The potential to cause faster increase in illness and deaths than almost any other natural health threat is present in an influenza pandemic. Preparedness and planning at the interpandemic period (before the strike) is essential for operational response to be adequate. This article describes a planned strategy to respond and prepare for a possible influenza pandemic attack. It also offers direction to local and state health departments and the health care system as the primary target to enhance preparation and planning, at the level where the main response activities at the identified stages get implemented internationally and locally.

In response and preparedness, the main characteristics of an influenza epidemic that have to be considered include:

• Concurrent impacts on different areas across the country, restraining the capacity of the jurisdictions to offer assistance and support to other affected regions.
• Increase of sick people that need outpatient medical care or hospitalization
• Delay and shortage of availability of vaccine and antiviral drugs
• Interruption of community and national infrastructure including commerce, transportation, public safety and utilities
• International spread of infection with outbursts globally.

Preparation and response plans

With the above understanding, the (HHS) Department of Health and Human Services continues to make strides in planning for effective response to an influenza attack. This has been achieved through specific programs for influenza and those centralize more on preparation increase for the bioterrorism and other health threat and infection disease that are emerging. Allocation of relevant material to develop influenza production capacity, increase vaccination for the influenza, surveillance and disease detection infrastructure, support public laboratory and plan, expand related research and improve health care system preparedness at the level of the community.

In aIDition, preparations can start in other important areas. The primary strategy is vaccination mainly to reduce the effects of the crisis but the duration currently necessary to create a vaccine and the role of the vaccine offer challenges to optimal prevention. Improving the current global surveillance network for the influenza can lead to earlier pandemic virus detection. Virus generation and identification of its production seeds which are a critical first step for the development of influenza vaccine. In aIDition to extending existing, sentinel surveillance sites, and expanding the number of global monitoring sites to function throughout the year, there has been an enhanced concomitant of laboratory capacity to subtype and identify influenza stands individually. Through that, vaccine development and research can be accelerated by testing and preparing candidate influenza vaccine strains during the inter-pandemic period. Doing research will guide optimal vaccine schedule and formulation, and assessing techniques that can enhance manufacturing using prospective and current methods for better vaccine and mitigation methods.

Heightened planning by the private and public health care sector to ensure the ability and potential of distributing the available vaccine to relevant target and priority groups, and in aIDition monitor effective vaccine and adverse events are necessary  steps to meet goals of response pandemic in all levels. Disease control strategies implementation to decrease the community and global spread of infection, while not changing the general pandemic magnitude of the pandemic, may lessen the number of infected people affected early during the outbreak course, before vaccines are available for prevention. Precautions, travel advisories and screen shots of people arriving from affected areas, restricting public gathering, closing schools, and quarantine of exposed people may be necessary steps for mitigating transmission, and different authority departments can get entrusted with handling this aspect. These interventions application are based on the evolving patterns of the epidemic epidemiology. Planning by local and State health departments and the coordination and health care system between the two is necessary to guarantee effective implementation of activities response and delivery of quality medical care in perspective of heightened services demands.

Procedures included in the preparation come from different institutions, as well as funding and technical assistance available to facilitate the planning. Consistency and planning coordination in the implementation with other plans of emergency response, such as those for SARS and bioterrorist threats can improve effectiveness and efficiency if strategized effectively. Another public health emergency programs such as the CDC Public Health Preparedness and Response Cooperative Agreements and the Health Resources and Services Administration (HRSA) Hospital Preparedness Program and the CDC Public Health Preparedness.   Jointly can provide states with resources to strengthen their ability to respond to natural disaster, infectious diseases, and bioterror attacks. For example through the funds and initiatives, provided by HRSA, States effectively improve the current health care services, coordination and emergency response capacity, as well as other public health emergencies.

This planning activity’s main aim is to guarantee an effective response including the delivery of quality medical care implementation in the context of the expected increased demand for services in an epidemic scenario. Finishing pandemic response plans and preparedness and testing them in the field, and tabletop exercise are essential next steps for its effectiveness. Plans for an epidemic are controlled in the HHS, Assistant Secretary for Health office. The Public Health Emergency Preparedness coordinates reaction activities by the Assistant Secretary on behalf of the Secretary in close coordination with the Department of Homeland Security.

The pandemic phases of the disease outline activities within the pandemic influenza response as stipulated by the WHO classification system.

This inter-pandemic phase of the pandemic is subdivided into 4 main levels.  First category is level zero that has no identification of an influenza-causing strand in human infection, therefore, pose no threat. Level one has a case alert of possible human infection by the virus strain. Level two has no documented person transition and unclear cause of outbreaks but has two or more speculated cases of infection outbreaks. Level three is the pandemic alert level with an outbreak in one country and people spread in the community for more than two weeks.

