CDC Releases Interim Pre-Pandemic Planning Guidance

Developed in close collaboration with federal agencies and partners in the public health, education, business, healthcare, and private sectors, the Centers for Disease Control and Prevention (CDC) has released a new interim pre-pandemic planning guidance.  The guidance is intended for State, territorial, tribal, and local communities and focuses on several non-pharmaceutical measures (interventions other than vaccination and drug treatment) that might be useful in reducing the harm posed by an influenza pandemic. Communities, individuals and families, employers, schools and other organizations will be asked to plan for the use of these interventions to help limit the spread of a pandemic, prevent disease and death, lessen the impact on the economy, and keep society functioning.

A Pandemic Severity Index that characterizes the severity of a pandemic is introduced, which provides planning recommendations for specific interventions that communities may use for a given level of pandemic severity, and suggests when these measures should be started and how long they should be used.  Also included are tailored planning guides for businesses and other employers, child care programs, elementary and secondary schools, colleges and universities, faith-based and community organizations, and individuals and families. 

This guidance will be updated when significant new information about the usefulness and feasibility of these approaches emerges.  Current community mitigation recommendations include:

1)     Asking ill people to voluntarily remain at home and not go to work or out in the community for about 7-10 days or until they are well and can no longer spread the infection to others;

2)     Asking members of households with a person who is ill to voluntarily remain at home for about 7 days;

3)     Dismissing students from schools (including public and private schools as well as colleges and universities) and school-based activities and closure of childcare programs for up to 12 weeks, coupled with protecting children and teenagers through social distancing in the community, to include reductions of out-of-school social contacts and community mixing; and

4)     Recommending social distancing of adults in the community, which may include cancellation of large public gatherings; changing workplace environments and schedules to decrease social density and preserve a healthy workplace to the greatest extent possible without disrupting essential services; ensuring work-leave policies to align incentives and facilitate adherence with the measures outlined above. 

These measures may serve as one component of a comprehensive community mitigation strategy that includes both pharmaceutical and non-pharmaceutical interventions, and this interim guidance includes initial discussion of a potential strategy for combining the use of antiviral medications with these interventions.  Moreover, according to the CDC, a vaccine would provide the best protection against the spread of the virus; however, it won’t be available when a pandemic begins.  Therefore, planning ahead on taking coordinated action early in a pandemic provides the best chance of limiting the spread of disease and reducing the number of people who become sick, until a vaccine becomes available during a pandemic. 

In order for all of these measures to take place, communities will have to be willing to plan ahead and accordingly  comply with the interventions if needed.  A Harvard School of Public Health public opinion poll on community mitigation interventions, conducted with a nationally representative sample of adults over the age of 18 years in the U.S. in September and October 2006, indicated that most respondents were willing to follow public health recommendations for the use of non-pharmaceutical interventions, but it also revealed financial and other concerns. 

To view the draft report on the poll, please visit http://www.keystone.org/Public_Policy/ReportCCM01-09-07.pdf.  To access the full interim guidance document, please visit http://www.pandemicflu.gov/plan/community/community_mitigation.pdf.

For additional information on Pandemic Flu, please go to www.pandemicflu.gov.

Source:  Interim Pre-Pandemic Planning Guidance:  Community Strategy for Pandemic Influenza Mitigation in the United States – Early, Targeted, Layered Use of Nonpharmaceutical Interventions, CDC, February 2007.