Building Community Resilience to COVID-19

Post Carbon Institute, Washington shows building community resilience is the "best" response to the looming economic, energy, and environmental challenges of the 21st Century. 

A resilient community is one that can maintain its essential identity while adapting to these and other challenges. 

It is evident that we can't "solve" many problems with technical fixes. The COVID-19 outbreak is one such public health challenge without precedents in living memory, which is testing our collective capacity to respond.

Stockholm Resilience Centre demonstrates how resilience helps with the coping of crises. Resilience is what gives people the psychological strength to cope with stress and hardship. 

Resilient people can utilise their skills and strengths to cope and recover from problems and challenges. Historical lessons from Hurricane Katrina and the Deepwater Horizon Oil Spill indicates that community resilience will offer "practical solutions" to contain the COVID-19 pandemic.

Community resilience to withstand and recover from the COVID-19 outbreak has become a topical issue because of limited resources for addressing the pandemic. Moreover, without applying communal strengths, we cannot defeat this global challenge. To be sure, increasing community resilience is particularly useful for preventing community transmission of COVID-19 through implementing effective precautionary measures against COVID-19. Such as social distancing and handwashing.

Governments have confirmed that community transmission of COVID-19 is gradually happening. Community transmission implies that coronavirus is now circulating in the community and can infect people with no history - either of travel to affected areas or of contact with the infected person.
Once community transmission is identified in a particular area, correctional facilities and detention centres are more likely to start seeing cases inside their walls.

The World Health Organization (WHO) and Disease Control and Prevention (CDC) highlight the significance of enhancing community resilience to curb the COVID-19 outbreak. The concept of "community resilience" captures and expands upon many traditional themes in emergency preparedness, recovery, response, and community development, as well as public health education and promotion.

'How to build community resilience to COVID-19?' is a million-dollar question, where public health education is predominantly neglected, investment in health sectors is severely scant, and corruption in health sectors is evident. Notwithstanding, as we are in a crossroads, it is high time to think about, talk about, and invest time and money to increase community resilience to COVID-19.

The overall resilience of a community rests on the extent to which community members practice healthy lifestyles and are aware of the community's health-related functional needs (e.g., number of people who need transportation assistance). If ignored, these needs can render the emergency response and recovery difficulties. To this end, firstly, we need to promote population health before (and after) an incident. 

Population health literacy is a distinct component of community resilience. It brings significant health concerns (e.g., community social distancing) into focus and addresses ways that resources can be allocated to overcome the problems that drive poor health conditions in the population. 
Health literacy is a neglected public health challenge even in Europe, let alone in Bangladesh. Studies state more than a third of the population faces difficulties in finding, understanding, evaluating, and using the information to manage their health.

Population health enhances community wellness. It can be promoted by investing in activities that lead to increasing public understanding of health (e.g., what to do if you have contracted coronavirus) and ensuring sufficient community health resources for timely information, access to health services, and testing and treatment facilities. 

Investing in community clinics and local hospitals are critical for promoting population health. Universities can launch a COVID-19 rapid response program for responding to the vast array of population health-related challenges created by the COVID-19 pandemic, as was done by the University of Washington.

A higher prevalence of poverty, unemployment, and food insecurity indicates higher levels of social vulnerability and lower levels of community resilience. Low levels of resilience might be exacerbated by lack of access to adequate resources and services such as serviceable healthcare infrastructure— an essential part of community resilience, particularly for vulnerable rural populations. 
Wuhan's experience underlines functioning critical infrastructure is imperative during the response to the COVID-19 emergency for both public health and safety, as well as community well-being.

Key activities that improve access to high-quality health, behavioural health, and social resources and services include ensuring continuity of care for those needing long-term medical/health services. For instance, addressing COVID-19 outbreak needs preparedness (protecting yourself and others from getting sick), response, and recovery activities. For these purposes, like the national level, community COVID-19 preparedness, and response plan must be prepared.

How do we link better risk communication with improved community resilience? Promoting public health education (i.e., school health and hospital and clinic education programs) is an essential lever for ensuring that individuals and communities are educated about health security risks and know how to prepare, respond, and recover. 

Public health education is mostly non-existent in Bangladesh, except family planning education that is also on the verge of collapse. Mass media currently plays a good role in providing public health education.

The Bureau of Health Education, the Director-General of Health Services (DGHS), has a broad portfolio of offering "public health education." This bureau applies several models for providing educational programs, such as Model Village and School Health Education. However, it is difficult to discern the effectiveness of these programs. 

In this transition of the COVID-19 outbreak, the government must reorient the public health education programs; mainly, investment is required in activities that build basic health literacy and awareness of health issues such as practising biosecurity measures to prevent COVID-19. Effective and coordinated health education networks can be established by embracing private colleges and hospitals, NGOs, and other development partners.

Enhancing community resilience has to be adopted in community-driven and participatory decision making. It has to, therefore, be promoted through citizen engagement, which entails the active participation of community residents in planning, response, and recovery activities. Evidence indicates this engagement has an intrinsic value of crisis management. 

Citizen engagement already set good instances of offering face masks, foods, hand sanitisers, personal protection equipment (PPE), and other logistics for mitigating the COVID-19 outbreak. A salient feature of citizen engagement is increasing self-sufficiency that encourages civic responsibility and promotes effective bystander responses.

Building resilience is an inherently collaborative endeavour, requiring a wide range of people and organisations to consider and prepare for the unknown. Applying public and private partnerships (PPPs) have paramount importance in building community resilience. Developing strong partnerships within and between governments and other organisations are vital for increasing trust and knowledge among community members and help maximise participation in emergency preparedness. Grassroots organisations are critical to our response to this corona crisis.

COVID-19 outbreaks are riding the exponential growth curve, and there is no end yet in sight. Increasing community resilience and its institutionalisation, at a minimum, are critical, as evidence of community transmission is apparent. 

The government should invest in building the 'social scaffolding' that acts as a catalyst for building community resilience. To this end, the recognition and participation of all members of communities, organisations, and civil societies are crucial. 

The author is Associate Professor of Agricultural Extension and Information System, Sher-e-Bangla Agricultural University.