Wuraola Oyewusi – "Medical Resilience and Pandemics" from Countering Terrorism on Tomorrow's Battlefield CISR (NATO COE-DAT Handbook 2) Medical resilience is a key critical infrastructure in a nation’s preparedness against vulnerabilities. Pandemics such as COVID-19 are potent disruptors of this infrastructure. Health systems that are considered low-resourced have adapted and deployed seemingly simple but effective methods to survive such disruptions. Read the collaborative study here. Email usarmy.carlisle.awc.mbx.parameters@army.mil to give feedback on this podcast or the monograph. Keywords: medical resilience, pandemics, COVID-19, low-resourced health systems Episode Transcript: Medical Resilience in Pandemics Stephanie Crider (Host) The views and opinions expressed in this podcast are those of the authors and are not necessarily those of the Department of the Army, the US Army War College, or any other agency of the US government. You’re listening to Conversations on Strategy. Today, I’m talking with Wuraola Oyewusi, author of “Medical Resilience and Pandemics,” in Countering Terrorism on Tomorrow’s Battlefield: Critical Infrastructure and Resiliency Handbook Two (Countering Terrorism on Tomorrow’s Battlefield: Critical Infrastructure Security and Resiliency Handbook 2). Welcome to Conversations on Strategy. I’m really glad you’re here. Wuraola Oyewusi Thank you, Stephanie. I’m glad I’m here too. Host Your chapter explores medical resilience as a component of critical infrastructure as well as using low-resourced health systems to build resilience. Will you please briefly expand on that? Oyewusi The work on this chapter focuses on a low-resourced health system (that) has managed to build a resilience against a disruption—this time around, a pandemic—uh, specifically, (coronavirus disease 2019 or) COVID-19. We explored Nigeria as a system that . . . it’s definitely not high resourced. The health-delivery system is not high resourced. And we explored some of the things that were done during the COVID-19 pandemic. Host Let’s talk about that in a little bit more detail. Like you said, your case study focused on Nigeria and COVID-19. How did Nigeria handle COVID-19? Oyewusi So, I’m going to give a bit of context. The first COVID-19 case—recorded one, I think we should emphasize that—was in February . . . February 27, 2020. Right when the whole world was finding out, that was when we found out about that in Nigeria, too. Another clear context that we should have as we go into our discussion is that Nigeria’s epidemic response is carried out in the context of a fragile and underresourced, existent health-delivery system. That means that, even before the pandemic, the system was overstretched, there was a lot of people. There were challenging fault lines already, and then we now had the disruption like COVID-19. So to help you understand this use case, one of the indexes that was used to gauge a country’s preparedness during the pandemic was the number of (intensive-care unit or) ICU beds to the population. Germany had about 29 beds to 100,000 people. The US had about 34 to 35 ICU beds to 100,000 people. Turkey had 48 beds to 100,000 people. But in Nigeria, we had about 0.07 beds to 100,000 people. So, I think that would lay down a context for why we are discussing this and how a disruption to critical infrastructure, like a pandemic, was done in Nigeria. Host What are some key lessons learned from Nigeria on managing pandemics? Oyewusi I’m going to discuss that on the three key items. The first one: There was leveraged experience and infrastructure. The second one: There was civilians, data analysis, and public data sharing. And the third one, which is probably one of the most interesting, are the nonpharmacological interventions. We have established that the system is overstressed. And, given the proportion of ICU to 100,000 people,