Development from a virus alert to an epidemic level is followed by response activities that include heightened global and local surveillance. These include virology and epidemiology investigation of a novel influenza strain including international cooperation with global stakeholders on vaccine development, containment and clinical testing.  That leads  towards licensing of pandemic vaccine, activation of local plans and coordination, and communication strategies implementation which educate the public and health care providers.

Relevance of the Pandemic Influenza Response and Preparedness Plan

The plan recommends and defines preparation activities that are to be implemented  to increase the effectiveness of the response. The plan also describes the pandemic response at federal level that should synchronize with local and state level implementations including roles, action, and responsibilities definitions of the stakeholders and concerned authorities. It also describes the implemented interventions as components of an effective pandemic response system. To provide then technical information on which response and preparations and structured, guide for the health care system  in the development of local and state pandemic influenza response and preparedness plans have to be efficient.

The response mainly aims to limit mortality and morbidity of influenza and its barriers during a crisis. It also aims to decrease economic loss and social disruptions

Central pandemic response and Preparedness principles

Detect critical strands of influenza through virologic and clinical surveillance of animal and human influenza disease. Rapidly license and develop vaccines against the dangerous strains and develop them in significant amounts to protect the population. Create a vaccine administration program that quickly responds to designated monitor and priority groups to increase safety and effectiveness.

Vaccine supply levels during pandemics will change over time.  Due to this preventive and antiviral drug therapy use in those not infected, interventions to decrease transition and exposure of infection will be vital approaches to lessen the disease potential of spread and burden until vaccine is available and quality care are essential. Defining the pandemic strain susceptibility to the current influenza target and antiviral drugs use of available supplies, by controlling the antiviral resistance develop and ensuring that this limited resource is effectively used. Implement modes of decreasing the spread of disease globally and within the country guided by the pandemic epidemiology. Assist local and state governments and the health care system with a preparation plans to maintain essential community services and give minimal medical care in the process. Effectively communicate with the health care providers, public, media and community leaders to clear any cause of panic.

Effective Pandemic Response Coordination

A national health crisis is present in an influenza pandemic, and it will require coordination of response activities. The (DHS) Department of Homeland Security has the main responsibility for organizing management of any local occurrence and will organize all response actions and support across all agencies and federal departments. The HHS should coordinate the overall medical and public health response efforts across all agencies and national governments. The HHS Secretariat has powers under the Public Health Service Act to coordinate response functions and declare a public health emergency in such situations. The president, activating the Federal Response Plan can declare an emergency in accordance with the Act that gives HHS authority for handling all the Support functions during such emergencies.

The HHS response events are organized in the Assistant Secretary for Public Health Emergency Preparedness office in relation with the assistant secretary’s office for the Public Health and Sciences and will be implemented through the Command centers secretary. The communication center will retain the connections with the HHS agency center of operations and other relevant departments and stakeholders.

Within their areas of the profession, the HHS agencies coordinate activities. Representatives will offer advice and recommendations for large-scale mitigation plans. Expert guidance and review also may be obtained from established committees by the Institute of Medicine, National Academy of Sciences or in other forms.

Conclusion

Of all the significant public health problems, that the world jointly faces currently is the potential of a global disease occurrence mainly known as an epidemic.  Globally no one is fully prepared today for a pandemic outbreak, but as shown by the article its safe to say we are better prepared to handle such situations today as compared to the early years.

Initiatives like the proposed HHS Pandemic Influenza Plan offer a backup strategy and blueprint from which to aIDress for the oncoming challenges before they happen. The plan includes responding effectively and being prepared which involves everyone, for example, the communities, individuals, states, business, international countries, federal agencies and organizations. Locally this program is used to make an effective preparation plan network that includes everyone working together for the joint benefit of all people.

It is uncertain if in the future another virus will emerge with relative potential to influence an international scale disease outbreak. History has repeatedly shown  that preparations enacted today for that future eventuality will have many lasting future benefits. The country will be better prepared for other similar emergencies, and concerned stakeholders and health care will realize significant advances.

Therefore, efficient and proper planning for a pandemic needs every level of authority within the nation to contribute and indeed, the world.  Influenza pandemic ubiquitous nature compels state, federal, and local governments, corporations, communities, individuals, families to learn about, collaborate, and preparations efforts to slow, respond, mitigate, and recover from a possible pandemic threat. The refinement, development, and exercise of pandemic influenza plans by the relevant authorities are important aspects of the preparedness initiatives.

The magnitude of the challenges faced by the international community pale in contrast should there be a global pandemic involved. Global partnerships and public cooperation will be essential in combating back and setting up already state in preparation for future recurrence. If jointly all stakeholders take the necessary steps, millions of lives can be saved in all countries and regions globally.