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Panel 200 - Opening Plenary: Leveraging Data for Science Advice and Rapid Response to Health Emergencies

Conference Day: 
Day 1 - November 13th 2019
Takeaways and recommendations: 

Opening Plenary: Leveraging Data for Science Advice and Rapid Response to Health Emergencies

Organized by:  Office of the Chief Science Advisor of Canada 

Speakers: Rolf Heuer, Chair of the European Commission’s Group of Scientific Advisors; Kamran Khan, Founder and CEO, BlueDot; Professor at the University of Toronto; Yasmin Khan, Consultant Physician, Public Health Ontario; Emergency Physician, University Health Network; Assistant Professor, University of Toronto; Sir Patrick Vallance, Chief Science Adviser to the Government of UK

Moderator: Mona Nemer, Chief Science Advisor of Canada 

Takeaways:

  1. Responding to an emergency requires a systems-level effort that is coordinated and integrated.

  2. Trusted sources of information (e.g., advisory committees) need to be established well in advance of an emergency to build effective working relationships within the system and to ensure advice can be provided quickly.

  3. Develop a communications strategy with a designated spokesperson to avoid different people giving conflicting messages. Communicate data and analysis in a way that is relevant and accessible to different audiences (e.g., scientists, government, healthcare workers, citizens). 

  4. Community engagement is essential to building trust and to understand local context (i.e., different communities may have different perceptions of risk).

  5. Be transparent around uncertainty. It is important to present synthesized evidence in a way that is useful to the recipients.

  6. Accessing timely data can be a challenge in emergency situations. Researchers may have that data but be reluctant to share until it’s published in a peer-reviewed journal. 

  7. Once an emergency preparedness plan has been developed test it with regular training exercises. 

  8. Following an emergency evaluate the process so that experience can feed back into evidence-based practice.

  9. Don’t be complacent between emergencies. Focus on preparing for the next emergency. 

  10. No one discipline or organization can tackle complex emergencies. An interdisciplinary approach involving public and community agencies, academia and industry is needed.

  11. When integrating data, consider the relevance of non-traditional sources (e.g., citizen science).

 

Experts share what works and what doesn’t in responding to health emergencies

When a health emergency happens, everyone from government officials and healthcare workers to first responders and citizens need fast access to reliable information that can save lives. And as the frequency of events like wildfires, spring floods and the spread of infectious disease increase, governments at all levels are looking for ways to leverage big data and scientific advice for better decision making.

Canada’s Chief Science Advisor Mona Nemer noted that many of today’s emergencies are making it more challenging to provide scientific advice when it’s needed.

“Complex emergencies require a lot of data and analysis of complex data. Where do we get data from, how do we ensure the integrity of the data and its relevance?” Nemer asked a panel of experts from Canada, Europe and the U.K. 

How the UK accesses science advice

Knowing where to turn for relevant and credible scientific advice is one of the biggest challenges during an emergency. Panelists stressed the importance of establishing clear communications channels well before an emergency happens.

In the U.K., for example, science advice related to emergencies comes primarily through two committees: the Scientific Advisory Group for Emergencies (SAGE) chaired by the government’s Chief Science Adviser (CSA) or a departmental Chief Scientific Adviser, and the Cabinet Office Briefing Room (COBRA), chaired by the Prime Minister or other ministers. At the local level, Scientific and Technical Advice Cells (STACs) provide on-the-ground advice which feeds into SAGE and other coordinating groups. 

SAGE provides integrated, concise and unbiased scientific advice directly to COBRA. The committee’s membership changes depending on the nature of the emergency, but typically includes multidisciplinary experts from government, academia and industry. SAGE has been called upon for several emergencies, including the potential Whaley Bridge dam collapse in 2019, the 2016 Zika outbreak and the 2010 volcano eruption in Iceland that blew a massive ash plume across Europe. 

“Our job is to get advice assimilated as thoroughly and as quickly as we can and turn into that into the practical science advice that needs to be fed into COBRA for people to be able to make decisions,” said Patrick Vallance, the U.K.’s Chief Science Adviser.

Prior to SAGE, Cabinet would often receive different or even conflicting scientific opinions from several sources. “The net effect of three or four pieces of advice occurring during an emergency during a ministerial meeting is that everyone ignores the science,” added Vallance.

SAGE members also help Cabinet prepare for future emergencies with “Golden Hour” documents that provide advice on how to prepare and respond to different potential emergencies. The committee holds simulation exercises to ensure the system can kick into action quickly and effectively.

