Scenario-Based Pandemic Preparedness and Response SOP Development in
Relation to the SASOP-AADMER Framework: a quick analysis of the proper
approach
The provisions and procedures contained in the SASOP are generally applicable to any disaster,
particularly disasters that cause physical damage to utilities/infrastructures and where search
and rescue efforts are primarily required. When confronted with an epidemic or pandemic, the
SASOP provisions are generally applicable, but some provisions need to be modified, or
additional provisions need to be specified, according to the unique characteristics of epidemics
and pandemics that are briefly described below.
Epidemics and pandemics, unlike other hazards, do not occur suddenly as a widespread event.
An epidemic originates and evolves from an index human case/s, or sometimes from infections
that jump the species barrier- e.g. from poultry to humans in the case of avian influenza. A
pandemic is a potential outcome of an epidemic. These disease outbreaks are continuously
progressing and developing, and early detection systems (surveillance) may be in place to
monitor progression, which may be slow (6 years now for avian influenza, from 2004) or rapid
(6 months from an epidemic to a pandemic in the case of the A/H1N1 2009 pandemic). While
epidemics could be confined within communities or an entire country, and could terminate
with the disease in question becoming endemic, pandemics are expansive—i.e. transboundary
and spread-out across several countries and continents, and may prevail with occurrences of
waves for several years.
The direct impacts of epidemics and pandemics relate to the spread of the infectious agent that
may cause mild to severe illnesses (morbidities) and few to numerous deaths (mortalities and
fatalities) among human populations. The segments of the population affected could vary—for
instance according to the age-predilection of the infecting agent (targeting the young and the
very old), the natural susceptibility of individuals (targeting the malnourished, the obese or
those with predisposing ailments and conditions), or according to the vulnerabilities of people
and communities (targeting the poor, homeless, drug addicts or the sexually promiscuous). The
occurrence of successive illnesses and deaths could lead to various indirect impacts, including
inciting societal panic that causes people/families to impose self-isolation. When severe
(resulting in expansive transmission, high morbidities and fatalities), the over-burdening of
healthcare services and auxiliary functions/operations (e.g. surveillance and diagnosis, supply of
medicines) is anticipated to occur, and the delivery of essential services to communities may be
severely paralyzed due to massive absenteeism. Aside from people imposing self-distancing,
restrictions on people movement and gathering will be imposed by authorities. A severe
epidemic that threatens to cross regional boundaries will urgently incite responses from
unaffected neighboring countries to deal with cross border transmission risks. A pandemic
affecting the entire region may have each country addressing their respective emergencies that
trigger similar needs for external assistance (relief), such as provision of additional healthcare
equipment, supplies and workers/providers, and possibly provision of essential supplies such as
food, water and goods and other services for operations and business continuity, and provision
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of human capacities necessary to ensure continuity of essential operations such as
telecommunications, transportation, and power-water supply-generation.
Considering the above scenario therefore, it can be surmised that in relation to the SASOP, the
types of Assets and Capacities that may be requested for or set as stockpiles during an epidemic
or pandemic require further specification. The roles/types of military assets and capacities
require specification as well. In the assessment of epidemic or pre-pandemic situations to
determine appropriate assistance needed by a country, the role of the Joint Emergency Rapid
Assessment Team (ERAT) may be assumed through the recently endorsed arrangement
contained in the ASEAN Minimum Standards on Joint Multisectoral Outbreak Investigation and
Response (MSJMOIR), in close coordination with WHO’s activation of its Global Outbreak Alert
and Response Network (GOARN). It also appears that additional provisions to the SASOP are
necessary to deal with the following issues (considering other issues): 1) cross border
negotiations (e.g. testing and quarantine of travelers), and 2) ensuring interdependencies for
operation continuity (e.g. expediting the supply of essential commodities, and delivery and
trade of goods and services). It is also necessary to specify the procedures in the delivery of
assistance cognizant of the need to observe public health precautions when and where
necessary. As a pandemic is a sequel to an epidemic, responses directed to an epidemic should
also be planned in the context of directing responses to a pandemic threat.
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