SummaryWhen a novel influenza A virus with pandemic potential emerges, nonpharmaceutical interventions (NPIs) often are the most readily available interventions to help slow transmission of the virus in communities, which is especially important before a pandemic vaccine becomes widely available. NPIs, also known as community mitigation measures, are actions that persons and communities can take to help slow the spread of respiratory virus infections, including seasonal and pandemic influenza viruses.These guidelines replace the 2007 Interim Pre-pandemic Planning Guidance: Community Strategy for Pandemic Influenza Mitigation in the United States — Early, Targeted, Layered Use of Nonpharmaceutical Interventions (https://stacks.cdc.gov/view/cdc/11425). Several elements remain unchanged from the 2007 guidance, which described recommended NPIs and the supporting rationale and key concepts for the use of these interventions during influenza pandemics. NPIs can be phased in, or layered, on the basis of pandemic severity and local transmission patterns over time. Categories of NPIs include personal protective measures for everyday use (e.g., voluntary home isolation of ill persons, respiratory etiquette, and hand hygiene); personal protective measures reserved for influenza pandemics (e.g., voluntary home quarantine of exposed household members and use of face masks in community settings when ill); community measures aimed at increasing social distancing (e.g., school closures and dismissals, social distancing in workplaces, and postponing or cancelling mass gatherings); and environmental measures (e.g., routine cleaning of frequently touched surfaces).Several new elements have been incorporated into the 2017 guidelines. First, to support updated recommendations on the use of NPIs, the latest scientific evidence available since the influenza A (H1N1)pdm09 pandemic has been added. Second, a summary of lessons learned from the 2009 H1N1 pandemic response is presented to underscore the importance of broad and flexible prepandemic planning. Third, a new section on community engagement has been included to highlight that the timely and effective use of NPIs depends on community acceptance and active participation. Fourth, to provide new or updated pandemic assessment and planning tools, the novel influenza virus pandemic intervals tool, the Influenza Risk Assessment Tool, the Pandemic Severity Assessment Framework, and a set of prepandemic planning scenarios are described. Finally, to facilitate implementation of the updated guidelines and to assist states and localities with prepandemic planning and decision-making, this report links to six supplemental prepandemic NPI planning guides for different community settings that are available online (https://www.cdc.gov/nonpharmaceutical-interventions).
Mentoring is commonly used to facilitate professional growth and workforce development in a variety of settings. Organizations can use mentoring to help achieve broader personnel goals including leadership development and succession planning. While mentorship can be incorporated into training programs in public health, there are other examples of structured mentoring, with time commitments ranging from minutes to months or longer. Based on a review of the literature in public health and aggregated personal subject matter expertise of existing programs at the Centers for Disease Control and Prevention, we summarize selected mentoring models that vary primarily by time commitments and meeting frequency and identify specific work situations to which they may be applicable, primarily from the federal job experience point of view. We also suggest specific tasks that mentor-mentee pairs can undertake, including review of writing samples, practice interviews, and development of the mentee's social media presence. The mentor-mentee relationship should be viewed as a reciprocally beneficial one that can be a source of learning and personal growth for individuals at all levels of professional achievement and across the span of their careers.
Emergence of a novel infectious disease, such as pandemic influenza, is the one global crisis most likely to affect the greatest number of people worldwide. Because of the potentially severe and contagious nature of influenza, a rapid multifaceted pandemic response, which includes nonpharmaceutical interventions (NPIs) and effective strategies for communication with the public are essential for a timely response and mitigating the spread of disease. A web-based questionnaire was administered via email in July 2015 to 62 Public Health Emergency Preparedness (PHEP) directors across jurisdictions that receive funding through the Centers for Disease Control and Prevention PHEP cooperative agreement. This report focuses on two modules: Public Information and Communication and Community Mitigation. Consistent and targeted communication are critical for the acceptability and success of NPIs. All 62 jurisdictions have developed or are in the process of developing a communications plan. Community-level NPIs such as home isolation, school closures, and respiratory etiquette play a critical role in mitigating the spread of disease. Effective, ongoing communication with the public is essential to ensuring wide spread compliance of NPI’s, especially among non–English-speaking populations. Planning should also include reaching vulnerable populations and identifying the correct legal authorities for closing schools and canceling mass gatherings.
The first Ebola cases in West Africa were reported by the Guinea Ministry of Health on March 23, 2014, and by June it became the largest recorded Ebola outbreak. Centers for Disease Control and Prevention field teams were deployed to West Africa, including in-country logistics staff who were critical for ensuring the movement of staff, equipment, and supplies to locations where public health knowledge and experience were applied to meet mission-related requirements. The logistics role was critical to creating the support for epidemiologists, medical doctors, laboratory staff, and health communicators involved in health promotion activities to successfully respond to the epidemic, both in the capital cities and in remote villages. Logistics personnel worked to procure equipment, such as portable video projectors, and have health promotion materials printed. Logistics staff also coordinated delivery of communication and health promotion materials to the embassy and provided assistance with distribution to various partners.
In April 2017, the Centers for Disease Control and Prevention (CDC) participated in the Gotham Shield Exercise, led by the Federal Emergency Management Agency (FEMA) and in collaboration with other federal agencies to test the federal, state and local government’s ability to respond to an improvised nuclear device (IND). With active engagement from CDC leadership, 266 scientific and support staff from across the agency participated in the Gotham Shield exercise. The scenario involved a 10-kiloton detonation near the Lincoln Tunnel in New Jersey. This nuclear detonation scenario provided CDC with the opportunity to test some of the all-hazards tools the agency uses during response to other national or international emergencies, such as Geographic Information Systems (GIS) and mapping tools, and apply these tools to a nuclear emergency. Geospatial analysis associated with real time data can provide near real time information for individuals and entities associated with response and recovery activities. This type of analysis can provide timely data in regard to maps and information used to properly place staging areas for Community Reception Centers (CRC), mass care locations, and other medical care and countermeasure related services. Maps showing locations of power loss, such as locations of lost or inoperable main electrical grid and substations, combined with real time data on where power is available provides valuable information for first responders and emergency managers as well as responders engaged in communicating critical public messages to affected populations in these areas. By using real-time information, response officials can direct the response, allocate scarce resources, aid in coordination efforts, and provide a more efficient means of providing critical public health and medical services. The results of the exercise highlight the importance of using geospatial analysis for response planning and effect mitigation before, during, and after a public health event of this magnitude, and the value they represent in informed decision making.
The Early Warning Infectious Disease Surveillance program (EWIDS) is part of the Cooperative Agreement on Public Health Preparedness and Response for Bioterrorism administered by the Centers for Disease Control and Prevention (CDC). The purpose of EWIDS is to develop and implement a program to collaborate with states or provinces across international borders, to provide rapid and effective laboratory confirmation, and to expand surveillance capabilities. Prior to September 11, 2001, funds were not allocated to states for improving cross-border epidemiologic and laboratory surveillance activities that would increase cross-border preparedness. States were required through the Cooperative Agreement to self-report data twice a year in progress reports to the Division of State and Local Readiness Management Information System (MIS). An analysis of self-reported activities was conducted to determine the activities that states most frequently chose to implement based on existing public health infrastructure along the U.S. borders, since analysis of preparedness activities on the border has not previously been conducted. This article discusses how states chose to address expanding infrastructure capacity with the EWIDS supplemental funding, the challenges that have prevented U.S. border states from addressing all suggested activities, and the importance of sustained funding for the investment of continued capacity building and collaboration with international partners.
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