Scenarios%20on%20the%20impact%20of%20pandemic%20influenza:%20preparedness%20planning

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Scenarios on the impact of pandemic influenza
preparedness planning

• Marianne van Genugten, Marie-Louise Heijnen, Hans
  Jager

2
Pandemic influenza?

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

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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

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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)

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Method

• Many uncertainties ? Scenario-analysis
• model and data
• expert consultation
• assumptions
• scenarios

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Model
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Data need

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

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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)

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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

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Number of hospitalisations and deaths
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Result 1 Avoided number of hospitalisations /
required doses
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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

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Preparedness planning

• RIVM ? policy makers
• Message policy makers ? flu can be serious
• minister of Health (national level)
• contingency planners (local level)

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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