Action steps: strategic oversight

Organizational structure

• Define at an early stage the “Service Model” or “Concept of Operations” – an understanding of how public health services will be delivered during the event.
• Actively seek partnerships among agencies at all levels.  Involve Organizing Committee representatives early.  Define and agree on roles and responsibilities early.
• Obtain approval and support for bylaws and operating procedures.
• Identify legal and regulatory issues that need to be addressed to ensure delivery of effective medical and public health services during the event.
• Establish memoranda of understanding and agreement, as needed.
• Identify resources for and hire a full-time alliance coordinator, and secure adequate staff.

 

Sydney 2000 Olympics: Legislation and regulations

For the Sydney 2000 Games, the principal regulatory issues related to visiting healthcare professionals and food safety.  With 80% of Olympic teams accompanied by their own health professional teams, there was a need to establish a legislative mechanism by which these providers could perform their duties without undergoing complex health professional registration requirements.  The Health Professionals (Special Events Exemption) Act 1997 was proclaimed on 25 March 1998.  This legislation enabled health professionals to provide services without registration in New South Wales as long as services were restricted to members of the relevant national team. Existing NSW regulations would also have imposed restrictions on the sale of food in temporary structures.  Given the large number of tents and other temporary structures planned for the Games, food regulations were amended to permit the use of such structures without compromising food safety.

 

Assessment and planning

• Gather experience from previous events.
• Identify areas where specific efforts are needed to focus planning activities.  Consider convening a public health planning summit well in advance to identify critical topic areas and key planning partners.
• Start with a situation analysis, i.e., an assessment of the capacity and deficiencies of the public health system and relevant public health agencies (e.g., capital, equipment, trained personnel, surveillance systems, laboratory capacity, coordination mechanisms, acute-care capacity, threat assessment procedures, relationships, financial resources). 
• Determine where no attention is needed, where some work needs to be done, and where immediate attention is required. 
• Prepare/write a plan that reflects the capacity assessment, lessons learned, and legacy component.  Include ways to increase capacity and, where appropriate, “buy in” capacity.
• Include an overall risk-management framework (if… then…).
• Specify realistic and achievable timelines, phases, milestones, and deliverables.
• Institute mechanisms for evaluation and transfer of lessons learned.  Develop a formal briefing process and capacity-building/training mechanisms to ensure that learning is passed to successors from event to event.

 

Funding and requirements

• Establish a common method across agencies for estimating workload, staffing needs, and costs.
• identify gaps in staff and resources as early as possible.  Request assistance from appropriate agencies to fill these needs.  Do not underestimate the level of daily routine work that will be required.
• Work with agencies as early as possible to identify roles and responsibilities and to determine how national staff and resources can be used most effectively to supplement/augment/ backup/enhance routine sub-national operations.
• Identify and clearly describe needs that cannot be met by sub-national resources.
• Work with the Organizing Committee to obtain national funding.  Identify existing funding streams that could be used to channel funds to planning agencies.

 

Training and exercises

• Plan to identify skills and competencies for system-wide and venue-specific activities at least 18 months before the event. 
• Identify training that is required to ensure that relevant staff have these competencies.
• Identify resources, trainers, and training materials.
• Schedule training well in advance of events, create a common training calendar, and track training milestones.
• Use competition events held in advance of the Games to help test and improve plans and procedures.

 

Credentials and permits

• Work with the Organizing Committee on pre-permit planning and inspection needs. 
• If venues are in different political jurisdictions, develop a common rule and standardized process for permits and inspections across all jurisdictions.
• Arrange for credentialing, parking passes, and on-site equipment storage.
• Collaborate on training and standardizing inspectors. 

 

Access and egress

• Consider the needs of health and emergency services for access to and egress from venues as well as movement around and within the site. 
• Ensure that each venue has adequate access and egress for emergency service vehicles.  Be sure that roadways and access routes are clearly marked and kept clear.  Ensure sufficient room for marshalling, maneuvering, repositioning, and deployment of emergency vehicles.
• Ensure the availability of adequate access and marshalling areas for large numbers of emergency vehicles in the event of a major incident.
• Ensure that emergency services personnel have access to all sub-sections of the venues, including performance, spectator, and parking areas.
• Ensure the availability of official parking permits for attending health and emergency services personnel.
• Arrange a suitable site for air evacuation.

 

Post-event activities

• Document lessons learned to identify processes that should be maintained, to improve public health systems, and to assist future host cities.
• Take time to celebrate large and small successes.
• Identify ways to maintain new processes developed for the Games that will benefit public health systems.

 

Athens 2004 Olympic Games: Potential Public Health Risks
Potential health risks identified prior to the Athens 2004 Olympic and Paralympic Games were identified and categorized according to cause (infectious and non-infectious) and likelihood of occurrence (high or low probability).
Risk category	High Risk	Low risk
Infectious diseases	Travelers’ diarrhea   Foodborne & waterborne diseases Airborne diseases   Sexually transmitted infections	Hepatitis A Brucellosis Non-endemic diseases SARS Deliberate use of biological agents
Non-infectious causes	Heat-related illness  Road crashes  Drowning – other injuries	Deliberate use of explosives, chemicalagents, or radionuclear material
Sources:  Hadji christodoulou et al. Mass gathering preparedness: the experience of the Athens 2004 Olympic and Para-Olympic Games.   J Environ Health 2005;67(9):52-7. Stergarchis and Tsouros, Chapter 1

Last reviewed: 4 May 2010