Special Update Two 29/02/2020 CDC Interim Pre-Pandemic Planning Guidance

Baltic Dry Index. 535 +18   Brent Crude 50.52 Spot Gold 1586

Covid-19 Cases 08/2/20 China 35,010   Deaths 726 (Maybe.)

Covid-19 Cases 15/2/20 China 67,101   Deaths 1,526 (Maybe.)

Covid-19 Cases 22/2/20 China 77,816   Deaths 2,260 (Maybe.)

Covid-19 Cases 29/2/20 China 85,686   Deaths 2,933 (Maybe.)

As it turns out, America’s CDC, the Centers for Disease Control produced an action plan for a pandemic influenza outbreak, all the way back in 2007. 

Sadly, no one there seems to have read it or sent it along to President Trump, the World Health Organisation, the Red Cross, the UK’s NHS nor any other European health body, nor anyone battling the Covid-19 crisis in Asia.

Below, some very interesting reading on what might be coming next as different authorities attempt to “manage” the coronavirus crisis.

To:	AHCA/NCAL Members
From:	Janice Zalen, Sr. Director of Special Programs,  202/898-2831, jzalen@ahca.org
Subject:	CDC Interim Pre-pandemic Planning Guidance
	Date: 2/6/2007 The best protection against pandemic influenza—a vaccine that is causing illness—he best protection against pandemic influenza—a vaccine that is

The best protection against pandemic influenza—a vaccine that is well-matched to the virus causing illness— well-matched to the virus causing illness—is not likely to be available at the outset of a pandemic.  Community strategies that do not involve vaccines or medications may serve as a first line of defense to help delay or mitigate the spread of influenza. Thus, on February 1, 2007, the Centers for Disease Control and Prevention (CDC) released Interim Pre-pandemic Planning Guidance:  Community Strategy for Pandemic Influenza Mitigation in the United States—Early, Targeted, Layered Use of Nonpharmaceutical Interventions.

This interim guidance introduces a Pandemic Severity Index (PSI) to characterize the severity of a pandemic. To help determine the most appropriate actions to take, the PSI takes into account the fact that the amount of harm caused by pandemics can vary greatly, with the variability having an impact on recommended public health, school and business actions. The PSI, which is modeled after the approach used to characterize hurricanes, has five different categories of pandemics, with a category 1 representing moderate severity and a category 5 representing the most severe.  The severity of a pandemic is primarily determined by its death rate.  A category 1 pandemic is as harmful as a severe seasonal influenza season, while a pandemic with the same intensity of the 1918 flu pandemic, or worse, would be classified as category 5.

The guidance provides planning recommendations for specific interventions that communities may use for a given level of pandemic severity, and suggests when these measures should be started and how long they should be used. Community mitigation recommendations include the following:

1. Asking ill people to voluntarily remain at home and not go to work or out in the community for about 7-10 days or until they are well and can no longer spread the infection to others (ill individuals may be treated with influenza antiviral medications, as appropriate, and if these medications are effective and available).
2. Asking members of households with a person who is ill to voluntarily remain at home for about 7 days (household members may be provided with antiviral medications, if these medications are effective and sufficient in quantity and feasible mechanisms for their distribution have been developed).
3. Dismissing students from schools (including public and private schools as well as colleges and universities) and school-based activities and closure of childcare programs for up to 12 weeks.
4. Recommending social distancing of adults in the community, which may include cancellation of large public gatherings; changing workplace environments and schedules to decrease social density and preserve a healthy workplace to the greatest extent possible without disrupting essential services; ensuring work-leave policies to align incentives and facilitate adherence with the measures outlined above.

While the above actions could significantly reduce the number of persons who become ill during a flu pandemic, they each carry potentially adverse consequences that community planners should anticipate and address in their planning efforts. Long term care providers also should begin to plan for these foreseeable unintended consequences of intervention.

The guidance describes many of the cascading second- and third-order consequences, and provides planners with initial recommendations on strategies to address them.  These recommendations may be revised in the coming months based on feedback that the government will seek from a variety of specific communities, including the private sector. The guidance notes that over time, exercises at the local, State, regional, and Federal level will help define the feasibility of the recommendations and ways to overcome barriers to successful implementation. 

As part of the continuing effort to raise awareness and educate the public about pandemic influenza and the need to prepare in advance, the Department of Health and Human Services also unveiled a number of new radio and television public service announcements (PSAs). The PSAs encourage people to learn more about pandemic influenza and to know more about their state and local community's efforts to prepare for a potential pandemic.

The pre-pandemic planning guidance was developed through a collaborative process that included public health officials, mathematical modelers, researchers, and stakeholders from government, academia, private industry, education, and civic and faith-based organizations.  The full document is available at
Community Strategy for Pandemic Influenza Mitigation (PDF - 2.51 MB).

Additional information is available as follows:

• LTC and other residential facilities pandemic influenza planning checklist: http://www.pandemicflu.gov/plan/healthcare/longtermcarechecklist.html
• Planning for a Pandemic/Epidemic or Disaster:   Caring for  Persons with Cognitive Impairment 
• General information: http://www.pandemicflu.gov/general/index.html 

https://www.ahcancal.org/facility_operations/disaster_planning/Pages/InterimPrePandemicPlanningGuidance.aspx

The monthly Coppock Indicators finished February

DJIA: 25,409 -75 Down. NASDAQ: 8,567 +171 Up. SP500: 2,954 +133 Up. 

A mixed bag. But given the severity of the still growing coronavirus crisis, I wouldn’t follow technical signals in what I think will turn into the first depression since the 1930s.