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Analysis - Pandemic Preparedness: Taking Our Cue From The Experts

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  • Analysis - Pandemic Preparedness: Taking Our Cue From The Experts

    Sunday, October 06, 2013

    Pandemic Preparedness: Taking Our Cue From The Experts

    Credit CDC

    # 7839

    Actuaries with better math skills than I have calculated the odds atabout 3-4% that during any given year, we could see a pandemic. This is based on seeing 3 full-fledged influenza pandemics in the last century (not to mention several Pseudo Pandemics And Viral Interlopers). Now, just 13 years into this new century, and we’ve already seen one pandemic (2009) and one near miss (SARS in 2003).

    While 3-4% may seem pretty small odds, it’s greater than the chance of seeing a direct hit with a CAT 5 hurricane on Miami or an 8.0 magnitude earthquake in Los Angeles during any given year. And those are high risk areas.

    With two emerging viruses in the wings (H7N9 and MERS-CoV), the continued threat of H5N1, plus a poke full of swine variant viruses, it certainly feels as if our odds of seeing some kind of global public health emergency over the next year or two are higher than normal.

    But how much higher? I’ve no idea.

    But one can certainly understand why public health officials are urging an enhanced level of vigilance during the upcoming flu season (see PAHO: Dr Keiji Fukuda Briefs Delegates On H7N9 & MERS-CoV). The messaging from public health agencies ranging from the World Health Organization, to theECDC, to Hong Kong’s HPC, to our own CDC runs pretty much the same:
    No one knows if any of these viruses will pose a pandemic threat, but given the stakes, no one is willing to ignore the possibility.
    Which should be motivating every family, business, organization and community to dust off their pandemic plans (you DO have a pandemic plan, right?) and make sure that it is adequate, up-to-date, and tested.
    If you don’t already have a plan, now is the time to appoint a CPO (Chief Pandemic Officer), and to give that person the green-light and resources to develop a workable plan.
    To help get you started, one of the nation’s leaders in pandemic and disaster planning -Public Health - Seattle & King County - produced a 20 minute film called Business Not As Usual back in 2008, designed to help introduce businesses to the core concepts of pandemic planning.
    Frankly,this video should be required viewing for every businesses owner, manager, and employee.

    You’ll also find a long list of preparedness resources available on this page as well:
    General resources:

    Business and government preparedness:

    Community Based Organization (CBO) preparedness:

    Personal preparedness:

    In 2009 OSHA created this fact sheet on protecting employees during a pandemic.

    • During an influenza pandemic, transmission of the pandemic virus can be anticipated in the workplace, not only from patients to workers in healthcare settings, but also from customers and coworkers in general work settings. Employers can use a set of occupational safety and health controls referred to as the "hierarchy of controls" to reduce exposures to pandemic influenza in their workplaces. The types of control measures, listed from most effective to least effective, that may be used to protect yourself, your workers and your customers are:
      • Engineering controls;
      • Administrative controls;
      • Work practices; and
      • Personal protective equipment (PPE).

      Next a 46-page PDF file from the Department of Labor and the HHS on preparing workplaces for an influenza pandemic.

      The CDC provides the following links for Community Mitigation of Pandemic Flu on their website.
      Mitigation Guide

      Community Strategy for Pandemic Influenza Mitigation (PDF - 10.3 MB)
      CDC guidelines on actions, designed primarily to reduce contact between people, that community government and health officials can take to try to limit the spread of infection should a pandemic flu develop. Appendixes 5, 6, and 7 contain information for childcare programs, elementary schools, and colleges and universities.

