Health Services Executive, 25-27 Middle Gardiner Street, Dublin 1, DO1 A4A3, Ireland.
Department of Public Health, Health Services Executive East, Dublin 8, Ireland.
Global Health. 2018 Mar 7;14(1):28. doi: 10.1186/s12992-018-0323-3.
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.
随着国际航空旅行速度和范围的不断扩大,传染病已经形成了一个全球性的交通网络,有可能将病原体引入非流行地区,并促进新型或突变的人畜共患病原体的快速传播。强有力的国家应急准备对于减轻国内传染病的传播以及防止向其他国家传播至关重要。鉴于应对通过航空旅行传播的传染病威胁的利益相关者范围复杂,在真正的紧急情况发生之前,广泛测试和实践协议非常重要。模拟演练包括根据危害的可能性和人群的脆弱性确定可能的情景,作为规划的基础,并为准备工作和能力提供有用的衡量标准。2016 年 10 月,爱尔兰的一个主要机场进行了一次现场模拟演练,首次纳入了公共卫生威胁,一架飞机上可能有一例中东呼吸综合征冠状病毒病例,还有一起起落架火灾。应对传染病威胁的反应的优势包括:适当的公共卫生风险评估、病例管理、乘客信息收集、向相关方通报以及向乘客和多个机构进行沟通。吸取的教训包括:o 演练规划不应过于雄心勃勃。在测试应急响应的太多方面时,公共卫生应对可能会被置于次要地位。o 在这种范围的实时演练中,实际实施沟通协议具有挑战性。这些协议应继续通过桌面演练进行检查和测试,以确保所有相关人员都熟悉这些协议,特别是在员工更替的情况下。o 必须明确各个机构的角色和责任,以避免角色混淆。o 必须在实际事件或测试之前考虑和准备好设备和基础设施能力,例如在重大事件期间是否需要增强手机信号。o 重要的是,演练将代表不同角色和观点的组织的个人聚集在一起,从而能够确定能力和局限性,并解决如何在低威胁协作环境中解决差距和重叠问题。