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In this chapter, we examine the ways that warning providers connect and collaborate with knowledge sources to produce effective warnings. We first look at the range of actors who produce warnings in the public and private sectors, the sources of information they draw on to comprehend the nature of the hazard, its impacts and the implications for those exposed and the process of drawing that information together to produce a warning. We consider the wide range of experts who connect hazard data with impact data to create tools for assessing the impacts of predicted hazards on people, buildings, infrastructure and business. Then we look at the diverse ways in which these tools need to take account of the way their outputs will feed into warnings and of the nature of partnerships that can facilitate this. The chapter includes examples of impact prediction in sport, health impacts of wildfires in Australia, a framework for impact prediction in New Zealand, and communication of impacts through social media in the UK.

BackgroundThunderstorm asthma is often characterised by a sudden surge in patients presenting with exacerbated symptoms of asthma linked to thunderstorm activity. On 17 June 2021, Public Health England (PHE) observed a large spike in health care seeking behaviour by patients presenting with asthma and difficulty breathing symptoms across parts of England.ObjectivesTo describe the epidemiology of the observed asthma spike and explore available meteorological and environmental data to understand potential causes of this episode.DesignA retrospective observational study was conducted of patient visits to health care services in England as monitored through surveillance systems routinely operated by PHE. The number of presentations during the asthma event was compared to expected levels for the overall population and across specific regions.SettingHealthcare services in England.Main outcome measuresNumber of patients presenting to healthcare services for asthma- and difficulty breathing-type symptoms.ResultsSpikes in asthma and difficulty breathing were detected across several PHE syndromic surveillance systems. Across affected areas ED attendances for asthma increased by 560% on 17 June compared to the average number of weekday daily attendances during the previous 4 weeks. GP out of hours contacts increased by 422%, NHS 111 calls 193%, NHS 111 online assessments 581% and ambulance call outs 54%. Increases were particularly noted in patient age groups 5-14 and 15-44 years. In non-affected regions, increases were small (ConclusionsAn unprecedented episode of asthma was recorded in England, characterised by significant surges in health care seeking behaviour. However, the links to meteorologically defined thunderstorm activity were not as clear as previous episodes, with less evidence of severe thunderstorm activity in those areas affected, prompting further discussion about the causes of these events and implications for public health management of the risk.