Including multiple hazards in early warning systems
Early warning systems (EWS) are more than just sirens or text message alerts. They are extensive networks of observation and communication that use a variety of expert and disaster risk knowledge to provide timely warnings and minimize the loss of life and livelihoods to disasters. They are also the improved and reinforced capacities of individuals, communities, business and institutions to take early action when warnings are received. Early warnings do not have sense if there is not early action.
The United Nations Office for Disaster Risk Reduction (UNDRR) has been working to support various organizations across the Caribbean to incorporate multiple hazards into their understanding of EWS. In addition to hydrometeorological hazards such as hurricanes and tropical storms, it is critical that EWS monitor biohazards such as epidemics and pandemics as well as geohazards such as earthquakes and volcanoes.
In a pandemic, effective EWS can help communities, governments and public health officials mobilize resources faster and respond more cost-effectively to the outbreak. Despite this, in late 2020 during the COVID-19 pandemic, only 81 countries had developed a national strategy for disaster risk reduction (DRR) in line with the Sendai Framework, and only few of those strategies accounted for pandemic threats. For EWS to be effective, they need to incorporate the full range of hazards: they need to be multi-hazard early warning systems (MHEWS). As stated in the Global Assessment Report 2019, the era of hazard-by-hazard risk reduction is over; present and future approaches to managing risk require an understanding of the systemic nature of risk, and should take into consideration the interconnections between hazards, vulnerabilities, exposure and also capacities.
In the last decade, the Caribbean has been hit by numerous disasters and tropical diseases, the most recent being the COVID-19 pandemic. A region already at a high risk of disaster, the Caribbean was forced to rapidly organize a public health response to the outbreak. The smaller islands in the region were prioritized, receiving high-quality intensive care units, while training for hospital staff was accelerated to meet the required number of units and mechanical ventilators. The rate of transmission quickly outpaced the available resources, causing major disruptions to the region’s health-care sector, among others.
Not only did SARS-CoV-2 cause life-threatening disease in the region, it also worsened other diseases. According to the Caribbean Public Health Agency (CARPHA), non-communicable diseases are the leading cause of death and disability in the non-Latin Caribbean (excluding Haiti). The people suffering from these diseases thus faced the additional burdens of COVID-19 and longer waiting times in hospitals to get the treatment they needed.
Just as they were beginning to recover from the global recession, the pandemic shocked the Caribbean economies, heightening their pre-existing risks and vulnerabilities. Saint Vincent and the Grenadines, for example, had to cope with multiple hazards at once: the eruption of La Soufrière, the COVID-19 pandemic, the dengue fever crisis and the effects of Hurricane Elsa. These situations forced authorities to mainstream a multi-hazard approach for managing disaster risk. How do we put people in shelters for hurricanes or volcanic eruptions in the middle of a pandemic?
Several communication systems and alerts were established to tackle the spread of SARS-CoV-2. CARPHA, via its Tourism and Health Program, developed the Caribbean Traveller’s Health App, a first-of-its-kind smartphone app designed for travellers as well as health and tourism stakeholders. The app allows users to log their symptoms, access live travel health information on Caribbean destinations (including a database of tourism facilities practising proactive health measures) and receive public health alerts.
This app also links with CARPHA’s COVID-19 situation reports, which, prior to December 2022, comprised weekly reports providing updates on SARS-CoV-2’s status across the Caribbean to help monitor and assess the pandemic’s risk to the region. The reports have since evolved into a reliable epidemiological source for CARPHA 26 member States.
CARPHA also established the Regional Health Communication Network, composed of specialists in health promotion and communication trained in risk communication and dedicated to responding to each phase of the pandemic. The agency’s communication strategy spanned websites, traditional and digital media, conferences, telephone hotlines, media clinics/training, in-person and/or virtual consultations, and instant messaging (WhatsApp) for responding to individuals and their families affected by the virus.
In 2022, Executive Director of CARPHA, Joy St. John, warned that although the pandemic was over, the region should stay on COVID-19 alert. CARPHA continued to promote confidence in vaccines’ ability to tackle subvariants as well as raise awareness of global vaccine inequality.
“While the subvariants may cause less severe acute disease than Delta,” Joy St. John said, “the Caribbean’s chronic disease profile has worsened with the pandemic, and more people are therefore vulnerable. Viruses do not respect the timelines of other disasters,” said Mami Mizutori, Special Representative of the Secretary-General for DRR.
Countries and organizations in the region are beginning to implement the lessons learned from the pandemic. In August 2022, the Pan American Health Organization held a regional workshop on pandemic/epidemic preparedness and response in Buenos Aires. The World Bank also doubled its financial support to the region’s health sector. The World Bank’s Health, Nutrition and Population portfolio in Latin America and the Caribbean totals US$ 3.9 billion in commitments (29 operations), of which US$ 2.3 billion are aimed at strengthening the resilience of health systems in the region.
Caribbean Community (CARICOM) member States are set to benefit from a fund for their “Health Systems Strengthening for CARICOM Member States to Respond to the COVID-19 Pandemic and Other Emerging and Re-emerging Threats” project. Spain is financing this through the CARICOM/Spain Joint Fund. The grant is valued at US$ 1,189,247 and will enable CARPHA to undertake a series of health interventions for its member States.
As more governments and organizations look to EWS to help monitor and mitigate COVID-19, the link between the virus and the environment becomes increasingly clear, and the need for MHEWS becomes more urgent. Is in this perspective that the Caribbean Disaster Emergency Management Agency, with the support of UNDRR, has created and revitalized the Regional Early Warning Consortium (REWSC), to serve as a strategic and advisory body for the advancement and strengthened coordination of EWS within the Caribbean region. The REWSC comprises representatives of institutions which have a mandate to support individual, cluster and MHEWS in the region and comprise regional agencies such as CARPHA, CCCCC, CMO, CIMH, CTU, CBU, CARDI, and OECS, and international organizations such as UNESCO-IOC, WFP, IFRC, UNDP, REAP, CREWS and UNDRR among others.
Countries need to be ready and able to detect outbreaks from the first case. When this becomes possible, they can respond and stop the spread of a disease before it reaches epidemic or pandemic proportions. Due to the high level of travel to, from and within the region, the Caribbean is vulnerable to biohazards. It is also vulnerable to climate and hydrometeorological hazards as well as geohazards, which could strike at any time, potentially co-occurring with others.
Effective MHEWS, alongside other cost-effective interventions such as primary health care and public health surveillance systems, can help not only to build resilience against future pandemics, but also shield populations from the full range of hazards before they become disasters.