Friday, June 16, 2017

HHS Pandemic Influenza Plan - 2017 Update


In April of this year, in CDC/HHS Community Pandemic Mitigation Plan - 2017, we looked the first major revision to the HHS's pandemic community mitigation plan in over a decade. In subsequent blogs (see PSAF Is The New Pandemic Severity Index and Community Pandemic Mitigation's Primary Goal : Flattening The Curve) we delved into some of the details.

Since the scramble to prepare for a pandemic in the middle of the last decade we've seen a moderate pandemic (2009), the emergence of both MERS-CoV and a variety of new novel flu strains (H7N9, H5N6, H10N8, etc.) and an unimaginably large Ebola outbreak that threatened to spill out of West Africa.
While much progress has been made to prepare for such events - including better diagnostics, and faster vaccine development - there is little doubt that the world remains ill prepared to deal with a severe influenza pandemic (see 2017 World Bank Report).
Yesterday the HHS released their first major update to their HHS Pandemic Influenza Plan since January 2009.  
This revised 52-page document not only looks at the challenges, and how we would deal with them today, but also outlines a 10 year-plan to improve our ability to respond to an influenza pandemic. 

We'll dissect this new update in greater detail over the next few days, but for now, the following except describes the scope of this 2017 update:


This 2017 Update to the HHS Pandemic Influenza Plan builds upon goals elaborated in the 2005 plan, describes ongoing work toward those goals, and identifies key actions for the next decade. Based on experience drawn over the past decade, it presents the current best thinking about how to address pandemic influenza challenges and builds upon the four domains featured in the 2005 plan:

1.Surveillance, Investigation, and Protective Public Health Measures
2.Vaccines and Antiviral Drugs
3.Health Care and Emergency Response
4.Communications and Outreach
In the 2017 Update, seven domains describe how HHS and its partners have added to the evidence base or applied lessons learned, and areas in which capabilities can be optimized:
1.Surveillance, Epidemiology, and Laboratory Activities
2.Community Mitigation Measures
3.Medical Countermeasures: Diagnostic Devices, Vaccines, Therapeutics, and Respiratory Devices
4.Health Care System Preparedness and Response Activities
5.Communications and Public Outreach
6.Scientific Infrastructure and Preparedness
7.Domestic and International Response Policy, Incident Management, and Global
Partnerships and Capacity Building
Taken together, the updated domains reflect an end-to-end systems approach to improving the way preparedness and response are integrated across sectors and disciplines, while remaining flexible for the conditions surrounding a specific pandemic. This more-nuanced and contemporary approach recognizes the interdependence of domain areas, which should lead to a better understanding of how the system functions as a whole.

By necessity, these domains have some overlapping content, reflecting the fact that this work is intimately integrated with other aspects of domestic and international pandemic preparedness and response. Within each domain, the Update summarizes the relevance to pandemic influenza, an accompanying goal, and a list of objectives for sustaining momentum that address ongoing work, challenges, and opportunities for the next decade. Evolving science and budget priorities will influence the direction and scope of progress that is critical to mitigating the next influenza pandemic.

(Continue . . . )

A dozen years ago, when the H5N1 bird flu virus loomed large, the public and private sector - along with individuals and organizations around the world - joined together to prepare for a potential pandemic. 

It was a relatively short, but extraordinary effort, blunted by:
  • The financial crisis of 2007-2008 - and slow recovery - which forced many private sector entities to put pandemic planning on the back burner.
  • And the 2009 H1N1 pandemic.  One that - while bad - was less severe than originally feared.  That convinced some that the fears over H5N1 were over hyped, and placated others who felt we'd `had our pandemic', and another one wasn't likely for decades.
Since then, we've seen relatively little new pandemic planning outside of public health agencies like the CDC, HHS, WHO, some NGOs, and some think tanks like CIDRAP, TFAH and the World Bank
This, despite the number of pandemic threats continuing to rise.
Last January, in Probably Not The Worst Idea In The World . . ., we discussed how now might be a good time for businesses and agencies to take out their old pandemic plans, dust them off, and revise them as needed.

Hopefully these recent updates to the HHS's pandemic plan will help inspire others - both in the public and private sectors - to follow suit.

For more on pandemic preparedness, you might want to revisit some of these recent blogs:

Upcoming Webinar: The Strategic National Stockpile
Are We Prepared to Help Low-Resource Populations Mitigate a Severe Pandemic?
CDC Updated Risk Assessment On China's H7N9 Virus

WHO: Candidate Vaccines For Pandemic Preparedness


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