RESPONSE ACTIVITIES BY PANDEMIC PHASE

Phase 1
Interpandemic Period:
No new virus in humans
No new virus subtypes havebeen detected in humans.
An virus subtype that has caused human infection may be present in animals.
If present in animals, the risk of humaninfection or disease is considered to be low.
Preparedness:
• Routine Monitoring

Phase 2
Interpandemic Period:
No new influenza virus subtypes have been detected in humans. However, a
circulating animal influenza virus subtype poses a substantial risk of human disease.
• Routine Monitoring

Phase 3
Pandemic Alert Period:
Human infection(s) with a new subtype, but no human-to-human spread, or at most rare instances of spread to a close contact.
• Same as above (review and update)
• Assess medical/vaccine/antiviral supplies
• Update vaccine program information
• Ensure legal/insurance issues resolved
• Review previous simulations and correct deficiencies
• Communication enhancement
• Assess surveillance, vaccine programs, antiviral availability, health services, emergency services, public health issues, communications
• Education

Phase 4
Pandemic Alert Period:
Small cluster(s) with limited human-to human transmission but spread is highly localized, suggesting that the virus is not well adapted to humans
• Same as above (review and update)
• Develop case definitions
• Review IC practice/procedures
• Assess “MASS VACCINATION” infrastructure
• Stratify risk group priority
• Ensure Health Services estimates current
• Ensure essential services
• travel advisories

Phase 5
Pandemic Alert Period:
Larger cluster(s) but human-to-human spread still localized, suggesting that the virus is becoming increasingly better adapted to humans, but may not yet be fully transmissible (substantial pandemic risk).
• Same as above (review and update)

Phase 6
Pandemic Period (not in North America):
Pandemic phase: increased and sustained transmission in general population. May have subsequent waves affecting different areas at different times.
• Same as above (review and update)
• Coordinate with bordering jurisdictions, provincial and federal authorities
• Vaccine purchase (when available)
• ADR activation (antivirals/vaccination)
• Ensure medical supplies
• Prioritize Lab resources
• Coordinate patient tracking
• Access human resources, volunteers
• Security (vaccine, drug, medical clinics, personnel)
• Activate emergency communications
• Review information tracking systems

Phase 6
Pandemic Period (in North America):
Increased and sustained transmission in general population. May have subsequent waves affecting different areas at different times with varying severity.
Full Activation
• State of emergency declared?
• Resource reallocation
• may have decrease in incidence locally but high
risk of 2nd wave due to ongoing pandemic
elsewhere

Post pandemic Period:
Return to Interpandemic Period.
• Return to Phase 1
• Maintain heightened awareness/surveillance
• Review Pandemic / Lessons learned
• Review economic impact to DRHD
• Return to routine monitoring
The distinction between phase 1 and phase 2 is based on the risk of human infection or disease resulting from circulating strains in animals. The distinction would be based on various factors and their relative importance according to current scientific knowledge. Factors may include: pathogenicity in animals and humans; occurrence in domesticated animals and livestock or only in wildlife; whether the virus is enzootic or epizootic, geographically localized or widespread; other information from the viral genome; and/or other scientific information

The distinction between phase 3, phase 4 and phase 5 is based on an assessment of the risk of a pandemic. Various factors and their relative importance according to current scientific knowledge may be considered. Factors may include: rate of transmission; geographical location and spread; severity of illness; presence of genes from human strains (if derived from an animal strain); other information from the viral genome; and/or other scientific information.
Source(s):
http://www.region.durham.on.ca/departments/health/disease_prevention/annexC...


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