Laying in Wait: Responding to the Pandemic Amidst Impending Disasters

On March 25th, the United Nations released an urgent appeal for USD 2 billion in humanitarian assistance for developing countries facing horrific challenges in managing the COVID-19 pandemic. Fully funding this humanitarian appeal will save countless lives, but given the depth of the social, economic, and environmental challenges facing many of these countries, we still need to think creatively about leveraging these funds to build resilience to multiple crises.

The pandemic is a monumental crisis for a world already facing massive humanitarian and development needs. Many countries that will be helped by this appeal are at war, hosting millions of refugees or internally displaced in crowded camps or urban settings with dramatically under-resourced health care systems. Additional funding will be needed to support the pandemic response, respond to the economic crisis unfolding, and make communities more resilient. This requires that, even in a fast-moving crisis, we think now about other risks we are facing, how to mitigate these risks, and where possible, build resilience. At the very least, as we move forward with COVID-19 response, we must avoid creating new risks that will endanger lives and livelihoods, and exacerbate conditions for those most vulnerable. 

To do this, we need to answer the question of ‘what’ are we trying to build resilience to? In the case of the Zurich Flood Resilience Alliance, we work in flood-prone countries and communities and, even in the midst of health emergencies, war, or famine, we know we must continue to build resilience to floods. The needs will be great: in 2019 alone, 14.7 million people were displaced by floods and storms. June is the start of monsoon season in Asia, where countries regularly face increasingly damaging extreme weather events and where we can reasonably predict communities will face floods that displace hundreds of thousands, if not millions of people.

Why is flooding a problem when we’re facing a health crisis? Floods cause people to congregate on higher ground and to seek safety in flood evacuation shelters and community centers such as schools, mosques, and churches that are packed tightly with people. Floods, and their resulting impacts (loss of housing, congregate sheltering, exposure to contaminated water, etc.) can also increase water-borne, vector-borne, and communicable disease outbreaks and infections, while damaging critical infrastructure required to maintain and access health facilities. These impacts result in doubly constrained health systems. Additionally, the crash of the formal and informal economy caused by lock downs will decrease households’ financial resources, limiting their ability to prepare for, respond to, or recover from a flood or other natural hazard. Altogether, this is a recipe for compounding much deadlier disasters.

What can and should the donor community, national governments, development and humanitarian practitioners do in flood prone areas?

Updated guidance from March 2020 on shelters developed by the Inter-Agency Standing Committee (IASC), the International Federation of Red Cross and Red Crescent Societies (IFRC), the International Organization for Migration (IOM), The UN Refugee Agency (UNHCR) and the World Health Organization (WHO) encourages implementation of “mitigation measures to reduce overcrowding” and provides other useful guidance on shelters, physical distancing, and crowd management. However, much more is needed to ensure that lives, livelihoods, and critical services are protected and that impacts of future disasters do not further exacerbate the spread of COVID-19. 

The international donor community must:

• Fully fund the pandemic humanitarian appeal while not pulling resources from preparing for, and responding to existing humanitarian crises;
• Plan now for raising additional funds for disasters that are likely to occur in the coming months; and,
• Support flexible funding that allows partners to plan and respond to current and future risks.

National Government and Development and Humanitarian Actors should:

