During an influenza pandemic, healthcare workers will be on the front lines delivering care to patients and preventing further spread of the disease. As the nation prepares for pandemic influenza, multiple avenues for protecting the health of the public are being carefully considered, ranging from rapid development of appropriate vaccines to quarantine plans should the need arise for their implementation. One vital aspect of pandemic influenza planning is the use of personal protective equipment (PPE)-the respirators, gowns, gloves, face shields, eye protection, and other equipment that will be used by healthcare workers and others in their day-to-day patient care responsibilities. However, efforts to appropriately protect healthcare workers from illness or from infecting their families and their patients are greatly hindered by the paucity of data on the transmission of influenza and the challenges associated with training and equipping healthcare workers with effective personal protective equipment. Due to this lack of knowledge on influenza transmission, it is not possible at the present time to definitively inform healthcare workers about what PPE is critical and what level of protection this equipment will provide in a pandemic. The outbreaks of severe acute respiratory syndrome (SARS) in 2003 have underscored the importance of protecting healthcare workers from infectious agents. The surge capacity that will be required to reduce mortality from a pandemic cannot be met if healthcare workers are themselves ill or are absent due to concerns about PPE efficacy. The IOM committee determined that there is an urgent need to address the lack of preparedness regarding effective PPE for use in an influenza pandemic. Preparing for an Influenza Pandemic : Personal Protective Equipment for Healthcare Workers identifies that require expeditious research and policy action: (1) Influenza transmission research should become an immediate and short-term research priority so that effective prevention and control strategies can be developed and refined. The current paucity of knowledge significantly hinders prevention efforts. (2) Employer and employee commitment to worker safety and appropriate use of PPE should be strengthened. Healthcare facilities should establish and promote a culture of safety. (3) An integrated effort is needed to understand the PPE requirements of the worker and to develop and utilize innovative materials and technologies to create the next generation of PPE capable of meeting these needs.

This guidance is an update of WHO global influenza preparedness plan: the role of WHO and recommendations for national measures before and during pandemics, published March 2005 (WHO/CDS/CSR/GIP/2005.5).

Public health officials and organizations around the world remain on high alert because of increasing concerns about the prospect of an influenza pandemic, which many experts believe to be inevitable. Moreover, recent problems with the availability and strain-specificity of vaccine for annual flu epidemics in some countries and the rise of pandemic strains of avian flu in disparate geographic regions have alarmed experts about the world's ability to prevent or contain a human pandemic. The workshop summary, The Threat of Pandemic Influenza: Are We Ready? addresses these urgent concerns. The report describes what steps the United States and other countries have taken thus far to prepare for the next outbreak of "killer flu." It also looks at gaps in readiness, including hospitals' inability to absorb a surge of patients and many nations' incapacity to monitor and detect flu outbreaks. The report points to the need for international agreements to share flu vaccine and antiviral stockpiles to ensure that the 88 percent of nations that cannot manufacture or stockpile these products have access to them. It chronicles the toll of the H5N1 strain of avian flu currently circulating among poultry in many parts of Asia, which now accounts for the culling of millions of birds and the death of at least 50 persons. And it compares the costs of preparations with the costs of illness and death that could arise during an outbreak.

Veteran journalist Gina Kolata's Flu: The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus That Caused It presents a fascinating look at true story of the world's deadliest disease. In 1918, the Great Flu Epidemic felled the young and healthy virtually overnight. An estimated forty million people died as the epidemic raged. Children were left orphaned and families were devastated. As many American soldiers were killed by the 1918 flu as were killed in battle during World War I. And no area of the globe was safe. Eskimos living in remote outposts in the frozen tundra were sickened and killed by the flu in such numbers that entire villages were wiped out. Scientists have recently rediscovered shards of the flu virus frozen in Alaska and preserved in scraps of tissue in a government warehouse. Gina Kolata, an acclaimed reporter for The New York Times, unravels the mystery of this lethal virus with the high drama of a great adventure story. Delving into the history of the flu and previous epidemics, detailing the science and the latest understanding of this mortal disease, Kolata addresses the prospects for a great epidemic recurring, and, most important, what can be done to prevent it.

In November 2018, an ad hoc planning committee at the National Academies of Sciences, Engineering, and Medicine planned two sister workshops held in Washington, DC, to examine the lessons from influenza pandemics and other major outbreaks, understand the extent to which the lessons have been learned, and discuss how they could be applied further to ensure that countries are sufficiently ready for future pandemics. This publication summarizes the presentations and discussions from both workshops.

