[OPINION] Towards a Disaster Risk Reduction approach to virus response

I bet every Filipino has gotten wind of the term “new normal” as we reach the pinnacle of our COVID-19 experience. The so-called “new normal” as a term is not new after all. It entered the Filipino lexicon in the wake of Supertyphoon Yolanda in 2013 – arguably the worst typhoon of all time in Philippine disaster history. Yolanda provided a good global case study of the risks of disasters and the need to do systematic disaster risk reduction (DRR).

Back then, “new normal” signaled a point when disasters became more frequent and pounded us harder – extreme weather events – because of climate change-associated environmental changes. This time, the term denotes a new way of living our quarantined life.

With “new normal” making a comeback in the time of COVID-19, the term’s convenient association with many things disaster and the daily conundrum of how to make things better in terms of our collective response, I would like to prescribe a DRR-centric approach to COVID-19 response.

This pandemic, following a cursory risk assessment exercise, is on all fronts a disaster. The hazard’s innate properties; our personal, organizational, and system vulnerabilities; exposure; and most importantly, the overall capacity of Philippine society to offset the negative consequences of COVID-19 make it so.

This global disaster had already resulted in health, economic, and social risks that are increasing, ever evolving and indicating that they’re here to stay. Thus, these should be managed not only boldly and swiftly but also systematically to effectively decrease its myriad risks now and in the future.

A DRR-centric approach can inform best our current response and recovery efforts to COVID-19, and prevention and preparedness for future pandemics and health threats, through the following concrete ways of thinking and doing: science-based and risk-informed planning and investment; disaster-oriented governance mechanisms; and community-focused efforts to build health and societal resilience. (READ: EXPLAINER: Who's supposed to be in charge during disasters?)

A dynamic analysis of hazards as they cross paths with COVID-19 is necessary. Knowing that the virus can spread rapidly in urban poor settings where population density is high and the general rule of “stay home” in place, we need to plan our response when massive fires break out and force many people to relocate in the usually cramped evacuation centers. In particular, what measures are there to enforce physical distancing so outbreaks of infectious diseases especially COVID-9 are averted?

A water crisis is something we cannot afford to have right now, with handwashing and hygiene playing an eminent role in infection control. On the opposite end, too much water can also deluge us. With the onset of the rainy season, typhoons and floods can render an almost complete lockdown that can prevent us from doing even essential things like getting our food supplies, going to work if we’re required, and transporting emergency cases to hospitals.

The “big one” earthquake scenario in NCR and the high number of instantaneous deaths as a direct impact is not far-fetched. It’s hard to imagine seeing health centers, hospitals, and quarantine facilities swamped by floods and decimated by earthquakes when they are expected to be delivering critical medical care to COVID-19 and non-COVID cases alike. The usual emergency evacuation and continuity of operations procedures in these critical health facilities should be revisited.

A volcanic eruption even if non-destructive can cause respiratory irritation and can further increase demand for the dwindling supply of masks, which is an essential in the new normal. Even with COVID-19 lording it over other potential disasters, other health threats like communicable diseases like measles, dengue, polio, and influenza, and non-communicable diseases like hypertension, diabetes, cancer, and other chronic conditions deserve equal attention. After all, these are our top killers disease-wise before COVID-19.

Elderly populations suffering from severe COVID-19 complications, informal settlers, and persons deprived of liberty stricken by the virus, health workers getting infected with COVID-19, hospitals being put under lockdown because of contamination, people dying of hunger because of lockdown-induced unemployment, breakdown of law and order because of growing discontent, economic collapse, political turmoil – these are sorry consequences that could be prevented by doing thorough risk assessment.

The least that we expect to happen is that our health system and society are overburdened by these risks even before the big fight with COVID-19 begins. Risk-informed planning and investment should guide us through in this time of uncertainties. From the thick of battle to our journey back to normalcy, risk assessment is crucial to weigh the benefits and risks of all our interventions.

Although some aspects of COVID-19 remain uncertain, having a DRR-centric approach will allow us to skip the learning curve at least in terms of deploying the right systems. Why build a new response system when there is an existing one? The DRR laws of the land are in place and response mechanisms from national to local through the DRR councils are perpetually activated because of frequent disasters. Thus, the existing DRR councils remain to be a viable mechanism for the government to conduct COVID-19 related work as it interfaces with private, business, civil society, people’s organizations, academia, and international partners. Response to disasters uses a cluster approach at different levels to address multifaceted issues. Why can't this tackle the pandemic?

There are multiple DRR funding streams and opportunities that can be tapped. Aside from the Bayanihan fund, the quick response fund (QRF), and local calamity fund, funds from donors can also be mobilized. Under the DRR council structure, there are people dedicated to and salaried to do disaster work. They can be go-to persons or force multipliers in the battle against COVID-19. If operationalization is the main priority, the Philippine DRR mechanism can be relied upon. (FAST FACTS: The NDRRMC)

Building health and societal resilience has to be a bottom-up undertaking. Strengthening primary health care and improving community preparedness and response have been identified time and again as critical factors in our DRR success story. People, families, communities, local government units are the real frontliners in defense of any hazard or disaster. Social capital on the ground is the real thing that saves lives. Successful interruption of COVID-19 transmission in the whole country starts with barangay-level actions and actors – barangay disaster committees, health emergency response teams, health workers. An enabled local government with strong sense-making, scientific calibrated response, and harnessing DRR capacities and good practices should be our strongest fortress in our ongoing battle against this pandemic.

Underpinning both DRR and COVID-19 response is the concept of resilience, which is the ability of a system to absorb and adapt to shocks so it can retain its normal functions and transform itself to be better and stronger with every disaster experience.

If a good disaster narrative can tell us how to do our COVID-19 response, a ray of hope may well be seen in the “new normal.” – Rappler.com

Ronald Law is a senior medical officer of the Department of Health’s emergency bureau. He teaches public health at the University of the Philippines-College of Public Health, Ateneo School of Medicine and Public Health, and the University of the East-Ramon Magsaysay Memorial Medical Center. He is a former Fulbright scholar who studied health security in the United States.