For many years, Israel has prepared emergency contingency plans, most often as a byproduct of military confrontations with possible application to the civilian sector. In recent years, with increased exposure to events in the world at large, there has been an organisational realignment incorporating natural disasters and particularly air crashes into existing plans. The Covid-19 pandemic is, in many ways, a test of planning adaptation to a challenge unforeseen in its nature and scope writes CRJ Advisory Panel Member Jay Levinson.
No one is a prophet able to foretell the future. Earthquakes can, to a certain measure, be anticipated based on history and seismic action, but their exact location, timing, and intensity are ominous unknowns. Earthquake response planning is critical, but it will always be a guideline and not a rigid scenario. This is one example of the basic inadequacy of planning, particularly at a national level. There must be a certain degree of flexibility based on reality on the ground. Perhaps one of the often overlooked benefits of planning is to instil in the planner a way of thinking to better navigate through complex situations that do not fit into ‘The Plan’.
In past years, a response to a pandemic with the severity and extent of Covid-19 was not foreseen by Israeli disaster planners. There were procedures for chemical attacks and industrial leaks. There were wartime plans to convert clinics into first aid stations to relieve pressure on hospitals. There was, however, no national plan to establish a large country-wide network of isolation facilities. That challenge was met with flexibility, as the largest hospital in the country took the lead with establishing a new department and an improvised standard. Other hospitals then followed suit.
Evacuation needed a re-think. Previous planning took into consideration the need to relocate people, be it after a fire destroying a house or a catastrophe effecting an entire neighbourhood. The procedure was to establish make-shift centres in schools and other similar facilities if a large number of people needed to be accommodated, with the assumption that those not taken by family or friends would be housed in a three-star hotel until other arrangements could be made. Three stars are the standard for government use, since they provide all necessities and are relatively inexpensive. Housing evacuees in luxury hotels was thought to pose a problem in eventually relocating evacuees.
Covid-19 caused a re-assessment of evacuation procedures. Home quarantine was a natural option during the period until a person showed symptoms that were certified as Covid-19, but then what would happen, particularly for people at high risk or pronounced infection? These medium-severity cases could not overload hospitals, but patients still needed not only medical care, but also isolation. Time in isolation would not be days, but weeks. It was quickly realised that three-star hotels were inappropriate. Facing a crisis in the tourism industry provided an opportunity. Empty five-star hotels were chosen to house coronavirus patients. It is not appropriate to call it room service, but the patients were kept in isolation with all their needs – medical and food – brought to them.
Some plans had to be scrapped. Shalva, a centre for disabled children, had been designated as an evacuation centre for those with special needs. The opposite had to be put into effect. All children were evacuated from the centre. Consistent with Ministry of Health protocols, it was deemed too dangerous to keep children and staff in close proximity to each other.
Of course, there were disaster plans that did work. The Tel Aviv Municipality had an arrangement to bring cooked meals to the homes of senior citizens and the needy in times of emergency. The mechanism was in place for various agencies to supply names and addresses. A fleet of city-owned vehicles delivered 6000 meals to home-bound families on the programme’s first day of operation.
There are numerous examples of plans that worked, those that failed, and those that were adapted to a developing crisis, the extent of which was unforeseen by all. In years to come there will be limitless critiques of success and failure. At this early stage one conclusion can be drawn. Serious disaster contingency planning is critical, even if it does not meet the demands of reality when disaster does strikes; the discussions and research that are part of devising a contingency plan foster a disaster mindset that enables innovative flexibility.