Modeling targeted layered containment of an influenza pandemic in the United States

Abstract

Planning a response to an outbreak of a pandemic strain of influenza is a high public health priority. Three research groups using different individual-based, stochastic simulation models have examined the consequences of intervention strategies chosen in consultation with U.S. public health workers. The first goal is to simulate the effectiveness of a set of potentially feasible intervention strategies. Combinations called targeted layered containment (TLC) of influenza antiviral treatment and prophylaxis and nonpharmaceutical interventions of quarantine, isolation, school closure, community social distancing, and workplace social distancing are considered. The second goal is to examine the robustness of the results to model assumptions. The comparisons focus on a pandemic outbreak in a population similar to that of Chicago, with Ϸ8.6 million people. The simulations suggest that at the expected transmissibility of a pandemic strain, timely implementation of a combination of targeted household antiviral prophylaxis, and social distancing measures could substantially lower the illness attack rate before a highly efficacious vaccine could become available. Timely initiation of measures and school closure play important roles. Because of the current lack of data on which to base such models, further field research is recommended to learn more about the sources of transmission and the effectiveness of social distancing measures in reducing influenza transmission.influenza antiviral agents ͉ mitigation ͉ prophylaxis ͉ social distancing ͉ transmission

A systems science perspective and transdisciplinary models for food and nutrition security

“…The field of infectious disease epidemiology has a strong tradition of mathematical and computational modeling (56)(57)(58)(59)(60)(61)(62)(63), with applications to many of the diseases discussed above (99)(100)(101). Such models provide important insights into the core dynamics of these diseases, and could provide an important component of a systems approach to food and nutrition security.…”

“…Progress in management of infectious diseases would directly or indirectly make a major contribution to reduction in malnutrition (2), and the links between nutrition and disease are complex enough to make modeling an important source of new insights. Modeling techniques such as ABM and SD are already widely used in epidemiology (56)(57)(58)(59)(60)(61)(62)(63)(102)(103)(104), where they offer advantages in capturing spatial and nonlinear dynamics, heterogeneity (56,105), and adaptive behavior. We have argued (above) that these same advantages make their application to agri-food systems compelling.…”

Modelling an influenza pandemic: A guide for the perplexed

“…7 Models suggest that nonpharmaceutical interventions that reduce R 0 through different, complementary mechanisms can sometimes be synergistic.…”

Selecting Nonpharmaceutical Strategies to Minimize Influenza Spread: The 2009 Influenza A (H1N1) Pandemic and beyond

“…Using multiple strategies early and in a coordinated fashion may be more effective in reducing transmission than using a single strategy. 10,11 Specific strategies are designed to affect influenza transmission at different times in the transmission process and in a pandemic. For example, social distancing measures (e.g., school dismissals) are intended for preemptive use and must be applied early and comprehensively throughout a community to be most effective.…”