Use and strengthen existing resources and systems

• Utilize existing DRR resources and thinking. For example, we will need more early warning alert and response networks which are critical for tracking the viruses’ spread and helping with information flows to provide messaging on hygiene practices and/or potential outbreaks. Many communities already have DRR committees and early warning systems for natural hazards that can be built on. Adapting early warning systems and community DRR committees to include public health outbreak measures will enable frontline workers and governments to more effectively manage COVID-19 and not duplicate efforts, saving time, resources and lives.
• Take a page from the DRR “playbook” around community engagement to build trust and develop mutual understanding with communities. This will ensure communities incorporate recommended health and preparedness practices to ensure better outcomes and prevent health facilities from getting overloaded if a disaster strikes during the pandemic.  Effective community engagement can also identify and tackle misinformation in a time of chaos. 
• Support and strengthen community health groups and structures to respond in parallel to COVID-19 and any other disasters that might (and unfortunately will) arise. Such groups are likely to be resource-scarce and over-stretched, and therefore will need: 1) additional resources (e.g. supplies, trainings, people, and funds) 2) adequate knowledge and contingency plans on how to prepare and operate during disaster situations; and, 3) support (e.g. childcare, food) to enable continuity of health services before, during and after additional disasters amidst the pandemic. 

Support local actors

• Given the global nature of the COVID pandemic, international support to countries in crisis will be extremely challenging – organizations are over-stretched and travel restrictions mean bringing in additional human resources will be difficult and include its own risks. Local responders are therefore absolutely key.
• It is therefore essential to invest in the capacities of local actors to prepare for and respond to the current- and future risks. This includes the current COVID crisis, the impacts of the measures put in place to reduce its spread, and the impacts of other shocks that will come.
• Supporting institutional capacities and ensuring funds reach these local actors will be key, with as little delay, transaction costs and “layers in the chain” as possible.

Ensure that vulnerable populations, especially older people and people with pre-existing medical conditions, are included throughout the Disaster Risk Management planning process.

• Organize consultations with the community to identify vulnerable populations who may have difficulty accessing: water and supplies to practice safe hygiene practices; information to take necessary action to protect themselves; and health facilities to seek care. Consider outreach strategies to deliver necessary supplies to vulnerable populations who may face barriers to reaching distribution points in a disaster situation.
• Understand capacity and needs of healthcare facilities and other institutions that house older people, and how their needs may change during a disaster amidst the pandemic

Ensure that health facilities and supplies are hazard resistant and accessible

• Consider the risk landscape as overflow health facilities are designated and built. For example, temporary health facilities should not be built in floodplains or in low lying areas in flood-prone communities, and they should be designed to separately manage COVID 19 cases from other cases.
• Ensure there are primary and backup power, water, sanitation and hygiene supply, sewerage, road access and security options for health facilities. These are critical services that must be maintained even in emergency conditions.
• Store stockpiles of medical supplies and equipment in hazard resistant buildings, e.g. outside of floodplains, and in areas that will be accessible during a disaster. All medical staff and community health workers must have sufficient training in personal protective equipment, and disease identification protocols.

Rethink emergency sheltering practices during a pandemic

• Pre-identify shelters with an understanding of the local risk landscape and how COVID-19 will amplify these risks. It will likely be unsafe to proceed with traditional safe shelter practices during the pandemic. Furthermore, designated shelters may have been repurposed to house COVID-19 patients.
• Provide temporary flood shelters for communities that do not have sufficient sheltering, adhering to public health pandemic guidelines like those provided in the IASC Interim Guidance. 
• Disseminate clear guidance on how low- and high-risk populations should shelter during a disaster while the pandemic is ongoing and in light of physical distancing and shelter-in-place rules. For example, are low-risk people expected to shelter-in-place despite rising waters in their homes? Where can high-risk people seek emergency shelter while also reducing their risk of contracting COVID-19?

Plan for recovery

• Recognize the impact on livelihoods and start thinking now about how to help communities, including businesses, get back on their feet. Working with local markets post-disaster can drive recovery and have a multiplier effect by injecting cash into the local economy, improving access to finance, providing economic opportunities for affected individuals, and protecting local networks and social capital. Consider how to incorporate Market Approaches to Disaster Recovery.

There are many other considerations we should be thinking about, so please share your thoughts below using the comment function. The urgency to use humanitarian funds effectively has never been greater. However, this is a new, rapidly evolving situation, and as in every crisis, we have a lot to learn. Sharing lessons learned quickly is key to making sure that we act in ways that save lives and build resilience globally.