Wednesday, July 24, 2024

PAHO IRIS: Developing Respiratory Pathogen Pandemic Preparedness Plans

#18,203

While No Pandemic Plan Survives Contact With A Novel Virus, it remains vital for countries, government agencies, and even the private sector to have well conceived and practical pandemic plans going into any public health crisis.

During the first decade of the 21st century when H5N1 was raging in Asia, there were huge pushes for pandemic planning, but after the relatively mild 2009 H1N1 pandemic, most were relegated to some dusty drawer, and forgotten. 

The CDC/HHS updated their pandemic plans in 2017 (see CDC/HHS Community Pandemic Mitigation Plan - 2017), but around the country (and around the world), actual pandemic preparedness had been largely put on a back burner. 

In August of 2019, in WHO: Survey Of Pandemic Preparedness In Member States, we saw the dismal results of a two-year survey of global pandemic preparedness. Sadly, only just over half (n=104, or 54%) of member states responded. And of those, just 92 stated they had a national pandemic plan. Nearly half (48%) of those plans were created prior to the 2009 pandemic, and have not been updated since. 
It gets worse, as only 40% of the responding countries have tested their pandemic preparedness plans - through simulated exercises - in the past 5 years.  

Much like the IHR 2005 compliance (see Lancet Preprint: National Surveillance for Novel Diseases - A Systematic Analysis of 195 Countries), all of this was self-reported, and in retrospect some of their readiness was badly `overstated'.

As the world discovered in 2020, it isn't enough to produce a glossy document.
 
Plans must be tested, and procedures honed and refined. Far too often, plans relied on overly optimistic assumptions about the expected impact from the virus, and the availability of vaccines, antivirals, and hospital beds. 

Since COVID, we've seen very little progress in pandemic planning. In fact, we seem to have back-slid, having dismantled much of our surveillance and reporting systems. But in the past few months, we've started to see some movement again.

A month ago, we saw South Korea CDC Release a Revised ‘Influenza Pandemic Preparedness and Response Plan’ and last week, Japan's Ministry of Health Unveiled Revised Pandemic Plans.   

Here in the United States, a month ago ASPR released their pandemic influenza preparedness and response strategy, and earlier this month the HHS committed $176 million to develop a pandemic influenza mRNA-based vaccine.

Last March the WHO released a 110-page document to assist member nations in preparing, or updating, their plans to deal with a novel respiratory pathogen pandemic (Link).


To further encourage nations to take action, last week PAHO release a 9-page introduction on how to go about creating, or updating, their pandemic response plans. 
Developing respiratory pathogen pandemic preparedness plans

View/Open
English; 9 pages (2.816Mb)
Date 2024-07-11

Document Number
PAHO/PHE/IHM/24-0002

Author
Pan American Health Organization
Planning for public health emergencies should ensure that capabilities developed during previous emergencies are maintained, incorporated, and put into practice when a new event of public health concern arises. Investments in pandemic preparedness lead to more rapid detection and a stronger response to public health threats, thereby shielding communities from the debilitating social and economic effects of epidemics and pandemics.
The Pan American Health Organization (PAHO) recognizes the efforts of countries in the Region of the Americas to develop and/or strengthen their respiratory pathogen pandemic plans. PAHO supports planning activities with tools and expertise, aligning these efforts with the Preparedness and Resilience for Emerging Threats (PRET) initiative.
The PRET initiative is an innovative approach to improving disease pandemic preparedness. It recognizes that the same systems, capacities, knowledge, and tools can be leveraged and applied for groups of pathogens based on their mode of transmission (respiratory, vector-borne, foodborne etc.). The PRET initiative incorporates the latest tools and approaches for shared learning and collective action established during the COVID-19 pandemic and other recent public health emergencies. It places the principles of equity, inclusivity, and coherence at the forefront.
This document outlines four steps for respiratory pathogen pandemic planning (PRET Module1). Step 1: Prepare, analyze the situation and engage stakeholders, Step 2: Draft the plan, Step 3: Evaluate, finalize and disseminate the plan and Step 4: Implement, monitor and continuously evaluate the plan.
The scope of this document is guide the process of updating and developing preparedness and response plans for pandemics caused by respiratory pathogens, in order to strengthen their basic capacities and encourage the countries of the Region of the Americas to have operational, proven plans, and with a regular monitoring and updating plan to address epidemics and pandemics in the face of this type of threat.
          https://iris.paho.org/bitstream/handle/10665.2/60550/PAHOPHEIHM240002_eng.pdf
 

Hopefully, more nations around the world will take note and act.  But pandemic planning isn't just for governments or agencies.  Businesses, both large and small, civic organizations, and even families should be making pandemic plans as well (see Does Your Company Have A CPO?).

While it may be years before the next pandemic emerges - as we've seen - the world can change literally overnight.  And once that happens, the options for preparedness rapidly wane. 

Sadly, many of the older CDC pandemic guidance documents have broken links, have been `retired', or are difficult to find.  After some searching I was able to find:

As they say, the ball is in your court. 

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