Mitigation strategies for pandemic influenza A: balancing conflicting policy objectives.

Mitigation of a severe influenza pandemic can be achieved using a range of interventions to reduce transmission. Interventions can reduce the impact of an outbreak and buy time until vaccines are developed, but they may have high social and economic costs. The non-linear effect on the epidemic dynam...

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Autores principales:	T Déirdre Hollingsworth, Don Klinkenberg, Hans Heesterbeek, Roy M Anderson
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/76ec612d9f5048c8bff52d19f152648e
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spelling	oai:doaj.org-article:76ec612d9f5048c8bff52d19f152648e2021-11-18T05:50:44ZMitigation strategies for pandemic influenza A: balancing conflicting policy objectives.1553-734X1553-735810.1371/journal.pcbi.1001076https://doaj.org/article/76ec612d9f5048c8bff52d19f152648e2011-02-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21347316/?tool=EBIhttps://doaj.org/toc/1553-734Xhttps://doaj.org/toc/1553-7358Mitigation of a severe influenza pandemic can be achieved using a range of interventions to reduce transmission. Interventions can reduce the impact of an outbreak and buy time until vaccines are developed, but they may have high social and economic costs. The non-linear effect on the epidemic dynamics means that suitable strategies crucially depend on the precise aim of the intervention. National pandemic influenza plans rarely contain clear statements of policy objectives or prioritization of potentially conflicting aims, such as minimizing mortality (depending on the severity of a pandemic) or peak prevalence or limiting the socio-economic burden of contact-reducing interventions. We use epidemiological models of influenza A to investigate how contact-reducing interventions and availability of antiviral drugs or pre-pandemic vaccines contribute to achieving particular policy objectives. Our analyses show that the ideal strategy depends on the aim of an intervention and that the achievement of one policy objective may preclude success with others, e.g., constraining peak demand for public health resources may lengthen the duration of the epidemic and hence its economic and social impact. Constraining total case numbers can be achieved by a range of strategies, whereas strategies which additionally constrain peak demand for services require a more sophisticated intervention. If, for example, there are multiple objectives which must be achieved prior to the availability of a pandemic vaccine (i.e., a time-limited intervention), our analysis shows that interventions should be implemented several weeks into the epidemic, not at the very start. This observation is shown to be robust across a range of constraints and for uncertainty in estimates of both R(0) and the timing of vaccine availability. These analyses highlight the need for more precise statements of policy objectives and their assumed consequences when planning and implementing strategies to mitigate the impact of an influenza pandemic.T Déirdre HollingsworthDon KlinkenbergHans HeesterbeekRoy M AndersonPublic Library of Science (PLoS)articleBiology (General)QH301-705.5ENPLoS Computational Biology, Vol 7, Iss 2, p e1001076 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Biology (General) QH301-705.5
spellingShingle	Biology (General) QH301-705.5 T Déirdre Hollingsworth Don Klinkenberg Hans Heesterbeek Roy M Anderson Mitigation strategies for pandemic influenza A: balancing conflicting policy objectives.
description	Mitigation of a severe influenza pandemic can be achieved using a range of interventions to reduce transmission. Interventions can reduce the impact of an outbreak and buy time until vaccines are developed, but they may have high social and economic costs. The non-linear effect on the epidemic dynamics means that suitable strategies crucially depend on the precise aim of the intervention. National pandemic influenza plans rarely contain clear statements of policy objectives or prioritization of potentially conflicting aims, such as minimizing mortality (depending on the severity of a pandemic) or peak prevalence or limiting the socio-economic burden of contact-reducing interventions. We use epidemiological models of influenza A to investigate how contact-reducing interventions and availability of antiviral drugs or pre-pandemic vaccines contribute to achieving particular policy objectives. Our analyses show that the ideal strategy depends on the aim of an intervention and that the achievement of one policy objective may preclude success with others, e.g., constraining peak demand for public health resources may lengthen the duration of the epidemic and hence its economic and social impact. Constraining total case numbers can be achieved by a range of strategies, whereas strategies which additionally constrain peak demand for services require a more sophisticated intervention. If, for example, there are multiple objectives which must be achieved prior to the availability of a pandemic vaccine (i.e., a time-limited intervention), our analysis shows that interventions should be implemented several weeks into the epidemic, not at the very start. This observation is shown to be robust across a range of constraints and for uncertainty in estimates of both R(0) and the timing of vaccine availability. These analyses highlight the need for more precise statements of policy objectives and their assumed consequences when planning and implementing strategies to mitigate the impact of an influenza pandemic.
format	article
author	T Déirdre Hollingsworth Don Klinkenberg Hans Heesterbeek Roy M Anderson
author_facet	T Déirdre Hollingsworth Don Klinkenberg Hans Heesterbeek Roy M Anderson
author_sort	T Déirdre Hollingsworth
title	Mitigation strategies for pandemic influenza A: balancing conflicting policy objectives.
title_short	Mitigation strategies for pandemic influenza A: balancing conflicting policy objectives.
title_full	Mitigation strategies for pandemic influenza A: balancing conflicting policy objectives.
title_fullStr	Mitigation strategies for pandemic influenza A: balancing conflicting policy objectives.
title_full_unstemmed	Mitigation strategies for pandemic influenza A: balancing conflicting policy objectives.
title_sort	mitigation strategies for pandemic influenza a: balancing conflicting policy objectives.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/76ec612d9f5048c8bff52d19f152648e
work_keys_str_mv	AT tdeirdrehollingsworth mitigationstrategiesforpandemicinfluenzaabalancingconflictingpolicyobjectives AT donklinkenberg mitigationstrategiesforpandemicinfluenzaabalancingconflictingpolicyobjectives AT hansheesterbeek mitigationstrategiesforpandemicinfluenzaabalancingconflictingpolicyobjectives AT roymanderson mitigationstrategiesforpandemicinfluenzaabalancingconflictingpolicyobjectives
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Mitigation strategies for pandemic influenza A: balancing conflicting policy objectives.

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