Pandemic Diseases Preparedness and Response

Nonpharmaceutical interventions (NPI), also known as community mitigation measures, are actions that individuals and communities can take to help slow the spread of influenza and other infectious diseases. When a novel influenza A virus with pandemic potential emerges, NPIs are the most readily available set of interventions to slow down its transmission in communities. Often cited as the first line of defense, NPIs are especially important during the initial months of an evolving pandemic while pandemic vaccines may not yet be available.
In this talk, we will review NPI use during the influenza pandemics of 1918, 1957, 1968, and 2009 in the United States and summarize how the lessons learned were used for further integration of NPIs in pandemic preparedness.

Africa is a verdant pasture for emerging and re-emerging pathogens. Sub Saharan Africa has combated Ebola, HIV, and tuberculosis epidemics and regular annual, sporadic, and concurrent outbreaks. It is therefore expected that these countries would have acquired a high level of disease response capacity. However, the arrival of covid19 in Egypt, (N. Africa) on 14 February and Nigeria (SSA) on 27 February 2020, and subsequent response by many African countries once again demonstrated their glaring unpreparedness. As of 7 June 2020, African countries had reported 184,333 covid19 cases and 5,071 deaths. According to the African CDC, as of January 2020, only two countries (South Africa and Senegal) were able to test for COVID19. Although two months later, the number of countries with capacity to test for covid19 had increased to 43, the critical shortage of test kits continue to hamper the effective performance of and ability to conduct tests needed to accurately determine and map out the burden of covid19 disease. The long years of neglect of the health system has led to poor health care delivery in many of the countries, with acute shortages of critical care beds and personal protective equipment PPE for the protection of frontline health workers. With a pandemic, and the global demand for these and other essential commodities – test kits, PPE, swabs, reagents, test cartridges, and other commodities- Africa is left, often dependent on donor funds, to compete for these scarce commodities. Many African countries, in combating covid19, are operating on lessons forgotten from past epidemics as they make ammunition of war against the covid19 invasion at the battle front.

SARS-CoV-2, the virus that causes COVID-19, emerged late in 2019 and quickly spread with devastating consequences around the world. The COVID-19 pandemic caught public health and political leaders unprepared to take quick and decisive action knowing that infectious disease outbreaks with pandemic potential have occurred with increased frequency for at least twenty years. Despite the growing threat, pandemic preparedness rarely received policy and resourcing priority, and lessons observed after each crisis were not applied to sustained lessons learned. Crises from SARS in 2002 to Ebola in 2018 share repeated weaknesses that are summarized as failures in 1) leadership and accountability; 2) collaboration; 3) coordination; 4) communication; and 5) innovation. It is difficult to predict how the SARS-CoV-2 virus will evolve, but we must remain vigilant and prepare for the next phases of the COVID-19 response whether vaccines are fielded or not. We must also prepare for the next novel infectious disease outbreak as a national security priority and turn long-standing lessons observed into sustained lessons learned. The preparedness enterprises must adopt a forward-thinking posture to anticipate future threats, recognize the importance of global one health security, and utilize after action learning to not only improve response, but also innovate to implement new prevention policies and strategies.

This presentation will describe the NYC public health response to COVID-19 and the key activities that occurred during each phase of the response. The presentation will reflect on how the response changed over time, the challenges faced, and the opportunities that lay ahead.