There is not one standardised approach to infectious disease outbreak responses and context adaptation is important. Irrespective of what your organisation decides to do, we recommend that you use these three principles to guide your work and ensure it remains relevant and that you minimize harm.
Outbreaks of infectious diseases typically bring about huge amounts of rapidly emerging information, particularly at the start of an outbreak. Below we include some advice from our first key principle: stay informed.
Identify key information sources: We recommend regularly checking the websites of your National Ministry of Health, World Health Organisation, and the Centres of Disease Control and Prevention. Following these organizations on social media (Facebook, Twitter) will also allow you to stay up to date on recent news and updates.
Check information before you act on it: If you see a surprising news story; don’t immediately assume it is true. Take time to look at the sources it is using and see whether that same information is reported elsewhere. If you are unsure, it’s best to rely on major international media sources as these will have had to have gone through a range of validation checks prior to publication.
Plan to adapt your programme: When designing a response programme you will need to make decisions without perfect evidence to back it up. It’s important to continue to pay attention to new information and adapt your programme based on this.
Involve others and stay connected
In order to reduce transmission of infectious disease outbreaks, we need to act fast and at scale. To do this, we need as many people and organisations involved as possible. Our second principle is: involve others and stay connected.
Below we recommend some practical actions for involving and coordinating activities where possible:
Identify people in your existing networks who you could partner with. This could include businesses, community leaders or social and religious organisations. Remember that for businesses, their most important asset is their staff, and that social groups couldn’t exist without their members. This is the time where they can show that through clear actions.
Identify where partners can add value: When you are working with different stakeholders, get them to focus on their employees or community first. For instance, depending on your focal disease, you might set up handwashing facilities at the entrance to buildings and in places where they meet. Then get them to think about the various ways they could contribute to your work. Local groups and businesses can provide financial support if that is what is needed, but partners can also contribute to your response through skills sharing. Examples of useful skills could include graphic design, media development, IT skills, and website design.
Set up communication channels: When you are working with others, make sure to set up communication channels for you to stay in touch should it not be possible for you to meet in person or work from an office. Mechanisms may already exist to support this in your country. For example, countries commonly affected by crises often have a National WASH Cluster and the Global Handwashing Partnership has established national handwashing partnerships in many countries. Establishing localised communication channels to bring together key leaders within your community is advised so that you can continue to learn about what is working and share information. For more guidance on selecting the right communication channel, see our resource here.
Learn from and build on local community action: Communities will develop their own coping mechanisms in response to infectious disease outbreaks. Make sure you take time to establish mechanisms to learn from your communities about what is working well and use this to shape and adapt your organisation’s work.
Align your work with the national response
Many organisations and individuals are motivated to play a role in response during outbreaks. However, it is important that all efforts are coordinated and adapted to your context. During a pandemic such as COVID-19, each country will typically be facing a different stage of the outbreak and will have a different set of national or local control measures that have been enacted. Therefore, our third principle focuses on aligning your work with the national response.
Below we recommend some practical actions to ensure that your work is consistent with national guidance and responsive to the situation in your country.
Be familiar with the government strategy and current guidelines. Normally these guidelines will be widely available or can be found via the Ministry for Health. Countries might also be encouraged to share their plans more widely. For example, this website has an archive detailing how each nation responded to the COVID-19 pandemic between 2020 - early 2022. It is also important that staff within your organisations adhere to national guidelines since they will often be involved in role-modelling good behaviours during their work with communities.
Be aware of what stage of the response your country is in. During outbreaks, the WHO will define the phase and response depending on transmission data. For instance, during the COVID-19 pandemic, the WHO defined 4 levels based on localised patterns of COVID-19 transmission. Organisations should be encouraged to put together a plan for how their work will be adapted at each one of these stages. There are also several global data trackers so that you can keep up to date with confirmed cases and mortality in your region. Here is one data tracker for mpox and another for COVID-19.
Identify high risk areas. Not all areas of a country are at equal risk during infectious disease outbreaks. For example, many infectious diseases spread more rapidly in areas with high population density, such as informal settlements in urban areas or displacement camps. If these settings exist in your country it makes sense to try to prioritise prevention measures in these settings. For more guidance on disease programming in camp-like settings, see our resource here.
Assess the risk locally and based on your organisational capacity
Our fourth guiding principle is take time to assess risk and err on the side of caution. Make sure that you are not putting your staff or communities at risk through your programming. Below are some practical tips for mitigating risk. Note that this section was written with COVID-19 preventative measures in mind, though certain activities will be applicable to diseases with similar transmission pathways:
1. Avoid community gatherings: During COVID-19 outbreaks, we would recommend that all response programmes avoid using large community gatherings. If, through assessment, you identify that there are no other ways of reaching a community, then you could consider organising events where people are physically distanced (such as in the image below where circles have been marked out with coloured sand).
2. Make a context-specific decision about household visits: In many countries, household level visits may be safe to conduct, but before doing this, make sure to first follow government advice and guidelines and to assess the risk locally. If your staff are in communities, make sure they have the ability to practice hygiene regularly and that they maintain physical distancing. You can find out more about how to do this safely in this brief.
3. Focus on mass media, social media and handwashing infrastructure: Identify or establish ways of reaching populations if in-person work is not possible. This could include radio, television, social media or text messages. Creating handwashing infrastructure will also be key. You can find out more about how to do this here.