Pandemic Influenza and Healthcare Demand in the Netherlands: Scenario Analysis

Abstract

In accordance with World Health Organization guidelines, the Dutch Ministry of Health, Welfare and Sports designed a national plan to minimize effects of pandemic influenza. Within the scope of the Dutch pandemic preparedness plan, we were asked to estimate the magnitude of the problem in terms of the number of hospitalizations and deaths during an influenza pandemic. Using scenario analysis, we also examined the potential effects of intervention options. We describe and compare the scenarios developed to understand the potential impact of a pandemic (i.e., illness, hospitalizations, deaths), various interventions, and critical model parameters. Scenario analysis is a helpful tool for making policy decisions about the design and planning of outbreak control management on a national, regional, or local level.

Assessing the role of basic control measures, antivirals and vaccine in curtailing pandemic influenza: scenarios for the US, UK and the Netherlands

“…We evaluated the role of intervention strategies incorporated in preparedness plans for the US, the United Kingdom (UK) and the Netherlands. We discuss the potential role of the different intervention strategies and compare our results with those reported in previous studies (van Genugten et al 2003;Longini et al 2004;Gani et al 2005;.…”

“…Disease parameters and initial conditions for each country are provided in tables 2 and 3. Results reported in parenthesis correspond to two cases considered for each of the following intervention strategies: (i) assumes two scenarios (p i Z z i Z1; p i Zz i Z0.8), (ii) assumes (lower, upper) Genugten et al 2003;Longini et al 2004;Ferguson et al 2005Ferguson et al , 2006Gani et al 2005;Germann et al 2006). Although the findings in these studies seem reassuring, these studies assume that antipandemic resources (such as antivirals and a vaccine) are widely available at the beginning of the pandemic.…”

“…This certainly differs from our simpler approach that uses a deterministic dynamical model (see also van Genugten et al 2003;Arino et al 2006;Brauer 2006;Chowell et al 2006). No doubt that these detailed simulation studies have provided reasonable estimates and assessments of the potential impact of a flu pandemic.…”

“…In the optimistic scenario, we assume high antiviral efficacy and coverage rates (upper-bound parameters in table 2). Similarly, the less optimistic scenario assumes lower-bound parameter values for the antiviral efficacy and coverage (Gani et al 2005) and the Netherlands (van Genugten et al 2002(van Genugten et al , 2003. …”

“…face masks), isolation in hospital wards and quarantine of suspected cases. The use of multiple interventions to limit the disease burden associated with a pandemic has been explored in several recent studies (van Genugten et al 2003;Longini et al 2004Ferguson et al 2005;Gani et al 2005;Germann et al 2006). Although these efforts have provided several potentially effective strategies, one question still remains, namely, whether a strategy that includes (i) massive stockpiling of antivirals, (ii) targeted antiviral prophylaxis, (iii) massive pre-vaccination of high-risk individuals, (iv) pneumococcal vaccine, or (v) a combination of these interventions can be considered optimal, given that these vital (pharmaceutical) resources will be of limited supply or delayed during a pandemic (Longini et al 2004.…”