iii. Public Policy for Handling Pandemics

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iii. Public Policy for Handling Pandemics

Following the H1N1 pandemic Influenza, the Government of India issued ‘Clinical management Protocol and Infection Control Guidelines. (7) But an overarching strategy is needed for handling a pandemic in the Indian context where the responsibilities lie divided between the central, state, and local governments.

Case Study 1: Pandemic Interval Framework
Details	U.S. Centers for Disease Control and Prevention (CDC) has developed a Pandemic Interval Framework (PIF) (8) to guide executives on the kind of public health action required at various stages of the progression of a pandemic. The six intervals and the action to be taken at each interval is summarized in the table 1.1. Below — [Figure: Pandemic Interval Framework]
Case Study 2: How Kerala Handled Nipah Virus Outbreak
Details	[Figure: Flattening the infection curve: Dealing with pandemics (Courtesy: CDC and Vox)] The Nipah outbreak in Kerala was a serious challenge because of high mortality rates (it killed nearly 70% of those affected during a previous outbreak in Bangladesh), lack of vaccines or specific treatment, and Kerala’s relative inexperience in handling virus outbreaks. That the very second case was diagnosed correctly points towards an alert medical community in the state. All contacts were traced, surveillance was carried out by a team of medical officials and district administration and potential cases were isolated. In this way, every single case reported thereafter was traced back to the first case or its related contacts. All contacts of all the cases (around 2000 people) were followed up on a daily basis. All suspected cases were moved to the isolation facility set up at Government Medical College, Kozhikode. An isolation protocol was established. Health personnel was trained and required safety gear was provided. For those infected, anti-viral drugs and life support, measures were provided. The state health minister actively supervised these efforts and the outbreak subsided in around five weeks. The deaths were limited to 16.
Case Study 3: China’s use of technology to manage the spread of COVID-19
Details	[Figure: Covid-19 China – Age-Wise Fatality (Courtesy: Vox)] Aggressive use of surveillance technology by the Chinese government aided by technology companies. Tech giants such as Alibaba and Baidu offer Artificial Intelligence (AI) gene sequencing tools. Infrared and facial recognition technology to identify and screen travelers. AI-enabled temperature measurement using thermal cameras. Use of robots and drones to remotely disinfect hospitals, deliver food and enforce quarantine measures. Apps that alert users when they are close to infected areas. Based on ID numbers and travel history, users of various tech platforms are assigned a QR code that instructs them whether they need to be in quarantine or are free to travel.

Table 1.1: Public Health Action at Different Intervals (Case Study 1 Pandemic interval Framework)

Intervals	Public Health Actions
Investigation of cases of novel virus infection	targeted monitoring and investigation. risk assessment of that virus with certain tools.
Recognition of the potential for transmission	focus on control of the outbreak. treatment of sick persons.
Initiation of a pandemic wave	occurs when people are easily infected with the novel virus
The acceleration of a pandemic wave	focuses on the use of appropriate non-pharmaceutical interventions like the closure of schools and social distancing and the use of medications (antivirals) and vaccines. the goal is to reduce the spread of the disease and prevent illness.
Deceleration of a pandemic wave	continued vaccination, and monitoring of pandemic virus circulation. reducing the use of non-pharmaceutical interventions.
Preparation for future pandemic waves	continued monitoring of pandemic virus activity. preparing for potential additional waves of infection.