This month, the UCL Warning Research Centre held its first-ever 3-day conference ‘Creating Effective Warnings for All’. In the face of extreme geophysical and meteorological hazards, and the complex interactions of multiple forms of risk, early warning systems (EWS) are crucial for boosting preparedness and emergency response to mitigate disasters rooted in everyday social conditions. Here are four key takeaways from the conference.
Panel discussion at the WRC conference. Photo by Ilan Kelman.
Integration
EWS extend beyond the technical mechanisms for alerting people about emergencies, such as sirens and instant notifications. Early warnings need to form part of an integrated process that strengthens multi-hazard education, risk perception, risk communication, and preparedness measures. This can help shift disaster management from being reactive to increasingly proactive.
Inclusivity
For EWS to be effective, they must be inclusive, incorporating local stakeholder knowledge. This type of approach recognises specific vulnerabilities and capacities for disaster risk reduction among communities. Solutions must be context-sensitive, resources need to align with needs, and projects need to be structured around participatory processes to determine what works, where, and for whom.
Timing
Timeframes are key, whether we are in a moment of disaster or in ‘peace time’. Norms can become entrenched in times of intensified uncertainty; however, disasters can also provide a transformative moment to reassess existing structures and emergency protocols. Equally, we should harness the time in between crises to strengthen preparedness frameworks and collaborative networks for future resilience.
Creativity
Creativity is a powerful tool for rethinking existing solutions or imagining new ones. Cartoons, graphic recording, cardboard theatre, acrobatics, and interactive workshops were among the creative approaches used in the conference sessions, encouraging exploration of interconnected themes, such as climate change and mental health.
Pauliina Vesaluoma recently completed the MSc in Risk, Disaster and Resilience at IRDR (2022/23). Natural hazard preparedness, volcanic risk reduction, and future resilience are among some of her main interests. Pauliina is currently undertaking a Business Resilience internship at Holcim.
The COVID-19 pandemic has posed major challenges to public health systems across the world. Meanwhile, vaccination has been developed and delivered at record speed, while its application has been limited by vaccine hesitancy, which refers to “a delay in acceptance or refusal of vaccination despite the availability of vaccination services”, defined by the World Health Organization (WHO) strategic advisory group of experts (WHO SAGE). This can be due to various reasons at various levels, such as misinformation, lack of trust in the healthcare system, or personal beliefs and values. It is a complex problem, resulting in challenges in understanding and designing targeted interventions to solve it.
A venue for all
The 16th Vaccine Congress held in Italy aimed to address vaccine-related issues and to build health system resilience by discussing the latest advancements in vaccine research, development and implementation. The congress brought together leading experts from the fields of vaccinology, public health, medicine, epidemiology, and social sciences, who discussed the challenges posed by vaccine development, vaccine delivery and vaccine hesitancy and ways to overcome them.
As one of the early career researchers in vaccine hesitancy, it is a great opportunity for me to discuss this issue with researchers from other backgrounds and understand the hesitancy problem through a broader lens. During the conference, our discussions centred around the importance of promoting accurate information about vaccines, improving communication between healthcare providers and the public, and increasing public trust in the healthcare system. In addition, we also discussed whether vaccination is actually safe and what kind of vaccination is safer. Admittedly, these questions were hard to answer and the only reliable evidence is the data from RCTs (in short term). However, it opens a new way for understanding the vaccine hesitancy problem – the vaccine itself has created the ideal conditions for mistrust to thrive, due to its complexity and variability of development and evaluation. To solve this problem, more collaboration is needed between experts from vaccine R&D, health education, behaviour science and more.
Introducing my research to other peers
The role of social media
One of the most-impressed presentations was “addressing vaccine hesitancy: integrating the Vaccine Trust Gauge and effective communication to advance confidence and uptake”, given by Prof Scott Ratzan, from CUNY School of Public Health and Health Policy. His speech highlighted the role of media in shaping public perception of vaccines and emphasized the need for health organizations to engage with the public and correct misinformation about vaccines on mass media and social media. In particular, social media platforms have become a major source of information for many people, and the spread of false information about vaccines on these platforms can lead to confusion and fear. In turn, this can lead to lower vaccine uptake and increase the risk of outbreaks of vaccine-preventable diseases.