Other groups feed into SAGE. For example, following the 2011 Fukushima nuclear disaster in Japan, the UK established the Joint Agency Modelling (JAM) working group which advises SAGE on the potential scale and impact scenarios of accidental radioactive releases. JAM is a standing group comprised of several government agencies, including environment, public health, meteorology and food standards. It can provide critical modeling data in a simple visual form within a few hours of an event happening.

“The really important lesson to learn is, don’t try to pull together a group like that during an emergency,” said Vallance. “They need to know each other and how to work together.”

The European model

The challenge is even greater for the European Union (EU) which must coordinate scientific advice across 28 countries. 

Referencing the 2018 report, Science Advice During Crisis, Rolf Heuer, chair the EU’s Group of Scientific Advisors, said the EU “ticks most boxes when it comes to setting up science advice systems during a crisis”:

  • clear communications across national borders

  • trust and understanding between providers and users of scientific advice

  • preparation (drills, mutual learning)

  • communicating science to the public as part of an overall communications strategy

One of the EU’s oldest science advice systems is the Early Warning and Response System (EWRS) of the European Centre for Disease Prevention and Control (ECDC). Created in 1998, this web-based platform links the Commission, public health authorities in member states, and the EDCD to provide rapid and coordinated responses to emergencies related to communicable diseases. 

The EWRS “supports the operation, cooperation and emergency response in almost every sector of EU policymaking,” said Rolf Heuer, who chairs the EU’s Group of Scientific Advisors, a key source of independent scientific advice to the European Commission. 

The EU’s Emergency Response Coordination Centre mobilizes assistance and expertise to ensure the rapid response to countries inside or outside the EU affected by a major disaster. It monitors events in real time using earth observation data delivered by the Commission’s Joint Research Centre. The research centre’s Disaster Risk Management Knowledge Centre also provides a networked approach to science policy that: translates complex science into useable information; provides science-based advice and timely and reliable scientific analysis; and links existing initiatives that contribute to the management of disaster risks.

Practical solutions for Canada

What are the practical, real-world actions that can make public health agencies more resilient and prepared when responding to an emergency? 

“There were system-level challenges that emerged around public health emergencies,” said Yasmin Khan, a Consultant Physician with Public Health Ontario. “The Naylor report (A report of the National Advisory Committee on SARS and Public Health) identified some of these system level challenges such as a lack of research capacity in the clinical and public health systems, difficulty with timely access to lab results, and weak links between public health and the personal health services system.”

Khan set out to identify approaches to support evidence-informed practice that can make public health agencies and communities more prepared and resilient, but soon discovered a lack of Canadian research on the issue. 

“There’s limited literature on this topic and most is U.S.-based,” said Khan, who was an emergency physician in Toronto during the 2009 H1N1 pandemic.

Based on focus groups with 130 public health professionals, Khan developed a Canadian framework for public health emergency preparedness that includes several indicators for measuring preparedness. Among them: governance and leadership to ensure integrated and coordinated system; collaboration within and outside the health system; knowledgeable and skilled staff; community engagement; clear and consistent messaging; and surveillance and monitoring. 

The role of big data and AI 

The private sector and technology are playing a growing role in monitoring infectious diseases that, with airplane travel, can spread across continents within hours. For example, Toronto firm BlueDot uses big data, artificial intelligence, machine learning and natural language processing to predict the worldwide spread of disease and track recent outbreaks.

The inspiration for BueDot came from its founder, Kamran Khan, who was a physician at Toronto’s St. Michael’s Hospital during the 2003 SARS outbreak. “We were all caught completely reactive, off guard and by surprise. The public health system was overwhelmed,” he told CSPC delegates. “If we want to stay in front of these threats we have to move faster.”

Technology offers a solution. BlueDot developed a global early warning system that tracks information in 60 languages in near real-time online. “That’s over 100,000 articles a day, every 15 minutes, 24 hours a day,” said Khan. “It’s automatically extracting the location, the pathogen, the place, the time and contextual factors that are relevant.” 

BlueDot then works with academic partners to cross-reference that information with genomics, demographics, meteorology and other evidence, as well as industry data on air passenger travel, to predict how a disease will move around the globe. The analyzed data are then translated into infectious disease alerts customized for each user’s needs.

Khan’s final message to delegates was to maintain a focus on the future emergency that will inevitably happen. “These are existential threats that can devastate populations, disrupt economies and cause social chaos. So, if I was to say what to focus on, it would be how to get prepared. Maintain that focus.”