Pandemic Influenza Severity Assessment (PISA) ANISE meeting March 2018 Kaat Vandemaele WHE/IHM/IPR/GIP
Why? What? When? How to assess severity? Examples Future work 1ANISE 2018 PISA 2
WHY PISA 3
Why assess influenza severity? Following the 2009 pandemic, the IHR Review Committee (2011) recommended: An early assessment followed by ongoing re-assessment as the pandemic evolves and new information becomes available, bearing in mind that severity will likely vary by place and over time; Quantitative values to define descriptive terms (e.g. mild, moderate and severe) to facilitate consistency; By applying, evaluating and refining tools to measure severity every year, WHO and Member States can be better prepared to assess severity in the next pandemic. Use of a basket of indicators (e.g. hospitalization rates, mortality data, identification of vulnerable populations and an assessment of the impact on health systems) derived from a pre-agreed minimum data set; The expression of confidence and uncertainty around any estimates. ANISE 2018 PISA 4
WHAT ANISE 2018 PISA 5
What is influenza severity? TRANSMISSIBILITY SERIOUSNESS OF DISEASE IMPACT The ease with which the virus is transmitting from one person to another The proportion of people with influenza who get really sick or die frominfluenzaeverely sick do individual people get when infected with the influenza virus? How does the influenza epidemic or pandemic affect the health-care system (and society)? ANISE 2018 PISA 6 6
What does PISA tell us? Timing Urgency Provides information on the Intensity Scale of the response. ANISE 2018 PISA 7
WHEN ANÌSE 2018 PISA 8
When do we assess severity? NOW! PANDEMIC By applying, evaluating and refining tools to measure severity every year, WHO and Member States can be better prepared to assess severity in the next pandemic. Ideally, on a weekly basis, after the beginning of the pandemic. Ideally, on a weekly basis, after the beginning of the epidemic. ANISE 2018 PISA 9
HOW ANISE 2018 PISA 10
PISA methodology Source: PISA guidance ANISE 2018 PISA 11
Severity assessments should be conducted at the national level using existing systems and data. ANISE 2018 PISA 12
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At the national level, countries compare their current data with their historical data to make qualitative assessments on severity as it compares to previous epidemics and pandemics within the country. ANISE 2018 PISA 14
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EXAMPLES ANISE 2018 PISA 16
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South Africa ANISE 2018 PISA 19
Global outputs ANISE 2018 PISA 20
Transmissibility
Impact
Additional sources of information SPECIAL STUDIES Outbreak investigations First few 100 cases Household studies Sero studies MODELLING Expected number of infections Timing of peak in activity Effect of interventions ANISE 2018 PISA 24
Current and future work Guidance published: www.who.int/influenza/monitoringandsurveillance/pisa Translations Communications strategy Training modules Modelling: establish collaborative structures; manage expectations Special studies: prioritize and establish collaborative structures Global outputs ANISE 2018 PISA 25
Implementation Regional roll out Workshops with countries in the region on how to set thresholds using the MEM method PISA included in the PIP work plan ANSIE 2018 PISA 26
Acknowledgements The WHO technical working group for PISA Technical experts involved in PISA pilot testing and development Global influenza Programme colleagues Aspen Hammond Julia Fitzner Bikram Maharjan Wenqing Zhang Regional office colleagues ANISE 2018 PISA 27
Thank you http://www.who.int/influenza/surveillance_monitoring/pisa/en/