However, the role of social media in shaping public perception of vaccines is crucial, and it is essential for health organizations to engage with the public on these platforms. Health organizations can use social media to correct misinformation about vaccines, provide accurate information, and address the concerns of the public, which is the way to build public trust and increase vaccine uptake. It can also be used to promote positive stories and experiences of people who have been vaccinated. By using social media in a proactive and strategic way, health organizations can counter the spread of misinformation about vaccines and help to increase public understanding of the importance of vaccination.
Slide summarizing our challenges for building vaccine trust, presented by Prof Scott Ratzan
Admittedly, it is also important to note that social media can also be used to spread false information and to promote anti-vaccine messages. Health organizations must be vigilant in monitoring social media and must take action to counter false information and misinformation. They can do this by partnering with trusted sources, such as public health organizations and scientific institutions, to provide accurate information about vaccines.
Challenges at community-level
Another key area of discussion was the importance of involving communities in the decision-making process about vaccines. In the second day of the conference, a roundtable discussion was held to make the statement on multisectoral actions for building trust to promote vaccine acceptance. I was fortunately involved in the discussion and shared my opinions. The discussion emphasized the need for health organizations to listen to the concerns of the public, provide clear and concise information about vaccines, and involve communities in the planning and implementation of vaccine programs. The challenges for addressing vaccine hesitancy at the community level includes:
Misinformation and distrust: The spread of misinformation and false information about vaccines can lead to confusion and distrust among the public. This can be particularly challenging for health organizations, as people are often exposed to a large amount of information from a variety of sources, including social media, friends, and family.
Personal beliefs and values: individuals may have personal beliefs or values that conflict with getting vaccinated. For example, they may believe that vaccines are unnatural or harmful, or that they are not necessary.
Lack of access to accurate information: communities may not have access to accurate information about vaccines, or may not understand the benefits of vaccination. This can lead to misunderstandings and reluctance to get vaccinated.
Healthcare provider distrust: individuals may not trust healthcare providers or the healthcare system, which can make them reluctant to get vaccinated.
Barriers to accessing vaccines: communities may face barriers to accessing vaccines, such as poverty, lack of transportation, or limited access to healthcare.
Resistance to change: individuals may resist getting vaccinated because they have always lived a certain way and are resistant to changing their habits or beliefs.
To address these challenges, several discussions were made between experts from different background, including researcher, healthcare workers, vaccine company staff, community workers and the public. They provided many insightful strategies to solve this problem. A statement paper proposed the framework for engaging multiple sectors for building vaccine trust was under preparation and will be published following the conference.
The congress also discussed the importance of providing equitable access to vaccines, particularly for marginalized communities. The speakers emphasized the need to address the root causes of vaccine hesitancy, such as poverty, lack of education, and poor access to healthcare, in order to ensure that everyone has access to vaccines.
Strengthen health system resilience
The congress also highlighted the importance of building a strong health system in order to improve vaccine uptake. The speakers discussed the need for investment in health systems to increase access to vaccines, improve the quality of care, and ensure that health systems are prepared to respond to the next public health crisis. It provided a new way for me to reconsider the role of my research in the health system and DRR.
Firstly, vaccine hesitancy can have a significant impact on the health system, both in terms of public health outcomes and healthcare costs. When individuals are reluctant or refuse to get vaccinated, it can lead to outbreaks of vaccine-preventable diseases, which can put vulnerable populations, such as the elderly, young children, and individuals with weakened immune systems, at risk. Outbreaks of vaccine-preventable diseases can also put a strain on the healthcare system, as more resources are needed to diagnose and treat cases and to control the spread of the disease. Secondly, vaccine hesitancy can lead to increased healthcare costs, as individuals who are not vaccinated are more likely to require medical care, including hospitalization, for vaccine-preventable diseases. This can put a strain on healthcare budgets, particularly in resource-limited settings, and can divert resources away from other important healthcare needs. In addition to the impact on public health and healthcare costs, vaccine hesitancy can also undermine efforts to achieve herd immunity, which is critical for controlling the spread of vaccine-preventable diseases.
