Group 1 report to the plenary

1. Group 1 report to the plenary 3rd NIC Meeting, WPR-SEAR

2. Objective 1: Need to strengthen surveillance • Surveillance strategy was adapted to the changing pandemic phase in all countries: • Attempts and challenges faced in monitoring severity • Serological surveillance

3. Objective 2: Need to strengthen NIC contingency planning • Q4:Existance of NIC contingency plan and how have NICs handled increased workload • So far, amongst the developing countries only Thailand has NIC contingency plan • BSL level required will affect greatly the contingency plan.

4. Objective 3: Need for timely shift from containment to mitigation and identify possible public health measures • Q6:Mitigation measures implemented so far • Public education on personal hygiene. • Modalities: • School-based hygiene education done in Thailand and Fiji. • Media campaign in Australia. • Contents: • Cough etiquette • Staying at home when sick • Hand-washing • Mask wearing (in some countries) • School closure • Many countries applied it despite some perceived it as ineffective. • Some countries applied in context of containment. • Destructive consequence in some countries.

5. Objective 3: Need for timely shift from containment to mitigation and identify possible public health measures • Q7:Decision making process in applying public health measures e.g. school closure • Resource stretch triggered alteration from containment to mitigation. • National level made the decision on who to prioritize in antiviral Tx, hygiene practices, school closure, etc. in Australia. • MOH decided initial school closure in Malaysia but the direction altered afterward to let each school to decide. • Q8:Experiences and lessons learned from public health measures application • Fiji ; sugar production company was engaged in hygiene practices while they maintain their productive capacity (major economy on the island). • Over-reaction to media campaign experienced in Australia.

6. Objective 3: Need for timely shift from containment to mitigation and identify possible public health measures • Q9:Primary concerns, needs and priorities in coming months • Stock piling of not only antivirals but also antibiotics and other pharmaceuticals pose concern to developing nations. • Zanamivir stock pile in preparation of resistance. Influenza virus develop resistance to zanamivir less frequently. • WHO has set no definite standard of what to stockpile to what extent.

7. Objective 4: Need for regional influenza information sharing mechanism • Q10:Needs of knowing other countries’ information • Virus spread does not observe national boundary. • Neighboring countries’ measures affect the epidemiology of a certain country. • Optimal use of internet technology for information sharing expected. • Information overflow is also posing a problem.

8. Objective 4: Need for regional influenza information sharing mechanism • Q11:Necessity of regional influenza information sharing mechanism • Needs: • Information sharing through IHR system does not capture seasonal influenza. • Monitoring non-pandemic strains is essential particularly for updating the candidate vaccine virus. • Periodical regional updates and discussion will be necessary to move forward in pandemic response. • Points to consider • Feedback should be quick since the evolution of the situation is rapid. • WHO CC feedback to NICs intended/PAC-Net in place and considered useful. • Regional mechanism may be prone to the level of transparency of the surveillance of each country. • Epidemiological and laboratory data matching is difficulty even in-country (expect regional mechanism to facilitate link?)

9. Other proposals and feedbacks • Country-specific rather than generic WHO guidance was proposed by some countries (Maybe more the MOH responsibility?). • NICs face challenge on how to communicate interpretations of the surveillance data in-country (e.g. CFR or number of deaths that provoked lots of public queries and concerns).