Gatavība Un Rīcība Infekcijas Slimības Izraisīta Apdraudējuma Un Ārkārtas Situācijas Gadījumā

Objectives

Latvia’s second annex to the State Disaster Medicine Plan, approved by Ministry of Health Order No. 01-01.1/26 on 4 March 2026, provides a framework for preparedness, response and recovery for pandemics, uncontrolled infectious disease outbreaks and other serious health threats that exceed routine institutional capacity or significantly disrupt healthcare delivery.[1][2][3]Its central purpose is to reduce disease transmission, protect population health, preserve access to essential healthcare, and restore routine services while retaining measures needed to detect recurrent outbreaks, pathogen mutations and antimicrobial resistance.[4][5][6]

• Strengthen preparedness through national, sectoral and institutional reserves of medicines, vaccines, medical devices and personal protective equipment; workforce development; hospital readiness; laboratory capacity; and digital systems for surveillance, notification, forecasting, modelling and information exchange.[7][8][9]
• Enhance epidemiological safety through case definitions, outbreak investigation, contact tracing, testing, isolation, quarantine, infection prevention and proportionate containment measures tailored to transmission routes, disease severity, incidence and healthcare impact.[4][10][11][12]
• Improve vaccination readiness by identifying risk groups, planning supply, logistics, access, reimbursement and pharmacovigilance, and delivering vaccination under Ministry of Health requirements and available financial arrangements.[7][13][14]
• Maintain continuity of emergency, urgent, life-saving, specialised and primary care by adapting planned services, managing patient flows, expanding or reallocating hospital capacity, and using remote consultations where appropriate.[2][15][16]
• Promote informed public action through risk communication, professional guidance, public education, rumour management, travel advice and proportionate prevention measures, including hygiene, ventilation, distancing and risk-based face-mask use.[17][18][19][20]
• Review emergency actions after an event, improve the plan through training and lessons learned, replenish critical stocks, and integrate adapted disease surveillance into routine systems.[5][6][21]

Implementation

The plan uses a graduated, multi-agency emergency-management model that moves from preparedness through enhanced response to recovery. Actions are adjusted to the infection’s epidemiological characteristics, the effectiveness of existing measures, available resources and pressure on health services.[4][2][22]The Ministry of Health provides strategic leadership, convenes emergency structures and coordinates with national health bodies, laboratories, healthcare and social-care providers, municipalities, educational institutions, law-enforcement bodies and international partners.[23][24][16]

• Activate governance arrangements by convening the Ministry of Health emergency management group within two hours of a changed risk assessment, convening the relevant emergency medical commission within one day, and preparing information on the epidemiological situation and cross-sector involvement within two days.[18][25]
• Coordinate preparedness through the Intersectoral Preparedness Planning Commission, municipal civil-protection commissions, updated institutional contact arrangements, regular legal and plan reviews, exercises, training and cooperation-territory civil-protection planning.[26][17][27][28]
• Operate surveillance through electronic case notification, self-reporting and integrated epidemiological information systems; monitor cases, contacts, laboratory results, outbreaks, transmission trends, hospitalisations and resource needs; and exchange information with the World Health Organization, European Centre for Disease Prevention and Control, European Commission and European Union mechanisms.[7][29][23][15]
• Manage laboratories by coordinating testing capacity, quality assurance, validation for emerging pathogens, sample logistics, timely results, national reference laboratory referral and contracts with private laboratories for publicly funded emergency testing.[30][31][15]
• Mobilise resources by assessing needs, centrally procuring, storing and distributing medicines, vaccines, sera, immunoglobulins, equipment, protective equipment and laboratory supplies; obtaining additional staff, facilities and beds; and considering international assistance where domestic provision is insufficient.[24][32][14]
• Maintain public communication by sharing material information within one hour of receipt, issuing prevention guidance to professionals within 24 hours where possible, providing daily media and website updates, monitoring misinformation, and communicating service changes, restrictions and preventive actions.[18][33][34]
• Apply travel and border measures through traveller advice, health monitoring, assessment and testing of symptomatic returnees, isolation and contact follow-up where indicated; entry screening is not generally supported because its benefit is insufficiently proven, although selective use may be considered for geographically isolated unaffected territories.[35][36][37]
• Monitor implementation through risk-based inspections of hygiene, anti-epidemic and pharmaceutical requirements, routine review of institutional plans, laboratory quality checks, resource reporting and post-emergency effectiveness reviews. The plan specifies selected operational deadlines, including 24-hour recording of hospitalised patients and deaths, but does not provide a consolidated quantitative indicator framework, independent audit mechanism or detailed budget.[38][15][6]