Overall, attending the 16th Vaccine Congress was a valuable and enriching experience for me as a PhD student. It provided a valuable opportunity to deepen my understanding of the current challenges and strategies for addressing vaccine hesitancy. During the conference, I had the opportunity to listen to leading experts in the field, and to engage in discussions with other researchers, healthcare professionals, and policymakers. This helped me to gain a comprehensive understanding of the current state of knowledge on vaccine hesitancy, and to identify areas for future research and inquiry, and enhance my own PhD project. I am grateful for the opportunity to attend this important event, and I look forward to continuing to engage with others in the field to advance our understanding of this important issue.
I would like to gratefully acknowledge the China Scholarship Council and University College London for funding my PhD study and the UCL Institute for Risk and Disaster Reduction for funding the expenses for me to attend the 16th Vaccine Congress in Italy.I would like to appreciate my supervisors Prof Patty Kostkova and Dr Caroline Wood for providing guidance to support my PhD research.
Lan Li is a PhD student at IRDR dPHE. Her research topic is integrating behavioural science into digital intervention to increase vaccine confidence. She is interested in social media research, digital public health, and vaccine hesitancy studies.
This event, chaired by Lisa Guppy, explored whether humanitarian organisations are ready to be part of the solution to the climate crisis. The key debate was how to provide timely and principled assistance with minimal environmental impact. By bringing together panellists from a diverse range of humanitarian backgrounds, this event provided a forum where two crucial questions could be answered – does the shelter sector have the will and capacity to be part of the solution? And, more importantly, is the sector even prepared to respond to the impending shifts in climate?
Aditya Bahadur opened the discussion by identifying the key shifts that the shelter sector will have to contend with. Although it is no secret that extreme climate-related events are on the rise, it is also important to acknowledge that these events are increasingly occurring both simultaneously and across boundaries. Due to urbanisation and the hyper-densification of our social and economic networks, disturbance in one place can lead to disaster in another – creating a ripple effect of crises. One way Bahadur suggested that the sector should address these shifts was by reforming data collection and planning approaches. Existing methods of data collection have severe issues with certainty and specificity, and a fresh perspective on big data could form the basis for a more effective approach. Bahadur also suggested bridging the disconnect between local and national response and focusing more on adaptive management rather than hard infrastructure. Local, regional and national approaches need to be scaled-up and brought together, particularly regarding municipal planning which needs to be much more informed by residents in informal settlements. Streamlining humanitarian finance is essential if these novel approaches are to be tested and implemented successfully.
The next speaker was Amelia Rule, who emphasised the need to unravel the narrative that high-tech innovation is the solution to shelter challenges. Instead, we should look to what already works in the shelter sector – such as hosting, which has already played an immensely important part in the ongoing Ukrainian crisis. Focus on high-tech innovation often overlooks scale, suitability and adaptability in local contexts. While Rule acknowledged that innovation is important, she emphasised that the solution is to build on pre-existing expertise. Problems with shelter must be looked at contextually; there is no clear-cut, ‘one-size-fits-all’ solution that can be applied in all contexts across the globe. Rule also dismissed the prevailing sentiment that migration is inherently negative; the benefits of migration and hosting need to be promoted. Hence, migration must be reframed as a sustainable and even desirable method of coping with climate change rather than a last resort.
Magnus Wolfe Murray (left) and Kate Crawford (right) at the HI Evening Conference. Photo by Ilan Kelman.
Magnus Wolfe Murray was incredibly strong in his conviction that the shelter sector is woefully underprepared to cope with the changing climate. Some of the complications he discussed included the difficulty in determining when a person has migrated for climate-related reasons, given there are often multiple intersecting factors involved. For instance, a person may claim that they migrated for economic reasons because they could not find work where they lived. But upon closer inspection, it may become clear that they migrated for climate-related reasons because drought prevented them from earning an income via their agricultural work. Wolfe Murray also argued that while there is increasing talk about adapting the shelter sector for climate change, there is not enough preparation being undertaken in the field. Material supply chains, particularly regarding bamboo, are currently very weak and resources are being used in a way that is not sustainable, even in communities where humanitarian support is present. It has become undeniable that environment and landscape management are intrinsically intertwined with individuals’ homes and the shelter sector. Thereby, these two cannot be separated or viewed as a dichotomy.
