-prone diseases such as Ebola, influenza and Sars are increasingly difficult to manage. The reasons for this include increasing conflict, fragile states and rising migration alongside the climate crisis, urbanisation and a lack of sanitation. These are, it said, “breeding grounds” for fast-spreading, catastrophic outbreaks.

The news comes soon after a report, named A World At Risk, said that current efforts to prepare for outbreaks in the wake of crises such as Ebola are 'grossly insufficient' and referenced the damage done by the 1918 Spanish flu pandemic and said modern advances in international travel would help the disease spread faster - a century ago the Spanish flu pandemic infected a third of the world's population and killed 50 million people.

It’s frightening when you consider previous epidemics – The Black Death, for example, claimed up to 200 million lives at a time when travel was largely restricted to the high seas and the fastest means on land was by horse.
In an age when we can jump on and off planes, travel the length and breadth of the country in scant hours and where city-dwellers spend hours a day cheek-by-jowl commuting on buses, trams and tubes – it’s no wonder germs can spread at breakneck speed.

In our rapidly changing and interconnected world, the experts say that we need to “fix the roof before the rain comes”. That means being prepared and planning effectively for what we’d do in the face of an outbreak.
The report’s authors say: “It is high time for urgent and sustained action. This must include increased funding at the community, national and international levels to prevent the spread of outbreaks. It also requires leaders to take proactive steps to strengthen preparedness co-ordination mechanisms across governments and society to respond quickly to an emergency.”

Health infrastructure and facilities will surely be key in managing the outbreak of any pandemic. Put simply, should an epidemic strike, there will be many more people needing medical care and they’re going to have to be managed safely and effectively to minimise risk to them, to the wider public and to the hospital staff. Hospitals are going to have to find space and capacity to treat people, and fast.

The World Health Organisation says that managing an epidemic calls for partnerships with service providers who can help healthcare providers such as hospitals add capacity – preferably partnerships that have been established in advance. This means they can call on them more speedily should disaster strike, and everyone knows what’s expected of them.
In the disaster movies, we see public spaces being used as temporary healthcare settings when epidemics hit – sports halls, community centres and the like – but this is not ideal for patients, their families, or the staff treating them.

So what else would work? Clearly, building extra hospital or additional clinical spaces isn’t an option – so what can be done? Organisations such as Q-bital Healthcare Solutions work alongside healthcare organisations to create extra capacity which is temporary but much more robust and absolutely clinically sound. The environments are not temporary, but they can be temporarily used.

In an epidemic, units can be quickly deployed to support areas which are struggling to meet the increased demand, or where, if space has been commandeered in one hospital to create a ‘hub’ for the treatment and containment of an epidemic, they can be used to create a more long-term ‘back-up’ in other locations to make up the shortfall – for example for dialysis patients.
Patients in either instance can be decanted to the mobile solution – whether that is a clinic, a ward or an operating theatre. Or if additional or faster turnaround of sterile equipment is required to meet the increased demand, a mobile central sterilisation unit can help to bridge the gap.

The mobile units create spaces which can be, if necessary, completely separate from the hospital creating an infection control ‘oasis’, or can be used for testing, triage or supporting the ‘walking wounded’ in clinics and wards. They can be used as additional ward space or even, if needed, a welfare area for staff who may have to stay on site for an extended period without going home. They can also be used for additional and self-contained morgue space, minimising the cross contamination risk.

With an imminent pandemic looking increasingly likely, it’s vital that healthcare providers all over the world, no matter if they’re in the top 13 countries best prepared or not, look carefully at how their infrastructure would cope if put under serious strain – if they don’t, they might have less than a weekend to save lives.

Q-bital Healthcare Solutions is a Key Network Partner of CRJ. For more details about partnerships and how we can work together, visit here

Ruth Wozencroft, 19/11/2019
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