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When participants were asked to contribute their own ideas for enhancing the trustworthiness of NTLs when antivirals are scarce, a common theme was the need to develop some kind of face-to-face verification system, as difficult as that might prove. Other ideas were to establish a whistleblower hotline through which the public could report abuse, and to keep NTLs local on the theory that local organizations would know their public and be harder to deceive. Some participants accepted that gaming of NTLs would be unpreventable during times of scarcity.

Antiviral Pick-Up and Delivery by Community Contacts

The second alternative strategy was presented to participants as a policy to encourage family, friends, neighbors, and other community contacts to pick up prescribed antiviral medications from pharmacies and deliver them to people home with influenza. No further details about this policy were offered, other than the suggestion that local community organizations might have a role in this strategy.

Participants were asked to consider:

1. What are the pros and cons of a pick-up and delivery strategy such as this one?

2. What might work well, what could go wrong, what are ways to improve?

3. Would you have any concerns about going to a pharmacy to pick up antiviral drugs during a pandemic?

Advantages and Disadvantages of Community Contact Pick-Up and Delivery

Many participants at the community conversations had generally positive reactions to the strategy of asking family and community contacts to pick up and deliver antiviral medications for the sick. This strategy’s advantages are that it could

•  be convenient for people sick at home with flu;

•  help contain the spread of disease by reducing the need for sick people to congregate in public places like pharmacies;

•  lead community members to check in on the sick; and



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