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| The Goal Of Pandemic Mitigation - Flattening The Curve |
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Not quite three months ago the World Health Organization released a comprehensive 91-page NPI Guidance document on the use of Non-Pharmaceutical Interventions during a severe influenza epidemic or pandemic, with recommendations based on the available scientific evidence.
Non-pharmaceutical public health measures for mitigating the risk and impact of epidemic and pandemic influenza
Authors:
World Health Organization
Publication details
Number of pages: 91
Publication date: October 2019
Languages: English
ISBN: 978-92-4-151683-9
Downloads
Non-pharmaceutical public health measures for mitigating the risk and impact of epidemic and pandemic influenza guidance PDF, 1MB
Annex: Report of systematic literature reviews
PDF, 3MB
During the month of November, in 5 different blogs (links below), we dissected the advice, and along the way I cautioned that no matter how well-meaning, or evidence based, no battle plan survives first contact with the enemy.
WHO Guidance: Non-pharmaceutical Public Health Measures for Mitigating the Risk and Impact of Epidemic and Pandemic Influenza
The WHO NPI Guidance : Personal Protection
The WHO NPI Guidance : Social Distancing
The WHO NPI Guidance : Environmental Measures
The WHO Pandemic Influenza NPI Guidance : Travel Measures
While I envisioned (and discussed) a certain amount of push back on these recommendations, I never imagined the extraordinary lengths that China (and to a lesser extent, Hong Kong) would go to contain - or at least mitigate - this epidemic.
Successful or not - and the jury is still out on that - many of China's measures could never be realistically implemented in the United States, Europe, or any other western nation. We may learn a lot from China's draconian response, but what we learn will be of limited practical value.
If (and it is still very much an `if'), this coronavirus spreads globally as an epidemic - without a vaccine or specific treatment - much of our pandemic playbook will be based on the WHO NPI recommendations or those promulgated in the CDC/HHS Community Pandemic Mitigation Plan - 2017.
If you haven't (recently) reviewed these documents, now might be an appropriate time to familiarize yourself with the available guidance, if for no other reason than to get a `feel' for what life might be like during an epidemic wave.But nCoV2019 is a new and still poorly understood virus - and these guidance docs were based primarily on the assumption we'd be dealing with a novel influenza virus - and so we can expect this advice will be tweaked, and updated, as we learn more.
China has decided that going `off book' is the only way to contain this virus, despite considerable risks to their economy and social order. Hopefully they'll succeed and the rest of the world will be spared a serious epidemic.But even if they fail, we have the advantage of seeing what works, and what doesn't, before large numbers of cases appear on our doorstep. Our public health agencies, and others, are actively looking for cases and tracking close contacts - something which didn't happen in China for at least a month - which undoubtedly allowed the virus to spread.
While the events occurring with nCoV2019 are concerning, we could have been blindsided like China was. We've had a month to take stock, put plans into motion, learn more about the virus, and even get to work on a vaccine (which is still a long way out).While none of that is guaranteed to prevent CoV2019 from having a big impact here, it is a decided advantage. And one we are lucky to have.
