162632 Estimating the Unanticipated Consequences of Pandemic Flu

Wednesday, November 7, 2007: 1:20 PM

David M. Abramson, PhD MPH , National Center for Disaster Preparedness, Columbia University, New York, NY
Daniel Bienstock, PhD , Operations Research, School of Engineering, Columbia University, New York, NY
Stephen S. Morse, PhD , Department of Epidemiology, Columbia University, New York, NY
Andrew Garrett, MD MPH , National Center for Disaster Preparedness, Columbia University, ny, NY
Gregory A. Thomas, MS , National Center for Disaster Preparedness, Mailman School of Public Health, Columbia University, New York, NY
Elizabeth Fuller, DrPH , Georgia Health Policy Center, Georgia State University, Atlanta, GA
Lisa Soloff , National Center for Disaster Preparedness, Mailman School of Public Health, Columbia University, New York, NY
Public health interventions to address a potential pandemic flu – whether pharmaceutical or non-pharmaceutical – may be regarded as a predictable first-order response. The operational success of contingency plans for the containment and treatment of pandemic flu may be tracked by measurable process outcomes (e.g., numbers of individuals or health care workers vaccinated, numbers of intensive care beds opened up) as well as health outcomes (e.g., flu-related morbidity and mortality, transmission rates, and attack rates). Less well-known or researched is the “second order response,” the social consequences of the first-order interventions. This could include health outcomes such as excess morbidity and mortality from untreated or under-treated illness and injury distinct from influenza, and social outcomes related to such issues as increased crowding, health system congestion, increasing scarcity of resources (including monetary resources), major population shifts, and degradation of various workforces (health care, urban infrastructure such as police and sanitation, critical infrastructure,etc.) with their consequent effects. This presentation will review available evidence and theoretical frameworks, as well as preliminary computer modeling using stochastic and robust optimization designs, to consider these “unanticipated consequences.” In particular, we will focus upon the following major themes: (1) Critical infrastructure loss; (2) Consequences of specific transportation shutdowns; (3) Consequences of school closures; (4) Social behavior related to elements of a pandemic, including historical evidence, survey research on population attitudes and anticipated behavior, and workforce-related issues; and (5) Health and social consequences of crowding and health system congestion, directly or indirectly associated with pandemic flu and first-order responses.

Learning Objectives:
1. Identify health and social consequences of non-pharmaceutical public health interventions to contain pandemic flu. 2. Apply theoretical framework and historical data to computer modeling of pandemic flu consequences, using both stochastic and robust optimization designs.

Keywords: Infectious Diseases, Public Health Research

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Social Epidemiology
See more of: Epidemiology