The role of Public Health during an emergency: the 2023 flood in the Emilia-Romagna Region

Abstract Issue Major meteorological events like floods are a primary issue for public health. In May 2023, the Emilia-Romagna Region (Italy) was hit by a major rainfall: more than 4.5 billion m3 of rainwater, more than 30 rivers overflowed, 36.000 displaced people, 17 casualties. Public health is called upon to mitigate health consequences with an epidemiological approach in the pre-disaster phase to better address the population; through rapid need assessment during the response phase; and through health surveillance and tracking systems in the post-disaster phase. Description of the problem A continuous epidemiological approach throughout the emergency was applied. Rescue: coordination for rescue and sheltering of displaced people (especially from flooded healthcare structures); veterinarian intervention for livestock assistance; carcass removal. Assistance: hygienic controls in shelters; distribution of a handbook with instructions for flooded residents and volunteers to prevent potential injuries and infectious disease outbreaks; immunization campaigns, primarily against tetanus and HAV. Health surveillance: monitoring of ER accesses and hospitalizations, notification of communicable diseases, syndromic surveillance. Post-emergency management: VBDs monitoring and preventive treatment, waste management, bathing water surveillance. Results A rapid need assessment was critical for the coordinated effort with other intervention forces, like the Civil Protection. A prompt risk communication ensured simple and clear information, mitigating the risks of exposure to floodwater. More than 10.000 vaccine doses were administered. The syndromic surveillance proved valuable in monitoring post-flood health trends. Lessons Several measures were implemented thanks to healthcare workers and volunteers. Nonetheless, a better and faster reaction is possible if disaster management protocols are already available. This experience must increase future preparedness of PH services. Key messages • Public health intervention is crucial in all phases of an emergency, to take care of the affected population and to prevent further health issues. • The public health response needs to be well-timed, long-lasting, and supported by a clear and well-defined risk communication to population and health workforce alike.