A pandemic strategy

The existing federal and provincial policy frameworks regarding disaster management and epidemic diseases fell flat on the face of the severity of Covid-19, forcing the federal government to make temporary policy arrangements against the pandemic.

Though a health pandemic is alien to national policy documents, an emergency is very much part of the National Disaster Response Plan 2019. It outlines a ‘bottom-top’ declaration of emergency at three tiers – by a district when things go out of control and by a province when the destruction and human loss due to disaster cannot be managed by it.

Disaster itself is defined as a severe disruption of the functioning of a community or society causing widespread human, material, economic or environmental losses which exceed the ability of the affected community or society to cope using its resources. It results from the combination of hazards (industrial incidents, oil spills, chemical, biological, radiological and nuclear incidents), conditions of vulnerability and insufficient capacity to reduce the potential negative consequences of risk, the National Disaster Response Plan explains.

Therefore, a biological hazard may cover the coronavirus pandemic. In other disasters like natural disasters, it's easy to declare an emergency as it depends on the magnitude. Emergency remains a post-disaster reaction. In situations like the coronavirus, when the disaster gradually unfolds, there is no benchmark to declare an emergency.

Even the WHO took some time to declare a pandemic for the reason that it may not incite unnecessary panic. It was on January 30 that initially, it announced a global public health emergency with a warning to countries to prepare for a pandemic.

“Using the word pandemic now does not fit the facts, but it may certainly cause fear,” a WHO representative said at a press briefing at the end of February. "What we see are epidemics in different parts of the world, affecting different countries in different ways."

A pandemic is the "worldwide spread of a new disease," according to the WHO. There are no cut-and-dry criteria for what reaches the level of pandemic and what does not, and there is no threshold of cases or deaths that triggers the definition.

The last time the WHO declared a pandemic was during the H1N1 outbreak in 2009, which infected nearly a quarter of the world’s population. However, that decision was criticized for creating unnecessary panic. SARS was not considered a pandemic, despite affecting people in 26 countries, and neither was MERS.

The WHO pandemic phases were developed in 1999 and revised in 2005. The stages apply to the entire world and provide a global framework to aid countries in pandemic preparedness and response planning. In this revision, the WHO has retained the use of a six-phased approach for easy incorporation of new recommendations and approaches into existing national preparedness and response plans. The grouping and description of pandemic phases have been revised to make them easier to understand, more precise, and based upon observable phenomena. Phases 1-3 correlate with preparedness, including capacity development and response planning activities, while Phases 4-6 signal the need for response and mitigation efforts.

In Pakistan, the devastation of the 2005 earthquake gave birth to the National Disaster Management Authority (NDMA), established as a federal agency after three provincial assemblies surrendered their powers to the parliament to legislate.

The NDMA is headed by a serving lieutenant general. It has a National Commission, which is chaired by the prime minister and has all chief ministers, governors, and ministers of the main federal ministries like Health. So far the NDMA’s capacity is more to prevent and manage natural disasters like earthquakes, floods, and droughts. In its initial reaction to the pandemic, the NSC established a National Coordination Committee with the representation of all provinces and relevant civilian and military stakeholders. The committee is to monitor the situation and make necessary decisions daily. The NDMA will be the lead operational agency and will coordinate its efforts with the provincial and district authorities for the required implementation of the preventive and curative actions.

However, the issue confronting the government was institutionalizing the Covid-19 response in a linear policy framework. The WHO also wants a Country Preparedness and Response Plan (CPRP) as part of its Strategic Preparedness and Response Plan (SPRP). It has already issued the guidelines for an initial CPRP, which should be developed for three months from February 1 to April 30.

Subsequent CPRPs will be developed based on the evolving situation and needs. The WHO guide outlines the priority steps and actions to be included in the CPRP across the major areas of the public health preparedness and response: country-level coordination, planning, and monitoring; risk communication and community engagement; surveillance, rapid-response teams, and case investigation; points of entry; national laboratories; infection prevention and control; case management; and operations support and logistics.

According to the WHO, this guide does not supersede existing national guidance and plans. Instead, this guide should be used to adapt existing relevant national plans rapidly. The UN and its partners will implement the adapted preparedness and response activities outlined in the CPRP to ensure that the best support possible is provided to national authorities and communities affected by Covid19.

These WHO guidelines will provide a framework for the recent opposition parties’ demand to chalk out a national action plan with mutual consultation so that all political forces can jointly fight the battle against the coronavirus.

The writer is a freelancecontributor.

Email: nadympak@hotmail.com