The Black Death. Cholera. Spanish flu. Swine flu. HIV/AIDS. COVID-19/SARS-CoV-2. Each of these pandemics has made (or, is making) a lasting impact on humanity. From the immediate mental image of the beaked masks worn in the Middle Ages (bubonic plague) and the birth of epidemiology (cholera) to recognizing the benefits of social distancing (1918 flu) and the harm of prejudice and misinformation (HIV/AIDS), pandemics have shown us how to survive infectious disease, as long as we heed their lessons. Preparing for Pandemics in the Modern World, edited by Christine Crudo Blackburn, brings together experts on pandemic preparedness and biosecurity to explore areas of weakness in pandemic prevention, preparedness, detection, and response. Even as COVID-19 makes its way around the world, leaders and policymakers are tasked with thinking ahead and preparing to effectively respond to the next such event—which experience shows us to be a matter of “when,” not “if.” Inside, chapters are divided into sections on the lessons learned from the 1918 influenza pandemic, the application of the One Health concept, and the role of the private sector in responding to potentially devastating disease outbreaks. A chapter on the impacts of supply chain disruption—in light of COVID-19—and an epilogue that discusses the current outbreak make Preparing for Pandemics in the Modern World a timely and accessibly written compilation on pandemic prevention, preparedness, detection, and response.

#1 New York Times bestseller “Barry will teach you almost everything you need to know about one of the deadliest outbreaks in human history.”—Bill Gates "Monumental... an authoritative and disturbing morality tale."—Chicago Tribune The strongest weapon against pandemic is the truth. Read why in the definitive account of the 1918 Flu Epidemic. Magisterial in its breadth of perspective and depth of research, The Great Influenza provides us with a precise and sobering model as we confront the epidemics looming on our own horizon. As Barry concludes, "The final lesson of 1918, a simple one yet one most difficult to execute, is that...those in authority must retain the public's trust. The way to do that is to distort nothing, to put the best face on nothing, to try to manipulate no one. Lincoln said that first, and best. A leader must make whatever horror exists concrete. Only then will people be able to break it apart." At the height of World War I, history’s most lethal influenza virus erupted in an army camp in Kansas, moved east with American troops, then exploded, killing as many as 100 million people worldwide. It killed more people in twenty-four months than AIDS killed in twenty-four years, more in a year than the Black Death killed in a century. But this was not the Middle Ages, and 1918 marked the first collision of science and epidemic disease.

Any strategy to cope with an influenza pandemic must be based on the knowledge and tools that are available at the time an epidemic may occur. In the near term, when we lack an adequate supply of vaccine and antiviral medication, strategies that rely on social distancing and physical barriers will be relatively more prominent as means to prevent spread of disease. The use of respirators and facemasks is one key part of a larger strategy to establish barriers and increase distance between infected and uninfected individuals. Respirators and facemasks may have a role in both clinical care and community settings. Reusability of Facemasks During an Influenza Pandemic: Facing the Flu answers a specific question about the role of respirators and facemasks to reduce the spread of flu: Can respirators and facemasks that are designed to be disposable be reused safely and effectively? The committee-assisted by outstanding staff-worked intensively to review the pertinent literature; consult with manufacturers, researchers, and medical specialists; and apply their expert judgment. This report offers findings and recommendations based on the evidence, pointing to actions that are appropriate now and to lines of research that can better inform future decisions.

An essential survival guide—both to pandemic influenza, and to the hype surrounding it. Written by an emergency physician and a public health physician, The Flu Pandemic and You is a timely and forthright guide on how to prepare for an influenza pandemic, and how to understand the broader context in which this health threat exists. With cool heads and professional expertise, Drs. Lam and Lee carefully explain how readers can assess their level of risk, and set out practical advice on how to contend with a pandemic, addressing such issues as: • How the flu virus works and what level of threat Canadians really face • How to help protect yourself and your family from contracting influenza • How to identify symptoms • What you need to know about antiviral drugs • What to do in a worst-case scenario The Flu Pandemic and You develops a lucid framework to help people understand the current anxiety about influenza in the context of the risks we all face in our daily lives. This crucially important book, full of reasoned, knowledgeable advice, is an indispensable resource for fearful times.

The emergence of severe acute respiratory syndrome (SARS) in late 2002 and 2003 challenged the global public health community to confront a novel epidemic that spread rapidly from its origins in southern China until it had reached more than 25 other countries within a matter of months. In addition to the number of patients infected with the SARS virus, the disease had profound economic and political repercussions in many of the affected regions. Recent reports of isolated new SARS cases and a fear that the disease could reemerge and spread have put public health officials on high alert for any indications of possible new outbreaks. This report examines the response to SARS by public health systems in individual countries, the biology of the SARS coronavirus and related coronaviruses in animals, the economic and political fallout of the SARS epidemic, quarantine law and other public health measures that apply to combating infectious diseases, and the role of international organizations and scientific cooperation in halting the spread of SARS. The report provides an illuminating survey of findings from the epidemic, along with an assessment of what might be needed in order to contain any future outbreaks of SARS or other emerging infections.