1. June 12, 2016 Extreme weather events and other natural hazards – the work of the HPA Professor Virginia Murray Health Protection Agency

2. Outline Health Protection Agency Examples Heat waves Cold weather Volcanic ash Flooding International dimensions Conclusion

3. Reducing key infections Minimising the health impact of environmental hazards including radiation, chemicals, poisonings and extreme events such as flooding Supporting safe and effective biological medicines

4. Co-ordinate investigations and outbreak control Laboratory services Advise government Respond to international health alerts

5. 194 countries implement entered into force on 15 June 2007 http://www.who.int/ihr/97892415 96664/en/index.htmlhttp://www.who.int/ihr/97892415 96664/en/index.html

6. Off Site NHS Tactical e.g. Hospital, PCT Emergency Centre NHS OFF SITE Operational/Clinical Response Hospital / Community / PCT’S SCENE OF INCIDENT Silver control(s) (Tactical) Individual agencies ON SITE Bronze (Operational) Individual agencies Strategic Coordinating Group (SCG) – Multi-Agency Health Protection OFF SITE Bronze other services ‘Health’ via Science and Technical Advice Cell) Police ‘Others’ GOLD SILVER BRONZE On/Off Site Tactical Control Fire Ambulance Cabinet Office Briefing Room

7. The Heatwave Plan for England First published in 2004 Reissued on 18th March 2010 http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/De arcolleagueletters/DH_114433http://www.dh.gov.uk/en/Publicationsandstatistics/Lettersandcirculars/De arcolleagueletters/DH_114433 “Information about the heatwave in 2009: HPA estimated there were approximately 300 excess summer deaths between 30th June and 2nd July” Daily CET and estimated number of excess deaths according to age-group in England and Wales, 2009 Source: HPA Centre for Infections estimates from ONS/GRO data

10. Winter kills – CMO annual report 2009 Every 1 degree Celsius decrease in average winter temperature results in 8,000 additional winter deaths in England Deaths occur due to increased cardiac, strokes and respiratory problems. Illnesses occur in a predictable pattern following cold weather, enabling local and national advance planning Mortality in England rises 18% during winter months, whereas other, colder, countries have smaller increases

15. http://archive.cabinetoffice.gov.uk/pittreview/_/media /assets/www.cabinetoffice.gov.uk/ flooding_review/pitt_revie w_full%20pdf.pdf

17. Pakistan Health Cluster bulletin * Shortage of Health Cluster partners in Sindh province, where relief activities need to be strengthened * Fears over malnutrition increases * 514 health facilities damaged or destroyed * Acute diarrhoea, acute respiratory infections, skin infections and suspected malaria remain leading causes of people seeking health care * Health concerns are evolving as winter approaches in KPK and northern Punjab with coming cooler weather and challenges for shelter http://www.whopak.org/idps/documents/bulletins/Health%20Cluster%20 Bulletin%20No%2019-Final.pdfhttp://www.whopak.org/idps/documents/bulletins/Health%20Cluster%20 Bulletin%20No%2019-Final.pdf

18. Safer hospitals and schools campaigns

22. Topics selected Climate change Changing institutional and public behaviour to early warnings Improving resilience to disasters through social and economic understanding Knowledge of the wide health impacts of disasters www.unisdr.org

23. Climate change disaster risk, exposure, vulnerability, and resilience human systems and ecosystems Managing risks from climate extremes at local level national level international level Toward a sustainable and resilient future Case studies

24. Conclusion Worldwide, effects of climate change and extreme events are apparent, with increasing significance for human health HPA routinely responds to chemical, biological, radiological and extreme events incidents Preparing Preventing Responding HPA collaborates with local, national and international partners