Speculative Models

Epidemiological Models

  • Modelling Infectious Diseases Agent Study (MIDAS) (NIGMS / NIH)
  • Researchers Model Avian Flu Outbreak, Impact of Interventions
    A carefully chosen combination of public health measures, if implemented early, could stop the spread of an avian flu outbreak at its source, suggest two international teams of researchers in Nature (August 3) and Science (August 5).
    The results suggest that an international stockpile of 3 million courses of flu antiviral drugs, combined with other interventions, could contain a pandemic. Treating infected individuals and everyone in their vicinity, along with closing schools and workplaces, could have more than a 90 percent chance of stopping the spread of a pandemic virus, according to the model. Ferguson emphasized that successful containment would depend on the early detection of the first cases and the rapid implementation of public health measures.
    • computer simulation of an uncontrolled outbreak of transmissible avian flu in people living in Thailand. Red indicates new cases while green indicates areas where the epidemic has finished. The movie shows the spread of infection and recovery over 300 days in Thailand and neighboring countries. (requires real player)
    • computer simulation of a controlled outbreak of transmissible avian flu in people living in Thailand. Red indicates areas of infection while blue indicates areas where a combination of control measures has been implemented. The movie shows that this approach contains the infection in 90 days, before it spreads elsewhere. req. real player)
  • from CDC’s References and Resources:
    • FluAid 2.0
      For download. Flu Aid 2.0 (currently a beta test version) is designed to help State and local-level public health officials plan, prepare, and practice for the next influenza pandemic by modeling the impact a pandemic might have on their community. The software is designed to provide a range of estimates of impact in terms of deaths, hospitalizations, and outpatient visits due to pandemic influenza. The software does not provide any description of how the pandemic will spread, i.e., when a specific community will be affected. For more information about FluAid 2.0, contact Martin Meltzer, Ph.D., Centers for Disease Control and Prevention, NCID/OD/OS, Mailstop C-12, 1600 Clifton Road, Atlanta, GA 30333, E-mail: qzm4@cdc.gov
    • Flu Surge
      For download. FluSurge is a spreadsheet-based model which provides hospital administrators and public health officials estimates of the surge in demand for hospital-based services during the next influenza pandemic. FluSurge estimates the number of hospitalizations and deaths of an influenza pandemic and compares the number of persons hospitalized, the number of persons requiring ICU care, and the number of persons requiring ventilator support during a pandemic with existing hospital capacity. For more information about FluSurge, contact Martin Meltzer, Ph.D., Centers for Disease Control and Prevention, NCID/OD/OS, Mailstop C-12, 1600 Clifton Road, Atlanta, GA 30333, E-mail: qzm4@cdc.gov.
    • Flu surge instructions .pdf, 47 pages
    • FluWorkLoss 1.0
      FluWorkLoss estimates the potential number of days lost from work due to an influenza pandemic. Users can change almost any input value, such as the number of workdays assumed lost when a worker becomes ill or the number of workdays lost due to a worker staying home to care for a family member. Users can also change the length and virulence of the pandemic so that a range of possible impacts can be estimated. FluWorkLoss provides a range of estimates of total workdays lost, as well as graphic illustrations of the workdays lost by week and percentage of total workdays lost to influenza-related illnesses. An example of the results produced by FluWorkLoss is given below.


  • In a word: Containment, by Dick Thompson, January 5, 2008
    Excerpt: Few scientists now believe that containment is actually achievable… …the seed of containment’s failure is in the word itself. It is a binary word. Something is contained or not… I believe that WHO and others should stop using the word now… To me, maintaining the public’s trust in health authorities throughout a pandemic is as important as restraining the spread of the virus at the start. An initial, high-profile failure of containment won’t help build trust.


References

  • Containing Pandemic Influenza at the Source. Ira M. Longini Jr, Azhar Nizam, Shufu Xu, Kumnuan Ungchusak, Wanna Hanshaoworakul, Derek A. T. Cummings, and Elizabeth M. Halloran. 10.1126/Science. 2005 Aug 12;309(5737):1083-7. Epub 2005 Aug 3 (subs. req.) abstract
  • Strategies for containing an emerging influenza pandemic in Southeast Asia. Neil M. Ferguson, Derek A.T. Cummings, Simon Cauchemez, Christophe Fraser, Steven Riley, Aronrag Meeyai, Sopon Iamsirithaworn and Donald S. Burke. Nature. 2005 Sep 8;437(7056):209–14. Epub 2005 Aug 3. abstract
  • Containing Pandemic Influenza with Antiviral Agents. Ira M. Longini, Jr. , M. Elizabeth Halloran, Azhar Nizam and Yang Yang. Am J Epidemiol. 2004 Apr 1;159(7):623–33. abstract full text pdf
  • related scientific papers at PubMed

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Tabletop Exercises

See also Community and Government Planning Exercises

One of the best ways to get your community or hospital ready for a crisis situation is through table top exercises. They not only encourage people to imagine and begin to plan mentally for what might happen, but perhaps more importantly, they bring people together from different domains and agencies that might otherwise not become acquainted. In a crisis, rather than the “plan on paper” that governs things, it will be the informal and personal relationships that get things done. These exercises help establish those relationships.

DHHS’s National Vaccine Program Office has devised a template for such an exercise. Here is their description. The entire document can be found here (link not working).

Alternative tabletop link from pandemicflu.gov

Pandemic Influenza Tabletop Exercise Package
INTRODUCTION
The purpose of this pandemic influenza tabletop exercise package is to provide states and local areas with tools to assist in planning and conducting tabletop exercises on the topic of pandemic influenza. Exercises serve to identify where plans may need to be refined or modified, and thus lead to strengthening preparedness. Exercises should be viewed as an integral part of planning activities.
This package includes two exercises: an overview exercise and a surge capacity exercise, as well as other resources helpful in planning and conducting these exercises. The exercises are designed for use at the state or local levels, and are designed to be general enough to be useful in any area. Users are encouraged to tailor the exercises as needed to meet their needs. The exercises and other resources included in the package are described below.
The objectives of these exercises are to:
* Raise awareness about impact of pandemic influenza on the health care system
* Increase understanding regarding the responsibilities of all participating agencies
* Determine whether current plans adequately address anticipated events
* Identify gaps in coordination between agencies
* Promote advance planning between health departments, hospitals, and other agencies.
Brief description of the exercises
Overview exercise The overview exercise addresses planning issues that will arise during the course of an influenza pandemic over an array of areas, including surveillance, vaccination, antiviral medications, communications, and emergency response. Participants for the overview exercise will include people who will be involved in planning for and responding to a pandemic, including, but not limited to staff in the areas of public health, public information, public safety, emergency management, and health care. The emphasis of this exercise is on the public health response.
Surge capacity exercise The surge capacity exercise focuses on medical surge capacity issues; these issues are addressed in greater depth than in the overview exercise. Participants for the surge capacity exercise will be from the same groups as for the overview exercise, but more heavily skewed toward representatives of local hospitals and emergency management services. The emphasis of this exercise is on the response of the health care system. Issues related to surveillance, vaccination, and antiviral medications are not addressed in this exercise.

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  • We might want to think about a positive scenario – “what went right, and what can we learn from it?”

Rapid Response Training: The Role of Public Health in a Multi-Agency Response to Avian Influenza in the United States from CSTE

See also Community and Government Planning Exercises

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Page last modified on October 12, 2009, at 09:43 PM by pogge