      Plan Now to Be Ready for the Next Flu Pandemic (PDF - 213.55 KB); (DOC - 51 KB)

      The Next Flu Pandemic: What to Expect (PDF - 226.83 KB); (DOC - 47 KB)
      While work is ongoing on both an H7N9 and a MERS vaccine, prospects for seeing either in the next year (or longer) are slim. The reasons for this are discussed in depth in several of my earlier blogs:Our first line of defense against either of these viruses is not going to be a shot or a pill, but a range of steps collectively called NPIs, or Non Pharmaceutical Interventions. The CDC’s Nonpharmaceutical Interventions (NPIs) webpage defines NPIs as:
      Nonpharmaceutical interventions (NPIs) are actions, apart from getting vaccinated and taking medicine, that people and communities can take to help slow the spread of illnesses like influenza (flu). NPIs are also known as community mitigation strategies.

      NPIs are geared to the virulence and spread of the virus, and may range from simple advice to `wash your hands and cover your coughs’ to mandatory school and business closings.

      Businesses, organizations, schools, and others should be considering how they can implement NPIs like these into their daily operations, steps that can not only reduce disease transmission, but may also allow them to continue to operate during a pandemic.

      Should the novel coronavirus, H7N9, or any other novel virus threaten, we’ll be talking a lot about NPIs, and their efficacy, impact, and practicality in the blog.

      No one can predict when the next pandemic will arrive, or how bad it will be. It may not happen for years. History only tells us that pandemics happen, and they have the potential to be very disruptive.
      We can’t prevent pandemics from happening anymore than we can stop earthquakes, floods, or tornadoes.
      But we can prepare for these eventualities, knowing that the advantage in any emergency always goes to those who are the best prepared.

    Posted by Michael Coston at <a class="timestamp-link" href="" rel="bookmark" title="permanent link"><abbr class="published" itemprop="datePublished" title="2013-10-06T08:46:00-04:00">8:46 AM</abbr> No comments: Links to this post
    Labels: H7N9, MERS-CoV, Pandemic, Preparedness

    PAHO: Dr Keiji Fukuda Briefs Delegates On H7N9 & MERS-CoV

    Dr Keiji Fukuda – Credit WHO

    # 7838

    The 53rd Directing Council of the Pan American Health Organization (PAHO) and 66th Session of the WHO Regional Committee for the Americas gathered in Washington D.C. between September 29th and October 3rd. Among the many presentations was a briefing by World Health Organization Assistant Director-General for Health Security and the Environment - Dr Keiji Fukuda – who briefed delegates on both the emerging MERS Coronavirus and the newest avian flu threat; H7N9.
    While both viruses have only produced limited regional outbreaks (in China and the Middle East) to date, Dr Fukuda urged member countries to be alert and to prepare their public health agencies to deal with the possible spread of either virus.
    The following excerpts come from the53rd Directing Council blog, posted 10/1/13. Follow the link to read it in its entirety.
    Fukuda briefs Directing Council delegates on MERS-CoV and A(H7N9)
    Keiji Fukuda, WHO Assistant Director-General for Health Security and Environment, briefed delegates to the 52nd Directing Council on the status of outbreaks of Middle East respiratory syndrome coronavirus (MERS-CoV) and the influenza virus A(H7N9), which are being closely monitored for their potential impact on international health security.
    Fukuda noted that there are both similarities and difference between the two viruses. Both are from animal reservoirs, both are “unusually pathogenic,” and both are capable of human-to-human transmission. Although neither has shown sustained transmission in the community, both remain major underlying public health risks.
    A(H7N9) is an avian influenza virus that so far has caused outbreaks only in China, the largest outbreak so far during March and April of 2013, when 130 cases were reported during one four-week period. The source of human infection is contact with infected poultry, said Fukuda, mostly in live markets. As with all influenza viruses, A(H7N9) appears to be more active in cold weather, both in birds and in humans.
    In contrast to A(H7N9)’s appearance only in China, MERS-CoV has been reported in nine countries, most in the Middle East, but also in Tunisia and in patients with histories of travel to the Middle East returning to France, Italy and the United Kingdom. Fukuda noted that less is known about coronaviruses in general than about influenza viruses, for example, it is not known if coronaviruses are seasonal.

    (Continue . . . )

    Posted by Michael Coston at 2013-10-06