Lecture 5: pandemics: Flashcards
Which diseases have been eradicated?
Smallpox (1980), Rinderpest (2011), poliovirus 2 (2016), poliovirus (2019).
What containment strategies did we learn from the plague/black death?
During the black death people discovered that quarantine is a very powerful containment tool. They would quarantine ships outside the city walls for 40 days (2x incubation time) to ensure everyone would be dead or free of plague. They also learned to isolate the sick. They were in corners in the street or locked inside their houses. This is of course a very cruel method. The plague masks and gowns and gloves were a precursor/attempt at PPE. This also practiced social distancing as people fled the towns or locked themselves in their country homes.
What interventions were used during the swine flu?
The interventions were: social distancing, cough hygiene, masks (although they were not used at population level, like COVID), antivirals as prophylaxis or treatment, vaccines. Antivirals were at first used to treat patients and as prophylactic treatment to their contacts. By summer it was understood that the spread couldn’t be stopped and antivirals were reserved for the ill. The vaccines were bought by countries who could afford them.
What was learned during the swine flu?
The swine flu started in Mexico and very quickly spread to the US. Within a few weeks, it spread all over the world. By the time the WHO announced a pandemic, the whole world was already suffering from it. At this point the aims in terms of containment were to delay and flatten the epidemic peak to reduce the burden in healthcare systems and reduce the number of cases. This was done to buy time for the production of a vaccine. The interventions were: social distancing, cough hygiene, masks (although they were not used at population level, like COVID), antivirals as prophylaxis or treatment, vaccines. Antivirals were at first used to treat patients and as prophylactic treatment to their contacts. By summer it was understood that the spread couldn’t be stopped and antivirals were reserved for the ill. The vaccines were bought by countries who could afford them. Meanwhile there was scepticism, as the hospitals were not full and the elderly had some natural immunity due to previous exposure. In addition, there was vaccination hesitancy as people thought the vaccine was developed to fast and thus not tested thoroughly enough and there was confusion about people needing one or two doses. Furthermore, there was discussion about the role of pharmaceutical lobbying.
Why was there scepticism during the swine flu pandemic?
There scepticism, as the hospitals were not full and the elderly had some natural immunity due to previous exposure. In addition, there was vaccination hesitancy as people thought the vaccine was developed to fast and thus not tested thoroughly enough and there was confusion about people needing one or two doses. Furthermore, there was discussion about the role of pharmaceutical lobbying.
However, 76% of the medical risk groups received flu vaccination of which 93% received a second dose. Half of healthcare workers and 78% of children were vaccinated.
What is the big difference between the interventions used during the swine flu pandemic and the covid pandemic?
Only hygiene interventions were used during the swine flu pandemic. Schools remained open and no public events were cancelled.
How many people were admitted to the hospital and how many people died of the swine flu in the Netherlands?
The flu caused >2000 patients to be admitted to the hospital in the Netherlands, of which half had a comorbidity. 63 people died of which 90% had a comorbidity.
What was the worldwide impact of swine flu?
Worldwide about 18000 confirmed deaths notified to the WHO, this is hugely underreported. There were about 200,000 deaths associated with the pandemic.
What did we learn from the swine flu pandemic?
he use of contact tracing in the early stages and that the role of antivirals, social distancing, vaccines and the role of human and animal surveillance systems was very important.
What were the lessons learned by the Ebola outbreak of 2013-2016?
Despite the advice of the WHO, countries implemented their own rules, contrary to WHO advice. That triggered anxiety in the population, which sometimes led to unprecedented actions.
What are the WHO criteria for a public health concern?
Criteria public health emergency of international concern: virus which poses a high risk to health, requires a coordinated international response, when the situation is unknown or unexpected, when there has to be a decision made by public health experts in order to leach a public health emergency. At the same time, all countries need to have a method to detect, assess, report and respond to outbreaks and have a functional, well-equipped point for infectious disease control that would be in contact with the WHO.
