Testing the Feasibility of Non-Pharmaceutical Interventions for Pandemic Influenza in Laos

Because developing countries will likely not have access to medicines or vaccines to help mitigate the impact of a pandemic, global focus has turned to the use of non-pharmaceutical interventions (NPIs) to reduce opportunities for contact with and transmission of the virus (e.g., social distancing). There are four basic NPIs: isolation and supportive treatment of all people suspected to have influenza; voluntary home quarantine of members of households with confirmed or probable influenza case(s); school closure and suspension of all school-based activities and childcare programs combined with social distancing in the community to achieve reductions of out-of-school social contacts and community mixing; use of social distancing measures to reduce contact between adults in the community and workplace (e.g., canceling large public gatherings, changing work schedules) to decrease social density.

This study uses participatory action research (PAR) tools such as in-depth interviews with community-level stakeholders in urban, rural and peri-urban areas to gauge what community members would do in the case of a pandemic (e.g., if food becomes unavailable, if health facilities close down). The PAR process brings together people from all walks of life and levels of responsibilities to discuss issues and design action plans to address community-level needs and situations.

The results provide insights into whether various NPIs practices are feasible in various settings in Lao PDR with regard to resources and planning, and how these findings can be used to shape national policies. These findings can also be used to create realistic drills and exercises that consider the effects of proposed NPIs and the cascading second-and third-order consequences.

This research will show whether many of these hypothetical interventions are realistic in a small, developing country and have implications about whether they are feasible in other, similar locations. Only feasible activities are likely to be taken seriously and ultimately implemented by government policymakers to prepare for the inevitable influenza pandemic.