Public health emergency operations center operations and coordination among Thailand, Cambodia, Lao PDR, and Malaysia during the COVID-19 pandemic

Figures & data

Table

Criteria for Literature and Documents included in the Desk Review
Databases and Search Engines	PubMed, Science Direct, Scopus, and Google Scholar
Publication Date	2017–2020
Language of Publication	English
Keywords	“preparedness”, “emergency preparedness”, “PHEOC”, “EOC”, “health emergency preparedness”, and international framework terms relevant to the Cambodia, Lao PDR, Malaysia, Thailand
Types of Documents	PHEOC legislative frameworks, practices, policies, and resources for international coordination among each of the listed countries
Countries (must have included at least one of the listed countries)	Cambodia, Lao PDR, Malaysia, Thailand
Other Documents	WHO/IHR Joint External Evaluation (JEE) reports for each country, online reports from WHO mechanisms including the Public Health Emergency Operations Centre Network (PHEOC-NET), ASEAN mechanisms including ASEAN EOC Network newsletter and the ASEAN+3 Field Epidemiology Training Network (FETN), and the Mekong Basin Disease Surveillance (MBDS) network.

Figure 1. The five provinces within Thailand that participated as sites to sub-national coordinating mechanisms along borders were Chiang Rai, Nan, Ubon Ratchathani, Sri Saket, and Satun.

A map of Thailand and its neighbouring countries (Myanmar, Lao PDR, Cambodia, and Malaysia) that visually highlight the geographic locations of the five border provinces in Thailand that were included in the assessment of coordination mechanisms.

Table 2. Core elements of emergency preparedness at the national level, adapted from WHO strategic framework for emergency preparedness.

	Policies and legislation that integrateemergency preparedness	Plans and technical guidance foremergency preparedness and response to emergent diseases	Multisectoral coordination mechanisms and public health emergency operations centres	Surveillance, early warning, and information management systems	Dedicated, trained, and equipped human resources for emergencies
Thailand	Communicable Diseases Act B.E. 2558 (2015) Disaster Prevention and Mitigation B.E. 2550	National Strategic Plan forEmerging Infectious Diseases inThailand (2017–2021) Pandemic InfluenzaPreparedness Plan	National Committee forCommunicable Disease Permanent central PHEOC at the Ministry of Health Provincial PHEOCs, but no clear inter-connectivity Subnational Committee of GHSA under the National Committee of IHR	Electronic surveillance systems and feedback mechanisms Gaps in integration of electronic systems with other sectors (e.g. private health sector)	Dedicated PHEOC staff at the nati-onal level Surveillance and rapid response teams at all levels MOH staff are trained and remobilized to support surge capacity, but high staff turnover
Cambodia	Sub-decree on Health Measures to Prevent and Respond to Public Health Emergency of International Concern at Points of Entry (2015)	One Health approach Influenza response plan Sub-decree on Health Measuresto Prevent and Respond to Public Health Emergency of International Concern at Points of Entry (2015)	National PHEOC and focal points at each of 25 provinces One Health preparedness integrated into PHEOC	Event-based surveillance and weekly reporting of notifiable diseases to the central level Reporting occurs through email, telephone, or in person	Rapid response teams at all levels Health workforce plan does not include public health professionals Few field epidemiologists
Lao PDR	National Policy onCommunicable Diseases Surveillance and Control Decree establishingcommunicable disease control committees	Influenza response plan National Work Plan for Emerging Infec-tious Diseases and Public Health Emergencies (2015)	Established PHEOC, operative since 2014 One Health preparedness integrated into PHEOC	Event-based surveillance and weekly reporting of notifiable diseases to the central level Some paper-based and phone-based systems complicate real-time reporting	Rapid response teams at all levels Gaps in epidemiologic and respo-nse capacities Few staff to supervise training programs
Malaysia	Prevention and Control of Diseases Act (1988) National Security Coun-cil Directive 20	Infectious Disease Outbreaks Manual (2015) National APSED-III Strategic Plan	National Crisis Preparedness and Response Center Permanent PHEOC at the Ministry of Health Established inter-connectivity with provincial PHEOCs	Electronic, web-based surveillance systems Integrated data systems to capture outbreaks and identify emergencies	Permanent PHEOC staff Pre-identification and training of surge staff for emergencies

Table 3. Common strengths and challenges in cross-border communications identified from questionnaires and sub-national meetings.

Common Strengths	Common Challenges
Strong existing partnerships between countries Memorandums of understanding facilitate information sharing between countries Quick informal communications through mobile phone messaging applications Training exercises, capacity-building, and logistical support between countries Strong leadership at national and sub-national levels	Differences in IT capacity and systems complicate data sharing Difficulties in identifying points of contact Delays in the exchange of information Outdated or non-specific memorandums of understanding Data-sharing and communications through unsecure platforms Limited workforce and high staff turnover Limited budget Language barriers