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The Department of Health and Human Services (HHS) and its Centers for Disease Control and Prevention (CDC), in cooperation with departments and agencies across the Federal Government, announced two new efforts designed to improve state, local and community preparedness for an influenza pandemic, which can occur when a new strain of flu appears for which people have no immunity, and disease spreads rapidly around the world.
The CDC released new guidance on community planning strategies that state and local community decision-makers, as well as individuals, need to consider based on the severity of an influenza pandemic. These strategies are important because the best protection against pandemic influenza -- a vaccine -- is not likely to be available at the outset of a pandemic. Community strategies that delay or reduce the impact of a pandemic (also called non-pharmaceutical interventions) may help reduce the spread of disease until a vaccine that is well-matched to the virus is available.
The CDC guidance released was developed in collaboration with other federal agencies and public health and private partners. The federal government has undertaken many efforts in the last few years to encourage and strengthen the nations pandemic influenza preparedness, and this guidance builds upon previously released planning documents and guidelines.
The threat of a pandemic continues to be real. We need to continue helping state and local decision-makers determine some of the specific actions they could take during the course of a pandemic to reduce illness and save lives, said HHS Secretary Mike Leavitt. An important consideration for action is the severity of a pandemic once it emerges. The new CDC guidelines are a step forward in that direction.
The new guidelines focus primarily on community-level measures that could be used during an influenza pandemic in an effort to reduce the spread of infection. In order to help authorities determine the most appropriate actions to take, the guidelines incorporate a new pandemic influenza planning tool for use by states, communities, businesses, schools and others. The tool, a Pandemic Severity Index (PSI), takes into account the fact that the amount of harm caused by pandemics can vary greatly, with that variability having an impact on recommended public health, school and business actions.
The PSI, which is modeled after the approach used to characterize hurricanes, has five different categories of pandemics, with a category 1 representing moderate severity and a category 5 representing the most severe. The severity of a pandemic is primarily determined by its death rate, or the percentage of infected people who die. A category 1 pandemic is as harmful as a severe seasonal influenza season, while a pandemic with the same intensity of the 1918 flu pandemic, or worse, would be classified as category 5.
Its important that we try in advance to imagine and evaluate some of the steps that could be taken to slow the spread of pandemic influenza in communities, said Dr. Julie Gerberding, CDC director. That requires a great deal of forethought, vision, and collaboration. Im proud of CDCs efforts to guide the efforts of many federal and state partners to develop the severity index -- and to then link severity with potential actions. We recognize that much work remains, but this new approach should help communities, schools, businesses, and others strengthen their pandemic influenza plans.
Based on the projected severity of the pandemic, government and health officials may recommend different actions communities can take in order to try to limit the spread of disease. These actions, which are designed primarily to reduce contact between people, may include:
Asking ill persons to remain at home or not go to work until they are no longer contagious (seven to 10 days). Ill persons will be treated with antiviral medication if drugs are available and effective against the pandemic strain.
Asking household members of ill persons to stay at home for seven days.
Dismissing students from schools and closing child care programs for up to three months for the most severe pandemics, and reducing contact among kids and teens in the community.
Recommending social distancing of adults in the community and at work, which may include closing large public gatherings, changing workplace environments and shifting work schedules without disrupting essential services.
These measures will be most effective if they are implemented early and uniformly across communities during a pandemic, objectives that can only be met through advance planning. The guidance illustrates the interventions that are likely to be recommended at each category of severity.
While these actions could significantly reduce the number of persons who become ill during a flu pandemic, they each carry potentially adverse consequences that community planners should anticipate and address in their planning efforts. The guidance describes many of these consequences, and provides planners with initial recommendations on strategies to address them. These recommendations may be revised in the coming months based on feedback that the government will seek from a variety of specific communities, including the private sector, education community, faith and community-based organizations and the public health community.
Planning guides for businesses and other employers, child care programs, elementary and secondary schools, colleges and universities, faith-based and community organizations, and individuals and families are included in the appendix of the guidance.
This guidance was developed through a collaborative process that included public health officials, mathematical modelers, researchers, and stakeholders from government, academia, private industry, education and civic and faith-based organizations. It will be refined as needed based on further knowledge gained from research, exercises and practical experience.
Source: Department of Health and Human Services