Page 13 - Smart public health emergency management and ICT implementations - A U4SSC deliverable on city platforms

between 460-370 B.C. 19,20 It is only from the mid-19th century that surveillance in its current format
came into being when the collection of data became key to shaping different forms of intervention.
Recently, public health surveillance has become remote , with the introduction of various forms of
21
distanced surveillance, including satellites and drones, and cutting-edge technologies like cameras,
sensors, actuators and the Internet of Things (IoT), combined with emerging applications (e.g.,
dashboards, analytics and AI-based face recognition – even under masks). 22

Surveillance systems detect public health outbreaks through the routine collection of pre-defined
23
data specific to diseases using case definitions (Indicator-based surveillance) . Predetermined
12
outbreak thresholds are often set for generating alerts and responses. Moreover, another detection
method uses ad hoc information about acute public health events (event-based surveillance). A
variety of official and unofficial information sources are collected to detect clusters of cases with
similar clinical signs and symptoms that may not match the presentation of readily identifiable
diseases. Official sources come from national and international authorities, while unofficial sources
include media reports and reports from the community.

Some indicative surveillance systems are used by the U.S. Centres for Disease Control and
Prevention (CDC) and others, such as a particular segment for Covid-19 known as the Emerging
Infections Network (EIN), which functions as a sentinel system to monitor new or resurgent infectious
diseases; the U.S.-Mexico Border Infectious Diseases Surveillance (BIDS) that was set up across
the U.S.-Mexican border; EMERGEncy ID NET, a network of academically affiliated emergency
medicine centres at hospitals in large U.S. cities; the ECDC also monitors for Europe through the
European Surveillance System (TESSy), which includes a framework for Covid-19; the UK Public
Health Surveillance System that integrated its public health and ICT strategies and launched a
Covid-19 dashboard; the Australian Communicable Diseases Intelligence; the Infectious Disease
Surveillance Centre (NESID); and the Chinese Centre for Disease Control and Prevention (China
CDC) 12,24,25,26,27,28,29 .These are just a few examples of the endeavours undertaken. Finally, laboratory-
based surveillance is utilized for emerging antimicrobial resistance.

This document intends to provide an overview of the potential of the smart city concept in dealing
with future health related disasters, while identifying gaps in the mechanisms adopted to manage
pandemics/epidemics in the past. Moreover, this document considers a smart city to be resilient,
which means that the smart city infrastructure will also be resilient (i.e., redundant and sufficient)
and capable of being sustainable against hazards in order to accomplish its mission.

Securing smart city resilience is difficult and is beyond the scope of this document. However, it is
important that this aspect is addressed and respected because, while dealing with health-related
disasters, a smart city concept should also consider the concept of “cascading disaster events or
emergencies”. These events are triggered by other physical hazards, which, if not considered in
the preparedness and mitigation phases, can cause massive disruption of smart city infrastructure
and therefore to the entire health system and services.

U4SSC: Smart public health emergency management and ICT implementations 3