Vision for a Global Operations Room

Mike Catchpole Chief Scientist, European Centre for Disease Prevention and Control

Public Health Emergencies Global threats – global responses

A Global Operations Centre Why Global?

Globalisation – International Travel

Distribution of confirmed cases of MERS-CoV by first available date, and probable place of infection, March 2012 – 28 September 2015 (n=1 608)

International Spread of Infectious Disease MERS-CoV Outbreak 2012-2015

Food Supply Chain: Established Links

Representation of the delivery quantities and routes of all examined seeds (six varieties including fenugreek). .

Germany

other countries

> 1000 kg

> 100 kg

> 10 kg

> 1 kg

≤ 1 kg

Retail France Sprout producer, Germany

Importer

Exporter

By courtesy of Olaf Mosbach-Schulz, EFSA. From:Weiser A et al. (2011). EHEC O104:H4 outbreak 2011 in Europe: a new tool to support the outbreak investigations on governmental side. Poster at the Medical . Poster on Biodefense Conference, Munich 25th-28th October 2011

Food supply chain – established links A tool developed for food backward and forward tracing by EFSA

A Global Operations Centre Why an Operations Centre?

“An EOC is an effective way to achieve coordination among agencies responding to a major emergency or disaster. The absence of an EOC seems to encourage the opposite.”

Scanlon J. "The Role of EOCs in Emergency Management: A Comparison of American and Canadian Experience."

A Global Operations Centre Why an Operations Centre?

• Multi-sectoral and multi-disciplinary nature of response to most (all) emergencies

• Effective communication and coordination are critical

• Timely, accurate information sharing and exchange is essential for taking action

Global Operations Centre Emergency Operations Centre Functions*

General Functions

• Command/Control/Coordination (of response)

• Operations

• Planning

• Logistics

• Public communication/information

• Finance/admin/policy

• Intelligence/data/information management

Public Health Functions

• Surveillance/epidemiology

• Data collection and analysis

• Disease control

• Laboratory functions

• Environmental health

• Health promotion, community engagement, and social mobilisation

*WHO EOC-NET Meeting Report, April 2015

Global Operations Centre Core Principles*

• Based on an all-hazards approach

• Modular, scalable or adaptable organization

• Support for joint engagement of multiple jurisdictions/organizations in management decisions

• Clear lines of accountability

• Integration and interoperability with partner agencies (national and international)

• Clearly defined roles and responsibilities, consistent with normal roles and supported by training

*WHO EOC-NET Meeting Report, April 2015

Global Operations Centre – When? Public Health Emergency Response

Public Health Emergency of International Concern

An extraordinary event, which is determined:

• to constitute a public health risk to other States through the international spread of disease; and

• to potentially require a coordinated international response

WHO, IHR (2005)

Global Operations Centre Pre-requisites for Success

• Mandate

• Trust

• Plans and procedures

• Staff

• Information management systems (including task management systems) – integrated/interoperable

• Communications technology and infrastructure

• Regular training and exercises

Mandate and Trust Political and Organisational Context

GHSI: Global Health Security Initiative GHSI: Global Health Security Initiative

International Health Regulations International Health Regulations

HSC

Decision 1082/2013/EC

Plans & Procedures Emergency Plans and Incident Procedures

Staffing Expertise, Roles, and Rotas

Public Health Functions

• Surveillance/epidemiology

• Data collection and analysis

• Disease control

• Laboratory functions

• Environmental health

• Health promotion, community engagement, and social mobilisation

Global Operations Centre Real-time Operational Intelligence

Data Signals

Collect Analyse Interpret

Detect Filter Validate

Analyse

Assess

Events

Control measures

Threats Early warning systems (EWRS, IHR) Bulletins and newsletters Organizational communication (meetings and teleconferences

Communicate

Identified risks Mandatory notification

Laboratory surveillance

Emerging risks Syndromic surveillance

Mortality monitoring Health care activity monitoring

Prescription monitoring

Non-healthcare based Poison centres

Behavioural surveillance Environmental surveillance

Veterinary surveillance Food safety/Water supply

Drug post-licensing monitoring

Domestic Media sources

EI focal points Professional sources

International Media sources News aggregators Professional sources National & International agencies

Event monitoring Surveillance systems

Event-based surveillance Indicator-based surveillance

ECDC Operations Centre Daily Roundtable

A Global Operations Centre Configuration

ICC Room 1 (Operations Room) For full layout see detailed Floor Plan

ICC Room 3 (Large Breakout Room or Call Centre)

Networked PC, DVD player, Freeview TV, Teleconferencing device, Video conferencing, additional phone & network points, 10 call centre handsets

ICC Rooms 4, 5 & 6

Networked PC, DVD player, Freeview TV, Teleconferencing device, Video conferencing, additional phone & network points

(Rooms 4&5 can be opened out to form a larger breakout room)

ICC Room 2

Video Conferencing, Teleconferencing device, call recording equipment, Networked PC, DVD player, Freeview TV, additional phone & network points

Hub and Spoke Model

EU Emergency Operations Centre(s) Distributed model

Challenges for a Global Operations Centre

• Establishing a clear mandate (leadership/support)

• Securing Staffing and Information System resources

• Achieving agreement with other sectors on "Concept of Operations“

• Developing common criteria for activation, escalation and de-escalation of emergency response levels

• The lack of standards and interoperability of public health EOCs and their related plans

• Ineffective communication of operational info and collaboration among and between EOCs and response teams

• Maintaining Directories of available expertise

• Regular international and inter-agency exercises

Historical issues in the management of emergency responses

• Lack of leadership

• Lack of coordination

• Lack of integration

• Lack or loss of resources

• Lack of planning

• Lack of media support

Global EOC Provides

− Expert focus of leadership

− A priori plans, good comms

− Overall command and control

− A priori plans, clear mandate

− Clarity of mandate, resources

− Clear and consistent communications, highly visible coordination

Daily Mirror, January 2000

Global Operations Centre What next?

Beyond global?

Acknowledgements

ECDC

- Denis Coulombier

- Hakim Khenniche

- Kaja Kaasik Aaslav

- Sergio Brusin

Public Health England

- Lynne Foster