Tuesday, March 12, 2019

WHO Global Influenza Strategy 2019-2030

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Credit ECDC – 125 years of  Pandemic  History 



















#13,927

We are just over a month shy of the 10th anniversary of the HHS Declaration Of A Public Health Emergency due to the emergence of a new swine-origin H1N1 flu virus, which by early summer of 2009 would be declared a pandemic. 
For anyone under the age of 50, this was their first - and so far, only - pandemic (excluding the psuedo-pandemic return of H1N1 in 1977). 
As the only pandemic in the past 50 years, it must seem like a rare, once-in-a-lifetime event to most of the world's population. And on top of that, for most people, it was a relatively mild event.

But for those of us just a dozen years older, this was our third pandemic. Both 1957 and 1968 were influenza pandemic years - and while neither matched the ferocity of H1N1 pandemic of 1918 - both global outbreaks killed millions of people around the world. 
The truth is, there is no time schedule for influenza pandemics. They can sometimes fall decades apart, or arrive back-to-back within a span of just a few years.
As we've discussed previously, we only know the types of influenza that have circulated in humans since early in the last century, but historic accounts suggest at least a dozen `influenza-like’ pandemics occurred in the 400 years prior to the 20th century.
Credit Pandemic Influenza's 500th Anniversary


All of which suggests that most of us will be around for the next influenza pandemic, and there are no guarantees it will be as mild as the last one.
 
Add in the fact that there are other potential pandemic triggers besides influenza (think MERS, SARS, Nipah, etc.) - many of which could benefit greatly by our highly mobile society - and the overall risks of seeing any type of pandemic in the near future climb even higher.
All of which makes our ability to tackle the next pandemic more than just of academic interest.
With the clock continuing to tick - and no shortage of potential pandemic viruses (see CDC IRAT list) in the wild - over the past couple of years we've seen a renewed push for global pandemic preparedness, including:

CDC: 2018 Interim Guidance On Allocating & Targeting Pandemic Influenza Vaccine
WHO: Global EOC Pandemic Flu Exercise (GEOCX)
CLADE X: Archived Video & Recap

CDC/HHS Community Pandemic Mitigation Plan - 2017
ECDC: Guide To Revising The Influenza Pandemic Preparedness Plan

Yesterday the World Health Organization released a new global influenza strategy for the decade ahead (2019-2030), with the the stated goals of preventing seasonal influenza, controlling the zoonotic spread of influenza to humans, and preparing for the next influenza pandemic.

Excerpts from the WHO's press release, and a link to the 31 page PDF file, follow, after which I'll return with a postscript:


WHO launches new global influenza strategy

11 March 2019

WHO today released a Global Influenza Strategy for 2019-2030 aimed at protecting people in all countries from the threat of influenza. The goal of the strategy is to prevent seasonal influenza, control the spread of influenza from animals to humans, and prepare for the next influenza pandemic.

“The threat of pandemic influenza is ever-present.” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “The on-going risk of a new influenza virus transmitting from animals to humans and potentially causing a pandemic is real. The question is not if we will have another pandemic, but when. We must be vigilant and prepared – the cost of a major influenza outbreak will far outweigh the price of prevention.”

Influenza remains one of the world’s greatest public health challenges. Every year across the globe, there are an estimated 1 billion cases, of which 3 to 5 million are severe cases, resulting in 290 000 to 650 000 influenza-related respiratory deaths. WHO recommends annual influenza vaccination as the most effective way to prevent influenza. Vaccination is especially important for people at higher risk of serious influenza complications and for health care workers.

The new strategy is the most comprehensive and far-reaching that WHO has ever developed for influenza. It outlines a path to protect populations every year and helps prepare for a pandemic through strengthening routine programmes. It has two overarching goals:
  1. Build stronger country capacities for disease surveillance and response, prevention and control, and preparedness. To achieve this, it calls for every country to have a tailored influenza programme that contributes to national and global preparedness and health security.
  2. Develop better tools to prevent, detect, control and treat influenza, such as more effective vaccines, antivirals and treatments, with the goal of making these accessible for all countries.
“With the partnerships and country-specific work we have been doing over the years, the world is better prepared than ever before for the next big outbreak, but we are still not prepared enough,” said Dr Tedros. “This strategy aims to get us to that point. Fundamentally, it is about preparing health systems to manage shocks, and this only happens when health systems are strong and healthy themselves.”
To successfully implement this strategy, effective partnerships are essential. WHO will expand partnerships to increase research, innovation and availability of new and improved global influenza tools to benefit all countries. At the same time WHO will work closely with countries to improve their capacities to prevent and control influenza.

(SNIP)


(Continue . . . )

While increased global preparedness for the next pandemic is essential (see World Bank: World Ill-Prepared For A Pandemic), so too are preparations at the community, and individual, level.

While governments and public health agencies work on developing and deploying vaccines, distributing antivirals, and keeping the lights on, much of the day-to-day burden of keeping society and the economy going will fall on local entities:
Hospitals, EMS, Police and Public Safety, local Emergency Management, Schools, Churches and Organizations, small businesses, Neighborhood Watch organizations, and ultimately individual families, their friends and their neighbors
Ready.gov urges that individuals and families take the following steps before a pandemic.

Before a Pandemic
  • Store a two week supply of water and food.
  • Periodically check your regular prescription drugs to ensure a continuous supply in your home.
  • Have any nonprescription drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and vitamins.
  • Get copies and maintain electronic versions of health records from doctors, hospitals, pharmacies and other sources and store them, for personal reference. Get help accessing electronic help records.
  • Talk with family members and loved ones about how they would be cared for if they got sick, or what will be needed to care for them in your home.
A pandemic could last a year or longer, and have several waves.  Businesses, both large and small, will need to have plans in place to operate as safely as possible during a pandemic (see Pandemic Planning For Business) - not only for the community good - but for their own economic survival (see CDC Business Pandemic Checklist).

One of the nation’s leaders in pandemic and disaster planning is Public Health - Seattle & King County.  In 2008 they produced a 20 minute film called Business Not As Usual, 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:

Admittedly we could easily go years, or even decades, before the next pandemic strikes. Or, it could begin somewhere in the world tomorrow. Like earthquakes along fault lines, and tornadoes in Tornado Alley, pandemics are inevitable. The timing is really the only question.
For a family or an individual - if you are well prepared for a flood, an earthquake, a hurricane, or any other extended disaster - you are in better shape to deal with a pandemic.  Unfortunately, fewer than half of all American households are even close to being prepared.
If you aren't already prepared for a two-week disruption in power, water, food or medicine distribution, or any other extended disaster, you should seriously consider making preparations now.  A good place to get started is by visiting Ready.gov.

Some other preparedness resources you might want to revisit include:
The Gift Of Preparedness - Winter 2018
#NatlPrep: Revisiting The Lloyds Blackout Scenario

#NatlPrep : Because Pandemics Happen
Disaster Planning For Major Events

Because whether it is a hurricane or an earthquake - a tornado or a wild fire - or even a pandemic . . .  disasters happen.  And they next one could strike close to home.