Abstract

In response to the onset of the Corona pandemic in 2020, the "Support for exceptional situations" Think Tank of DIN’s Health Commission (KGw) considered how standardization can contribute even more to the management of exceptional health situations in the future.

In the body of standards, there are numerous standards for processes and products that can contribute to the management of exceptional health situations. But these standards might not be known to the actors, and the selection and combination of relevant content from various standards is difficult in an exceptional situation. The fact that the actors do not necessarily have a professional background in dealing with exceptional situations should be taken into account, as should the fact that the exceptional situation may also present an unknown challenge.

The members of the Think Tank have discussed instruments and approaches to solve, or at least simplify, this problem for persons acting in an exceptional health situation, taking into consideration the fact that the nature of a future exceptional health situation is not known in advance.

The result is a modular proposal for a fundamental approach that can be combined with references to concrete standards.

When an exceptional health situation occurs, a comparison of different scenarios shows that dealing with all situations results in principle fields of action that need to be addressed. Roughly speaking, these fields of action concern the recognition and assessment of, and the reaction to the exceptional situation.

In each of these fields it is important to apply standardized procedures, or to use products and solutions that support standardized procedures. As soon as these “actors” are described in the fields of action for the respective exceptional situation, suitable standards can be used for implementation. The first step was to develop a standards matrix for this purpose, which was assigned to the critical infrastructure sectors (or “KRITIS”) as defined by the Federal Office of Civil Protection and Disaster Assistance (BBK).

Download the KRITIS standards matrix here.

DIN can help find the “best practice”!

DIN’s Health Commission (KGw) has compiled an overview of standards that can be useful for managing tasks in the field of emergency response. While the current focus of this overview is primarily on the Corona pandemic, other areas of emergency response preparedness and resilience are also covered. The overview, in a matrix, assigns management standards from a wide range of areas at DIN that have been identified as useful to the critical infrastructure sectors (“KRITIS”) defined by the Federal Office of Civil Protection and Disaster Assistance (BBK). Only organizational, structural and management standards are listed, but not product standards (see table).

“After” the pandemic is before the next pandemic!

Although the measures and structures of emergency response to the current COVID 19 pandemic can be considered as being established and suitable for now, the resilience of one's own area of responsibility should still be optimized in view of future challenges.

Can it “get worse”?

The need for and usefulness of a (self-)critical analysis is illustrated by the following "USE CASE", which is a brief description of three scenarios that are intended to serve as reference points for standardized considerations at DIN in support of emergency response measures.

Scenarios

I.

Starting in North America, a plant infection spreads pandemically around the world, leading to the failure of grain harvests. Massive food shortages occur, which can only be inadequately compensated for as the pandemic progresses, even with the help of global trade. Because research into pathogen identification and control has been neglected, no control agents are available.

II.

A human-to-human aerogenically transmissible viral disease spreads pandemically from Africa, with similar lethality to Ebola (2014 - 2016), and spreads as rapidly as the British Corona virus mutation (2021). No specific drugs or rapid test methods are available. mRNA vaccines have yet to be adapted, licensed and produced. Secure supply chains for all steps of production and worldwide distribution of vaccines need to be optimized globally.

III.

A form of avian influenza spreads from Asia that is highly contagious and deadly for domestic and wild poultry. There are reports that this animal disease can also spread to humans. Emergency slaughters and far-reaching export bans from affected countries massively affect global trade and cause food shortages. Specific drugs for treatment or vaccines are not available.

The following fields of action under the heading "OPTIMIZED MANAGEMENT" have been identified and require further consideration. The critical infrastructure sectors (“KRITIS”) standards matrix was developed to implement point 4 (see overview).

1. Standardized sensor technology
   Based on the extensive experience gained in dealing with the Corona pandemic (2019 onwards), the aim is to continuously monitor impending developments of epidemics and pandemics in the animal and plant world, as well as in the human sector in order to be able to act quickly. This requires a sensitive, globally active network for sensor technology with digitalized evaluation using artificial intelligence. For this network, the basic requirements for interfaces must be defined in an open-system manner. Standards and specifications must be able to be adapted at short notice, even multiple times.
2. Standardized knowledge transfer
   The exchange of information among scientists, researchers, politicians and emergency response managers must be unambiguously possible at national, European and international level across all levels of administration.
3. Standardized information
   The population is informed via standardized interfaces with clear, consistent and comprehensible reasoning via the media, increasingly via social media. Social media in particular must be monitored and evaluated with the help of standardized procedures in order to detect and nip in the bud the targeted or accidental spread of fake news.
4. Standardized management
   Emergency response measures are initially the responsibility of the state and, according to the current legal situation, the responsibility of the German federal states as the upper emergency response and disaster control authorities. However, the Corona pandemic revealed in many areas the need for targeted and stringent action outside the established (state) structures or in addition to them.
   Standardized (and proven) management guidance is available for the disaster control sector, although it was not comprehensively and uniformly applied to the challenges of public health emergency response in the Corona pandemic. In the course of the pandemic, many people outside the state structures who were obliged to take action also recognized the usefulness of structured disaster control management in their respective areas of responsibility.
   DIN can already offer an overview of the national and international management standards developed by expert committees that reflect the current state of science and technology. These standards can also be a source of knowledge and offer "best practice" for those obliged to act and those responsible outside the previous target groups and users of standards. See here the attached matrix.     
5. Standardized structural and technical installations
   Structural, technical and other visible measures must be planned by teams who are aware of previous solutions and who implement them according to current requirements. Standards and specifications are prerequisites for the exchange of knowledge, questions and answers.

DIN is working to provide support, security and trust.

Possibilities of approach and implementation

• A type of meta-standard / standardization roadmap is conceivable in order to identify and visualize the areas concerned and their interconnectedness. This generates a matrix that contains unique assignments and comprehensible information modules for the specific USE CASE. The aim is to provide an overview for handling the diverse and complex exceptional situations in a clear and easy-to-find manner.
• In the sense of Smart Standards, not only the provision of "whole" standards should be considered, but also in particular the linking to relevant sections within one or more standards to the present USE CASE.
• The creation of integration profiles is conceivable, that show how and where standards help to map certain work processes or ensure action security.
• Standards on exceptional situations are little known. For this reason, there are sometimes very contradictory definitions and this makes communication and a coordinated approach difficult. Appropriate communication channels and offers are created here to make standardization better known and to use it quickly in exceptional situations for the benefit of all.
• Consultation channels must be integrated in order to ensure the provision and compilation of modules for the needs situation in an agile manner and to enable the necessary consultations on the standards by experts (DIN and external).

If you are interested in participating in the special committee "Think Tank - Support for Exceptional Situations" and would like to actively contribute to a quick implementation, please contact the KGw office (baerbel.wernicke@din.de).