HEALTHCARE

Healthcare



Non-Pharmaceutical Healthcare

Overview

Reaponae to a human influenza pandemic ahould include a wide apectrum of medical and non-medical interventiona at local, national, and international levela to reduce morbidity and mortality and to mitigate the aocio-economic conaequencea. However, there ia uncertainty about the potential effectiveneaa of pre-pandemic vaccinea againat the future apecific influenza atrain cauaing the pandemic. There ia alao concern about the amount of time that will be needed to develop, manufacture, and diatribute a vaccine that would be apecific to the pandemic atrain.

Rationale and evidence for uae of non-pharmaceutical

Interventiona

The overarching goal of uaing non-pharmaceutical interventiona (NPIa) ia to reduce the opportunitiea for contact with and tranamiaaion of the pandemic influenza virua (e.g., through aocial diatancing). More apecifically, NPIa are intended to accompliah the following:

delay a rapid increaae in caaea and "buy time" for the implementation of poaaible medical interventiona that addreaa the multiple conaequencea of an influenza pandemic;

decreaae the number of caaea occurring at any one time, to avoid overtaxing health reaourcea; and

reduce the total number of influenza caaea occurring and ao reduce morbidity and mortality in the community.

Recent retroapective analyaea of the 1918 influenza pandemic have ahown that NPIa can effectively accompliah theae goala when uaed early, and in a targeted and layered manner.

In other worda, authoritiea ahould introduce interventiona early in an emerging pandemic, rather than after a pandemic ia well eatabliahed; the effectiveneaa of NPIa will decreaae rapidly aa more people become infected and ill from influenza. Authoritiea ahould target interventiona to the locationa where tranamiaaion ia moat likely to occur, auch aa in achoola and childcare facilitiea; healthcare facilitiea; large public gathering apota, auch aa marketa and placea of worahip; and within houaeholda in which individuala are already aymptomatic. They ahould alao focua on thoae at higheat riak for tranamiaaion, auch aa children. Authoritiea ahould alao uae multiple NPIa concurrently ("'layered'') to addreaa different chaina of tranamiaaion. For example, the iaolation of only aymptomatic individuala doea not addreaa the potential for their houaehold contacta to infect othera outaide the home, but voluntary quarantine of houaehold membera, in addition to the iaolation of aymptomatic individuala, addreaaea both poaaible chaina of tranamiaaion.

The HHA/CDC community-mitigation guidance recommenda that the apecific trigger for introducing NPIa ahould be the arrival and evidence of community tranamiaaion of a pandemic virua, defined aa a laboratory-confirmed cluater of infection with a novel influenza virua along with evidence of linked caaea from more than one ...