Monitoring & Evaluation

The annex establishes an operational monitoring and accountability system centred on integrated epidemiological surveillance, laboratory reporting, risk assessment, resource monitoring, public communication and inter-institutional information exchange during preparedness, emergency response and recovery.[7][29][6]

• Develop and operate electronic notification, self-reporting and integrated epidemiological information systems to record, consolidate and analyse cases, contacts, outbreaks and vaccination data.[7][8]
• Monitor reported and registered cases, laboratory results, transmission trends, epidemiological investigations, disease forecasts and international risk information from the World Health Organization and the European Centre for Disease Prevention and Control.[29][2][39]
• Maintain laboratory surveillance through capacity monitoring, quality assurance, validation of tests for newly emerging infections, rapid reporting of results, specimen logistics and referral of selected samples for advanced investigation.[7][30][31]
• Record hospitalised patients and patient deaths every 24 hours, and regularly collect information on inpatient capacity, available resources, additional resource needs and institutions requiring additional personnel.[15][14]
• Monitor pharmacovigilance, including possible adverse reactions to medicines and vaccines, and supervise pharmaceutical circulation using e-health and pharmaceutical database information.[39][8][38]
• Supervise compliance with hygiene, anti-epidemic and preventive-measure requirements on a risk-assessed basis, including review of healthcare institutions’ infection-control and contingency plans.[9][31][40]
• Review health-sector legal acts governing infectious disease emergency responsibilities at least annually, updating them in response to identified risks, constraints and lessons from exercises.[26]
• Evaluate the effectiveness of emergency, containment and communication actions, analyse the emergency response after the event, and use findings to improve the State Disaster Medicine Plan and its communication provisions.[5][6]
• Maintain daily monitoring of mass-media information and update public websites at least once daily; provide regular media updates and share new emergency information within one hour where required.[18][33][34]
• Report initial risk assessments, affected-person numbers and resource requirements to the Ministry of Health, and report the epidemiological situation to the Crisis Management Council and Cabinet crisis-management meeting when appropriate.[23]
• Adapt surveillance during recovery by integrating it into routine systems and continuing to detect renewed outbreaks, pathogen mutations and antimicrobial resistance.[5][6]

Explicit operational timeliness requirements include a changed risk assessment within one hour, convening the Ministry of Health emergency leadership group within two hours, convening the State Operational Medical Commission within one day, preparing cross-sector information within two days, and initiating specified epidemiological investigations and preventive actions within one day.[18][24][25]

The annex does not specify a consolidated quantitative indicator framework, standard evaluation methodology, universal reporting template, independent audit process, sanctions for non-compliance or a detailed standalone accountability framework beyond assigned institutional responsibilities, surveillance, reporting, oversight and review processes.[30][18][15]

Costing & Financing

The annex requires resource preparedness and mobilisation across medicines, vaccines, personal protective equipment, medical devices, laboratory supplies, beds, staff, premises, information systems and laboratory capacity, but it provides no quantified overall budget or costed implementation plan.[7][38][14]

• Plan, procure, centrally store, allocate and distribute medicines, vaccines, sera, immunoglobulins, medical equipment, personal protective equipment, laboratory equipment, supplies and reagents according to assessed need.[24][14]
• Maintain medicine reserves equivalent to three months’ consumption in hospitals and one month’s consumption in qualifying outpatient institutions and the Emergency Medical Service.[9]
• Review reserve medical resources, medicine stocks and planned deliveries, assess their suitability for the emergency concerned, and plan additional procurement where necessary.[11][41]
• Assess available and priority resources across the state, sectors and institutions; update resource-request and allocation algorithms; and mobilise additional personnel, equipment, beds, facilities and laboratory capacity during emergencies.[29][2][30]
• Maintain vaccination access and reimbursement arrangements, including tariffs and procedure-list amendments, within established arrangements and allocated or available financial resources.[7][9][14]
• Arrange publicly funded emergency laboratory testing where required, including contracts with private laboratories, and participate in European Commission joint procurement arrangements.[30][8]
• Compile information on resource use and remaining stocks of personal protective equipment, medicines and medical devices after an emergency, and assess replenishment options.[6][21]
• Identify needs that cannot be met through domestic healthcare arrangements or procurement, and request and receive international assistance under the applicable plan where necessary.[32][14]

No budget totals, monetary allocations, unit costs, funding-source amounts, financing gaps, resource-mobilisation targets, exchange-rate assumptions or quantified economic assumptions are specified.[29][30][12]