Epidemic and pandemic preparedness and response in a multi-hazard context: COVID-19 pandemic as a point of reference

Abstract Background Infectious diseases which manifest in the form of epidemics or pandemics not only cause devastating impacts on public health systems but disrupt the functioning of the entire socio-economic architecture. Further, risks associated with pandemics and epidemics become exacerbated with coincident compound hazards. The COVID-19 pandemic highlighted the need for a broader understanding of cascading and systemic challenges posed by epidemics and pandemics amidst compound hazards. This study explains key elements and components of epidemic and pandemic preparedness and response systems, aligned to key interventional phases, focusing to a multi-hazard context. Methods A systematic literature review was used to collect data through peer-reviewed journal articles. Manuscript search was conducted using three electronic databases: PubMed, Scopus and ScienceDirect. Thirty-eight research papers were included in the analysis and 17 experts were involved in the validation, which was conducted using three rounds of consultative meetings and a validation workshop. Results Epidemiological surveillance and early detection, risk and vulnerability assessments, preparedness, prediction and decision making, alerts and early warning, preventive strategies, control and mitigation, response, and elimination were identified as key elements associated with epidemic and pandemic preparedness and response systems amidst a multi-hazard context. All elements appear integrated within three interventional phases, identified as upstream, interface and downstream that are dedicated to specific interventions, ranging from decision-making to disease elimination. A conceptual framework on epidemic and pandemic preparedness and response systems was developed capturing key elements and interventional phases that relate to several epidemic and pandemic stages. Conclusions A holistic approach with a focus on all interventional phases is required for preparedness and response to pandemics and epidemics to counter their cascading and systemic effects. Further, a paradigm shift in the preparedness and response for multi-hazards during an epidemic or pandemic is essential due to the multiple challenges posed by concurrent hazards.