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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: Hollingsworth, T. Déirdre, Klinkenberg, Don, Heesterbeek, Hans, Anderson, Roy M.
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3037387/
https://www.ncbi.nlm.nih.gov/pubmed/21347316
http://dx.doi.org/10.1371/journal.pcbi.1001076
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author Hollingsworth, T. Déirdre
Klinkenberg, Don
Heesterbeek, Hans
Anderson, Roy M.
author_facet Hollingsworth, T. Déirdre
Klinkenberg, Don
Heesterbeek, Hans
Anderson, Roy M.
author_sort Hollingsworth, T. Déirdre
collection PubMed
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.
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spelling pubmed-30373872011-02-23 Mitigation Strategies for Pandemic Influenza A: Balancing Conflicting Policy Objectives Hollingsworth, T. Déirdre Klinkenberg, Don Heesterbeek, Hans Anderson, Roy M. PLoS Comput Biol Research Article 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. Public Library of Science 2011-02-10 /pmc/articles/PMC3037387/ /pubmed/21347316 http://dx.doi.org/10.1371/journal.pcbi.1001076 Text en Hollingsworth et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Hollingsworth, T. Déirdre
Klinkenberg, Don
Heesterbeek, Hans
Anderson, Roy M.
Mitigation Strategies for Pandemic Influenza A: Balancing Conflicting Policy Objectives
title 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_short Mitigation Strategies for Pandemic Influenza A: Balancing Conflicting Policy Objectives
title_sort mitigation strategies for pandemic influenza a: balancing conflicting policy objectives
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3037387/
https://www.ncbi.nlm.nih.gov/pubmed/21347316
http://dx.doi.org/10.1371/journal.pcbi.1001076
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