Table Summary of Non-Pharmaceutical Interventions Reserved for Influenza Pandemics

Attachment B: NPIs reserved for influenza pandemics table

Non-Pharmaceutical Interventions (NPIs) Reserved for Influenza Pandemics
NPI	CDC Recommendation1
Voluntary home quarantine	CDC might recommend voluntary home quarantine of exposed household members as a personal protective measure during severe, very severe, or extreme influenza pandemics in combination with other personal protective measures such as respiratory etiquette and hand hygiene. If a member of the household is symptomatic with confirmed or probable pandemic influenza, then all members of the household should stay home for up to 3 days (the estimated incubation period for seasonal influenza), starting from their initial contact with the ill person, to monitor for influenza symptoms.
Use of face masks in community settings by ill persons	CDC might recommend the use of face masks by ill persons as a source control measure during severe, very severe, or extreme influenza pandemics when crowded community settings cannot be avoided (e.g., when adults and children with influenza symptoms seek medical attention) or when ill persons are in close contact with others (e.g., when symptomatic persons share common spaces with other household members or symptomatic postpartum women care for and nurse their infants). Some evidence indicates that face mask use by ill persons might protect others from infection.
School closures and dismissals	CDC might recommend the use of preemptive, coordinated school closures and dismissals during severe, very severe, or extreme influenza pandemics. This recommendation is in accord with the conclusions of the U.S. Community Preventive Services Task Force2, which makes the following recommendations: The task force recommends preemptive, coordinated school dismissals during a severe influenza pandemic. The task force found insufficient evidence to recommend for or against preemptive, coordinated school dismissals during a mild or moderate influenza pandemic. In these instances, jurisdictions should make decisions that balance local benefits and potential harms.
Social distancing measures at schools, workplaces, and mass gatherings	Even though the evidence base for the effectiveness of some of these measures is limited, CDC might recommend the simultaneous use of multiple social distancing measures to help reduce the spread of influenza in community settings (e.g., schools, workplaces, and mass gatherings) during severe, very severe, or extreme influenza pandemics while minimizing the secondary consequences of the measures. Social distancing measures include the following: Increasing the distance to at least 3 feet between persons when possible might reduce person-to-person transmission. This applies to apparently healthy persons without symptoms. In the event of a very severe or extreme pandemic, this recommended minimal distance between people might be increased. Persons in community settings who show symptoms consistent with influenza and who might be infected with (probable) pandemic influenza should be separated from well persons as soon as practical, be sent home, and practice voluntary home isolation.

References

1. Qualls N, Levitt A, Kanade N, et al. Community Mitigation Guidelines to Prevent Pandemic Influenza – United States, 2017. Morbidity and Mortality Weekly Report. Recommendations and Reports. 2017; 66(1):1-34. Available at: https://www.cdc.gov/mmwr/volumes/66/rr/pdfs/rr6601.pdf

2. U.S. Community Preventive Services Task Force (USCPSTF). Emergency Preparedness and Response: School Dismissals to Reduce Transmission of Pandemic Influenza [The Community Guide Systematic Review]. 2012 August. Available at: https://www.thecommunityguide.org/findings/emergency-preparedness-and-response-school-dismissals-reduce-transmission-pandemic-influenza

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