Planning and preparing for public health threats at airports

Abstract

The ever-increasing speed and scope of human mobility by international air travel has led to a global transport network for infectious diseases with the potential to introduce pathogens into non-endemic areas, and to facilitate rapid spread of novel or mutated zoonotic agents.Robust national emergency preparedness is vital to mitigate the transmission of infectious diseases agents domestically and to prevent onward spread to other countries. Given the complex range of stakeholders who respond to an infectious disease threat being transmitted through air travel, it is important that protocols be tested and practised extensively in advance of a real emergency. Simulation exercises include the identification of possible scenarios based on the probability of hazards and the vulnerability of populations as a basis for planning, and provide a useful measure of preparedness efforts and capabilities.In October 2016, a live simulation exercise was conducted at a major airport in Ireland incorporating a public health threat for the first time, with the notification of a possible case of MERS-CoV aboard an aircraft plus an undercarriage fire. Strengths of the response to the communicable disease threat included appropriate public health risk assessment, case management, passenger information gathering, notification to relevant parties, and communication to passengers and multiple agencies.Lessons learned include:o Exercise planning should not be overly ambitious. In testing too many facets of emergency response, the public health response could be deprioritised.o The practical implementation of communication protocols in a real-time exercise of this scope proved challenging. These protocols should continue to be checked and tested by desk-top exercises to ensure that all staff concerned are familiar with them, especially in the context of staff turn-over.o The roles and responsibilities of the various agencies must be clear to avoid role confusion.o Equipment and infrastructure capacities must be considered and in place in advance of an actual incident or test, for example whether or not cell phone signals require boosting during a major event.Importantly, exercises bring together individuals representing organisations with different roles and perspectives allowing identification of capabilities and limitations, and problem solving about how to address the gaps and overlaps in a low-threat collaborative setting.

Educating, training, and exercising for infectious disease control with emphasis on cross-border settings: an integrative review

“…Also, training needs were obtained via literature studies, the ETE designers’ experienced-based vision [ 23 ], or by inquiry of disaster plans and local emergency management policies [ 55 , 69 ]. Several studies specifically aimed to identify gaps and needs through the exercise [ 56 , 68 ].…”

“… California Department of Health Services and the California Distance Learning Health Network Table-top exercise 3,5 h divided over two sessions at the same day Stated as SMART goals derived from competencies Online lectures and tabletop exercise at the same day; on-site and with local partners. – RR: broadcast 821/25000 (3.3) RR: tabletop 164/− (−) RR knowledge test: 735/25000 (2.9) RR teleconference: 21/− (−) – Rating statements; Telecall interviews after table-top Knowledge test; Telecall interviews after table-top on skills and confidence – – CBS Martin G., 2018, Ireland, [ 56 ] – Airport- &PH personnel, fire officers, police, health service responders – Response to a plane with MERS-suspection on board. – Exercise material reflected the WHO Simulation Guide.…”

“…plans; 3.7 for broadcast info; Survey tabletop facilitators: 4.7 program was appropriate for their health departments; 4.3 training helped increasing capacity to respond; program helped to identify key deficiencies in preparedness, as well as to learn what is and is not in their control. Future tabletops address more localized concerns and have materials earlier available; Knowledge: 90% had 100% score; survey tabletop particpant: teleconference satisfaction, skill, confidence: pairing of broadcast with tabletop was effective complementary training; training helped them better understand their plans, roles of decion makers in the chain of command; - CBS Martin G., 2018, Ireland, [ 56 ] Lessons learned in hot debrief + observers/evaluators during the exercise Unknown/> 200 Methodology: Exercise planning should not be overly ambitious. If testing too many facets of the emergency response protocols, the public health response can be deprioritised; the practical implementation of communication protocols in a real time exercise of this scope proved challenging; the roles and responsibilities of the various agencies involved needs to be clear.…”

Development of a competency profile for professionals involved in infectious disease preparedness and response in the air transport public health sector

“…Nowadays, people travel further, faster, and in higher numbers than ever before [1]. While the increased speed of human mobility has economic advantages [2], it also has created a global transport network for infectious diseases [3,4]. Air travel and airports contribute to this network due to the high number of passengers from across the world coming together in confined spaces.…”

“…As is revealed by previous studies, strong capacity alone is not sufficient. During outbreaks of Severe Acute Respiratory Syndrome (SARS), Ebola Virus Disease (EVD), and Zika Virus disease, there was a lack of clarity on responsibilities among airport personnel and public health authorities [5], leading to insufficient communication and coordination among local and national stakeholders [3,5]. In the case of SARS, the delay in the implementation of control measures tripled the epidemic size of the outbreak [11].…”