The final speaker, Kate Crawford, built on arguments from the panellists and described how built infrastructures embed systems of privilege and bypass. She primarily discussed difficulties with investment in the shelter sector, including finding ways to get money to flow to risky projects. There is almost always a web of invisible confidence-inducing assurances that are at play when investors decide to spend money on shelter. The important distinction is that it is not risk that investors have a problem with, but rather unquantified risk. If we could measure how effective different shelter solutions are in an objective and quantifiable way, then investors would be more willing to commit funds to the cause. Crawford also suggested looking internally for solutions rather than always focussing our attention overseas. Measuring and retrofitting housing in the UK, for example, can be very beneficial for improving shelter policy and infrastructure.
The event concluded with a Q&A. Several questions from the audience asked whether there are any positive shifts in thinking when it comes to shelter-related solutions to climate change, and if humanitarian actors are ready to make this a priority. Panellists suggested that half the battle is for humanitarian actors to be reflective of their impact on the environment and hold themselves accountable, and we are already beginning to see this. However, there is not much evidence of sustainable solutions currently being employed at scale. Rule suggested there is also a risk that ‘greening’ the response is a tick-box, performative exercise that does not actually translate into real change. The humanitarian community needs to work together to have a collective front, rather than applying for different funding opportunities and experimenting with solutions in a competitive manner. The will for change is there, even if we are not seeing this change being enacted on a large scale. Despite Wolfe Murray’s concern about the scale of seismic change that is approaching, and the unprecedented migrant crisis that will most likely follow, he still believes there is reason for hope. An example he gave was the great success in restoring fertility to the Loess Plateau in China. This shows that the tragedies which arise from climate change are not inevitable and there are models that already exist which can rehabilitate damaged eco-systems. Overall, the shelter sector is not yet ready for the challenges ahead, but if the humanitarian community works together to overcome these issues, then perhaps the future will not be as bleak as our panellists have predicted. It was evident from discussions amongst the panellists and attendees that systematic change and transformation is possible if we act together, and we act now.
The event was live-streamed and you can watch the video here on the Institute for Risk and Disaster Reduction YouTube channel.
Evie Lunn is a BSc student at IRDR. Contact at: evie.lunn.21@ucl.ac.uk
If you missed it, last summer UCL Institute for Risk and Disaster Reduction (IRDR) and the Warning Research Centre hosted an online conference exploring Why Warnings Matter. A varied day’s activities full of stimulating discussion with questions from the audience, the IRDR’s 11th Annual Conference has left much to be reflected upon—as well as launching the UCL Warning Research Centre.
This blog is part three of a series presenting the key findings from the conference proceedings. Today we get a glimpse of Dr Oliver Morgan and Dr Gail Carson in conversation with Andrew Revkin, discussing global public health in the COVID-19 pandemic.
The rapporteurs whose notes form this material are Calum MacKay and Simone Phillips, who are both from the University of Glasgow on the MSc Earth Futures Programme. Any mistakes or misrepresentation of the participants’ words are the author’s own.
Part Three.
“In Conversation”
with Dr Oliver Morgan, WHO, Dr Gail Carson, GOARN,
and Andrew Revkin
Oliver Morgan is the Director of the Health Emergency Information and Risk Assessment Department in the WHO Health Emergencies Program.
Gail Carson is Director of Network Development at the International Severe Acute Respiratory and Emerging Infection Consortium.
Andrew Revkin, moderating this session, is an environmental journalist and is the founding director of the Initiative on Communication and Sustainability at Columbia University’s Earth Institute.
