Pandemic Influenza Plan - Centers for Disease Control and ...

1 Pandemic Influenza Plan2017 Department of Health and Human ServicesContents FOREWORD .. 3 EXECUTIVE SUMMARY .. 5 INTRODUCTION .. 7 SCOPE, AUDIENCE, AND PURPOSE .. 10 Influenza RESPONSE ACTIVITIES .. 11 PLANNING TOOLS FOR PREPARATION AND RESPONSE .. 12 THE 2017 UPDATE TO THE HHS Pandemic Influenza plan .. 13 Domain 1 Surveillance, epidemiology , and Laboratory Activiti es .. 14 Domain 2 Community Mitigation Measures .. 18 Domain 3 Medical Countermeasures: Diagnosti c Device s, Vaccines, Therapeutics, and Resp iratory Devic es .. 21 Domain 4 Health Care System Preparedness and Response Activities .. 27 Domain 5 Communications and Public Outreac h .. 30 Domain 6 Scientifi c Infrastructure and Preparedness .. 32 Domain 7 Domestic and International Response Policy, Incident Management, and Global Partnerships and Capacity Building.

2 35 CONCLUSIONS .. 40 APPENDIX A .. 41 PLANNING 41 Planning Assumptions .. 42 Table Estimated Illness, Types of Medic al Care, and Deaths fr om a Moderate to Very Severe Influenza Pandemic .. 44 APPENDIX B .. 45 PLANNING TOOLS .. 45 Pandemic Inte rvals Framework .. 46 Fi gure Preparedness and response framework f or novel i nfluenza A vir us pandemics: CDC 47 Table Preparedness and response framework f or novel i nfluenza A vir us pandemics: World Health Organization phases and CDC intervals, with federal and stat e/loc al 48 Influenza Risk Assessment T ool (IRAT) .. 50 Pandemic Severit y Assessment Framework (PSAF) .. 51 FOREWORD The last Pandemic Infl uenza plan for the Department of Health a nd Human Servi c es Update was issued in 2009.

3 Since that time, our nation has experienced, and learned from, the 2009 Influenza A(H1N1) Pandemic and the emergence o f other Influenza virus es of concern, such as H7N9 that emerged in 2013 in China and continues to cause periodic outbreaks. W e have also responded to other se rious di seas e outbreaks, including Ebola and Zika v irus. Each instance has highlig hted the need to be as prepared as we c an be because a fast, effective public health response demands it. The original 2005 plan was audacious in its goals f or domestic Pandemic vaccine pr oduction capacity, for stoc kpiling of antiv iral drugs and pre-pandemi c vaccines, and for using community mitig ation measures to slow spread of Disease . At the time of the plan s writing, the N ation was wholly unprepared to address the significant medical and health needs that a severe Pandemic might present.

4 Challenges included limi ted domestic vaccine manufacturing capacity, a very low supply of antiv iral drugs, and lack of community planning f or responding to an infecti ous diseas e outbreak. More than t en years later, we have many successes to celebrate but we must not become complacent, because so many challenges remain. Today, wi th a domestic vaccine manufacturing c apacity well-es tablished, stockp iles maintained, and evidence-based guidance on preventio n, mitigation and treatment available for st ate and loc al governments, the private s ector, indivi duals, and fa mili es, we fac e different challenges how to sustain the advances we have made, to keep up wi th the c hanges in how people live and work, and to close in on those goals that have proved more elusiv e.

5 Pandemi c Influenza is different from other outbreaks we have faced because the characteristics of Influenza virus es their propensity to c hange, the ability to sp read easily among people, and the r outes of transmission make the di sease challengi ng to co ntain. Throughout hi story , Influenza pandemics have led to wi des pread illness and death. Pandemic infl uenza is not a t heoretic al thre at; r ather, it i s a recurring threat. Even s o, we don t know when the next pandemi c will occur, or h ow severe it will be. The 2005 Pandemic Influ enza plan and subsequent updates focused planning for a severe Pandemic wi th e ffects that would extend beyond health consequences to i nclude social and economic disruptio n.

6 By preparing exclusively for a very s evere Pandemic , the plan did not include specific guidance f or the type of pandemi c we experienced in 2009, which w as comparatively less severe. However, the c apabilities that were developed through the HHS plan , the National Strategy for Pandemic Influenza , and its companion 2006 Implementation plan , were eff ectively adapted and used to respond to the Pandemic that emerged. Lessons learned were c aptured to inform future responses. We issue this 2017 Update to the HHS Pandemic Influenza plan with the aim of highlighting and building upon the successes of the last decade, and making clear the 3 additional efforts that are needed to improve Pandemic preparedness. These efforts are described in the seven domains that form the basis for this update.

7 However, scientifi c progress in the last dec ade compels us not only to articulat e what is possible, but w hat is needed to truly transform our Pandemic prepare dness to be more visionary. Innovation and new approaches should be considered to augment planning and response. W ith this in mind, HHS is exploring: The development of innovative diagnostic testing and Disease monitoring, building on the emerging technologies used for personalized health, including the potential for home diagnostic testing and on-line access to health care services. Re-conceptualizing r espiratory protection to limit transmi ssion of dis ease from those who are infected to those who are well and protect caregivers and other responders by redesigning respiratory protective devices so t hey provide better protection and are easy and practic al to use.

8 Accelerating vaccine and a ntiv iral development, with a goal of having vaccine ready for administration within 3 months of the emergence of a Pandemic strai n, and approved broad spectrum antiv iral therapies suitable for a range o f Influenza and other v iral pathogens. Modernizing medical countermeasure distribution a nd administration by linking information technolo gy and m odern supply chain science to patterns of human behavior and care seeking. Ensuring people get the right care at the right pl ace and at the right time, beginning wi th tools to aid individuals in their care seeking a nd decisi on making, and implementing surge strategies so that people receive care that is safe and appropriate to their level of need, thereby conserving hi gher levels of care for t hose who need it.

9 Thes e g oals are attai nable , but achieving them w ill require dedication in terms of res ourc es, in novation, education and outreach, and commitment. Although Pandemic Influenza threats are one of the greatest public health challenges of our time, other emerging infectious diseases can also have a devastating impact on human health. Balancing the need to respond to threats as they emerge with the long-term preparedness activities needed to mitigate them represents a significant challenge. However, the capacity and capabilities developed for Pandemic Influenza preparedness will enable HHS to respond more effectively to other emerging infectious diseases. 4 EXECUTIVE SUMMARY In 2 005, the Depart ment of Health and Human Servic es (HHS) developed the HHS Pandemic Infl uenza plan to prevent, Control , and mitigate t he effects of Influenza virus es that p ose high risk to humans.

10 Influ enza virus es, of which there are many ty pes, can cause rapid, wi despread di sease and death. Pandemic Influenza outbreaks in the 20th Century alone left tens o f milli ons of people dead in their wake and c ost hundreds of billi ons of dollars in lost liv es, wages , productivi ty and economic devas tati on. Influenza virus es wi th pandemi c potenti al require the rapid development, pro duction and availability of medical countermeasures (MCMs) such as v accines, diagnostics and antiv iral drugs to mitigate the impact of the Pandemic , as well as additional preparedness and response e fforts beyond medical countermeasures. HHS has made substantial progress in Pandemic Influenza preparedness since the 2005 plan was released.