Estimating the Potential Economic Impact of the Next Influenza Pandemic upon Belize

1. Estimating the Potential Economic Impact of the Next Influenza Pandemic upon Belize Paul Edwards – MOH Belize Rony Maza – PAHO/WHO Belize San Jose, Costa Rica December 16, 2005

2. Country Information Belize’s Population, by Age

3. Country Information-Cont. Basic Hospital Resources Source: CSO mid-year estimates, Belize 2004.

4. Results: Potential Impact on Belize of the Next Influenza Pandemic: 1960s/70s Scenario

5. Results: Potential Impact on Belize of the Next Influenza Pandemic: 1960s/70s Scenario – Cont’d

6. Results: Potential Impact on Belize of the Next Influenza Pandemic: 1960s/70s scenario – Cont’d

7. Results: Potential Impact on Belize of the Next Influenza Pandemic: 1960s/70s Scenario – Cont’d

8. Total Estimates, per Health Outcome, from two Scenarios of Potential Impact of Next Influenza Pandemic in Belize: Most likely (min, max)

9. Demand for Hospital-based Resources: 1960/70s Scenario: 35% Attack Rate: 8 Weeks Duration

10. Hospital Admissions by Week: 1960/70s Scenario: Hospital Admissions (most likely, min, max weekly admissions): 8 weeks duration

11. Demand for Hospital-based Resources: 1918-type scenario: 35% attack rate: 8 weeks duration

12. Hospital admissions by week: 1918-type scenario: 35% attack rate (most likely, min, max weekly admissions): 8 wks duration

13. Workdays Lost due to an Influenza Pandemic: Two scenarios, 8 weeks duration, 35% attack rate † * Percent of annual workdays, calculated as 132,821 fulltime equivalents employed of those aged 15-59 years age (88.4% of 150,250), multiplied by 250 workdays per year. † See Appendix III for details of methods and assumptions ** Estimated based on other studies which demonstrate a 30-40% increase for the 1918-type scenario as compared to the 1960/1970 scenario therefore an average of 35% was utilized

14. Economic Impact: Work-days Lost

15. Value of Lost Workdays Source: CSO: [GDP/(workforce X employment rate)]/250 work days/year= $62.4

16. Value of Direct Medical Care * Total of 1016 (893 + (70% of 177) ** KHMH Budget $7M. Bed occupancy 78.5% of 115 beds (90.3). Therefore ($7M/90.3)/365=$212.38 * Assumed 70% of deaths require medical care equivalent of 10 days ICU Source:

17. MINISTRY OF HEALTH INFLUENZA PANDEMIC PREPAREDNESS PLAN 100 nm NOVEMBER 2005 BELIZE

18. Planning Process • National Committee established with technical sub-committees • 3 preparatory meetings organized • Meeting with stakeholders • Presentation to Cabinet and approval • Development of guidelines and SOPs

19. Background Information • Belize is free of both LPIA and HPIA • Surveillance in both poultry and wild birds

20. Factors Considered in Developing the Plan • Large population of migratory birds: 28% of bird species are migratory (from North and South America) • Significantly large poultry industry • 3% of national population from Asian descent – who travel to and from affected areas • Importation of supplies/equipment from Asian countries • The longest distance migrant is the Arctic Terns. They migrate from the Arctic circle to Antarctica each year – an annual distance of approximately 25,000 miles.

21. Purpose and Objectives of the Plan • Purpose: To protect the Belizean population from the predicted outbreak of the avian flu • General Objective: To reduce the risk and the impact of the avian flu on the country • Specific Objectives: • Reduce opportunities for human infection • Minimize the economic impact on the agricultural/poultry industry • Strengthen early warning systems • Control or delay spread at the source • Reduce morbidity and mortality, and social disruption

22. Response Periods and Phases

23. Budget Summary

24. THANK YOU GRACIAS