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Scenarios on the impact of pandemic influenza: preparedness planning

Marianne van Genugten, Marie-Louise Heijnen, Hans Jager. Scenarios on the impact of pandemic influenza: preparedness planning. Pandemic influenza?. Influenza viruses changes slightly and frequently over time (antigenic drift) In some years the virus changes dramatically (antigenic shift)

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Scenarios on the impact of pandemic influenza: preparedness planning

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  1. Marianne van Genugten, Marie-Louise Heijnen, Hans Jager Scenarios on the impact of pandemic influenza: preparedness planning

  2. Pandemic influenza? • Influenza viruses changes slightly and frequently over time (antigenic drift) • In some years the virus changes dramatically (antigenic shift) • Earlier pandemics

  3. Pandemic plan • Another influenza pandemic is inevitable • High morbidity and mortality  Influenza pandemic plan The Dutch Ministry on Health, Welfare and sports has designed a national plan in order to minimise the effects of pandemic influenza

  4. Question What is the expected number of of hospitalisations and deaths during an influenza pandemic? 1) What are options for intervention?  Building-up of stocks (national level) 2) Number of hospital beds needed versus available.  Contingency planning (local level)

  5. Method Many uncertainties  Scenario-analysis • model and data • expert consultation • assumptions • scenario’s

  6. Model

  7. Data need • Population by risk • Age-specific attack, hospitalisation and death rates • including excess • Efficacy

  8. Main assumptions pandemic influenza  ‘usual’ epidemic influenza • age-specific hospitalisation, death and attack rates as in earlier epidemics • basic care (sensitivity analysis on age-specific rates)

  9. Scenarios • Non intervention • No influenza vaccine available and pneumococcal vaccination of risk groups • No influenza vaccine available and therapeutic use of antivirals for each person with influenza like illness • Influenza vaccine available

  10. Number of hospitalisations and deaths

  11. Result 1: Avoided number of hospitalisations / required doses

  12. Result 2: Hospital beds needed/available Non intervention scenario • duration 6 weeks • length of hospital stay 8-14 days  6.000-8.500 beds needed Total number of beds 55.000 Beds available depends on occupancy rate and nursing staff available

  13. Preparedness planning RIVM  policy makers Message policy makers  ‘flu’ can be serious minister of Health (national level) contingency planners (local level)

  14. Conclusions Scenario-analysis supports decision makers and contingency planners on national and local level Insight in • the number of hospitalisations and deaths • comparison of intervention options • the crucial model parameters

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