ECDC role in Public Health Event (PHE)

The overall aim of ECDC during a PHE is to minimize the impact of the crisis on EU citizens, by assisting the MS and the European Commission in their response activities. This is achieved by: 

• Providing access to, adapting or developing background documentation, scientific documentation and investigation & response guidelines;
• Providing risk assessment, scientific advise and recommendations on control measures based on scientific evidence;
• Ensuring EU-wide coordination of risk assessment activities; 
• Supporting MS, upon request, in response activities;
• Communicating on risk to constituents, partners, media and the public.
• Guiding principles to PHE management

An emergency is an exceptional event that exceeds or potentially exceeds the capacity of normal resources to cope.

Events become emergencies based on two factors: the volume of work to be performed and the time in which the organization must respond.  The event may be sudden and unexpected, as in a local outbreak of communicable disease, or slowly evolving as in a disease pandemic. The term “Emergency” is used in the PHE plan as a concept that relates to the context in which it occurs. This depends on many variables that make superficially similar events quite different from each other, and they include such factors as magnitude, location and impact of the event; availability of human and material resources to address it; mandates, strengths and limitations of emergency response and management agencies; degree of resilience in individuals, agencies and social systems; and other factors that contribute to the uniqueness of each situation. “Crisis” has a broader meaning and relates to events which are, or may become abnormal, the management of which requires the allocation of specific resources and a clear set of organisational arrangements.

During crises, the volume of work increases radically, while the time available for processing and decision making is greatly reduced. As a result, organizational structures and communication links, which are adequate under normal conditions, are overwhelmed.

In order to ensure an efficient response to PHE, the following guiding principles are enforced:

• Normal operations regarding core ECDC missions must continue, although their level of priority may be adjusted;
• A PHE manager concentrates technical leadership and team coordination;
• Core staff in each component of the PHE management structures should be entirely dedicated to crisis management and be relieved from their normal duties;
• All strategic decisions should be taken under the oversight of the ECDC Director;
• All communications with constituents, partners, media and the public should be done in accordance with the emergency communication plan;
• - PHE objectives, processes and tasks are geared towards outputs.

ECDC had developed its Public Health Event Operation Plan in 2006 and the document sets out arrangements for dealing with crises at ECDC. It is designed to fit within the framework of Business Continuity Planning being developed in ECDC, and to have interoperability with other institutional plans involving European Union public health bodies. It includes: 

• Reference of the plan with other plans, guidelines and Standard Operating Procedures
• Impact criteria of an event for decision-taking on the allegiance of resources
• The mechanisms for alert and activation
• The set up of a dedicated PHE management structure
• The preparedness steps and the role of the Emergency Operation Centre

This PHE Plan is a development of practice of management determined by the strategic guidance of ECDC Governance cycle. ECDC Governing bodies interpret and set the strategic direction of the agency. The plan describes the specific organisational arrangement to cope with a crisis, and give directions to ECDC Units’ crisis specific plans. Guidelines on how to deal with specific threats have also reference to the overall PHE plan. The operational aspects of the plans are set out in Standard Operating Procedures, the use of which guide ECDC and associated experts on the response to public health events. The evaluation of the management of specific events (lessons identified) should provide ECDC governance with further input on how to redirect the strategic planning of ECDC activities. This PHE Plan, as well the SOPs applied in ECDC, has to be interoperable with similar plans in Member States and at European Commission. 

Emergency Operation Centre (EOC)

The set up of a dedicated PHE management structure was defined since the implementation of ECDC and in in  June 2006, the ECDC EOC became operational.  Is located on the ground floor and it is made of 5 main rooms: 

• An  Operations Room is the hearth of the EOC and upon an PHE hosts the EOC Management Group and the coordinators of the Operational Groups.
• An Internal Decision Room to be used upon an PHE by the Strategic Team and for briefings with the  Director.
• Two Functional Rooms that will hosts daily activities of the Operational Grioups upon a PHE.
• A Briefing Room that can be used for daily briefings with operational groups. It can host up to 25 people.

The ECDC EOC is operated in normal circumstances by the Preparedness and Response Unit. Daily epidemiological briefings are held in the EOC. Since its inauguration the EOC has been activated to respond to a real PHE occurring in 2007 as well in simulation exercises. ECDC participates in EU-wide exercises and other international public health crisis simulation exercises. Participation in such exercises is followed by an internal evaluation of the plan and adjustments implemented subsequently. A yearly internal ECDC exercise is conducted and evaluated.

EOC Country missions

In 2007, following ECDC invitation to various MS to share information on their different levels of preparation and development in the area of responding to a crisis during a public health event, some country missions to visit emergency facilities at National Institutes were planed. In 2008, the Emergency Operations Centre (EOC) team started to visit MS  in order to improve levels of knowledge and exchange experiences. The visit mission represents opportunities to facilitate collaboration in the field of activities required to support the response to a crisis during a public health event (epidemic intelligence activities, plans, SOPs, facilities, equipments, communication tools, etc).

The missions to visit local structures are based on the following areas: 

1. Generic preparedness for crisis: a basic description of ECDC crisis team: training, profile and tasks of team members.
2. National collaboration: country national and regional structure; collaboration levels with the Ministry of Health or other National institutes; collaboration with other bodies involved in crisis (civil protection, etc.)
3. Crisis facilities: specific facilities available for use during a crisis (Emergency Operation Centre, crisis room, etc); availability of systems equipment, e.g. videoconference, teleconference, etc ; logistics to be used during a crisis.
4. Epidemic intelligence procedures: ECDC Epidemic Intelligence procedure; daily procedures (routines, sources of information, strategies, geographical and temporal focus, criteria, reports, documentation, 24h/7d duty system).
5. Public Health Event (PHE) plan: plan to deal with the crisis in Public Health; plan organisation and  command structure; integration  with any other Business Continuity Plan ; mobilisation of resources; team deployment to the field and types of equipment resources available for this purpose.
6. Tools: tools used for the threat detection and threat tracking.
7. Training.
8. System evaluation: availability of internal evaluation processes; simulation exercises, plan and revision of procedures on a regular basis.
9. Documentation: types and purpose of documentation used e.g.:  reports, forms, templates, checklists, etc.
10. Visits are planned for several countries in 2009.