Key points of the session
The session started off with a question being posed to the presenters that asked what was keeping them up at night that was a threat or opportunity that was not being assessed properly. Their main fears were seeing high proportions of disease and death in children alongside the manifestation of under-resourced countries being last in dealing with major risks. The key example of this would be vaccine disparity. A pattern that is consistent across the globe with systems having bias to those who are more capable. Communities that are affected by infectious diseases and other events are often the poorest and most disadvantaged, so they therefore struggle to recover, the impact is long lasting and generational. With COVID-19 we are going to see this in a societal and educational context. Another main challenge is to keep up with a lot of the information that’s been being generated. So, the more we learn, the more interconnected we are, the more information there is about what’s happening in the world. However, in many ways we can get overloaded with that information, and it’s circulating in different media through different communications channels. From this we have to determine what information is of major concern and how to effectively deal with it.
There are so many competing priorities it’s incredibly hard to prioritise action. We need international networks to collaborate effectively so we can be effective at the ground level and listen to local people’s priorities, needs and frustrations to build trust and capacity to recover from events. When working at ground level it is also vital to have teams with people from multiple disciplinary backgrounds. This allows us to take into account all aspects of a community’s needs and generate successful collaboration and coordination.
To achieve this, we also must invest in infrastructure that facilitates transdisciplinary work. Pandemic responses are always difficult as they are typically controlled at a community level all of which are incredibly unique and variable. We must recognise and embrace the diversity of information and peoples’ different circumstances that is gathered from unique public health systems. By combining this information with the use of our social media channels we can shift public health away from an era of traditional surveillance to one that uses and embraces collaborative intelligence. This is where we take information from different parts of our society and different levels of science, to understand what the risks are, and to assess them. By having that engagement upfront, you have a much better way of interacting with your communities when you need to. The lack of community engagement was a huge issue in the UK in its response to COVID-19.
If we’re taking a much more expansive and holistic approach to understanding risk, then our workforce needs to change. We need to value different skill sets, whether they’re from the more community-based skill sets, sciences with a more community-based focus, or whether they’re data science skill sets. One of the grand challenges, therefore, that we now face in public health is that in the contemporary, larger, and interconnected world, we don’t have a contemporary workforce that successfully interacts with all of those different parts of our society. With COVID-19 we can learn some of these lessons, make those investments, and communicate with our governments about what those investments should be. We must think about younger people who are coming into their professional lives, and we need to have a much more broader approach to public health.
We have become sideloaded into specialties in our work. We need to have an interdisciplinary conversation. Collaboration is vital—working together and listening to each other. We need to be better organised to enhance communication and that organisation must be bottom up, middle, and top down. Citizen engagement is therefore key to all of this.
Questions and Answers
If you had an unlimited budget, what two things would you spend on to make things better?
Oliver
The more open we are with communication and passing information, the more benefits there are. That’s what I would change. I think those benefits far outweigh any perceived disbenefits from open information and I think that it’s not a financial thing, it’s more of a change in our collective mindset that is actually for our collective benefit. Whether that’s in environmental space, or health space or any other space, in the longer term this is going to be much more beneficial for all of us. The global-good view on public health is something that we should really embrace coming out of the pandemic.
Gail
I would probably try and pull in the experience on IP [intellectual property] and data rights. Not just IP, but the associated data rights. It would help to make sure that those who are less fortunate than some of us in the West can have access to supplies and treatments. Whether it’s accessing therapeutics or vaccines etc. a lot quicker. Obviously, there are issues with the manufacturing capability and all the supply chain issues that have to go with that. But if I was to choose one thing it would be for the lower middle income countries securing IP and data rights.
Are you guys excited about the future of public health due to the increased interest from governments due to COVID-19 or do you think it’s a false dawn?
Oliver
It is hugely exciting and very promising looking forward. There has been a huge increase in public health literacy. Citizen science is a vital positive step, that pushes all of us to engage in issues in a much better way.
Next up and the final blog of this series is the second panel discussion from the conference proceedings: Warnings for Organisations. Subscribe to be in the know!
Don’t forget, last time we presented the keynote speech from Mami Mizutori, the Assistant Secretary-General and Special Representative of the Secretary-General for Disaster Risk Reduction, United Nations Office for Disaster Risk Reduction (UNISDR).
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