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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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Public Health Lessons for
Non-Vaccine Influenza
Interventions

Looking Past COVID-19

Alexander Capron, Patricia García, and Ellen Schenk, Editors

Committee on Public Health Interventions and Countermeasures
for Advancing Pandemic and Seasonal Influenza Preparedness and
Response

Board on Global Health

Health and Medicine Division

A Consensus Study Report of

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and

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THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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This activity was supported by a contract between the National Academy of Sciences and the Office of Global Affairs with the U.S. Department of Health and Human Services. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

International Standard Book Number-13: 978-0-309-08817-6
International Standard Book Number-10: 0-309-08817-8
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2022. Public health lessons for non-vaccine influenza interventions: Looking past COVID-19. Washington, DC: The National Academies Press. https://doi.org/10.17226/26283.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

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Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process, and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

For information about other products and activities of the National Academies, please visit www.nationalacademies.org/about/whatwedo.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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COMMITTEE ON PUBLIC HEALTH INTERVENTIONS AND COUNTERMEASURES FOR ADVANCING PANDEMIC AND SEASONAL INFLUENZA PREPAREDNESS AND RESPONSE

ALEXANDER M. CAPRON (Chair), University Professor, Scott H. Bice Chair in Healthcare Law, Policy, and Ethics, and Professor of Medicine and Law, University of Southern California

PATRICIA J. GARCÍA (Vice Chair), Professor, Cayetano Heredia University

LUKOYE ATWOLI, Professor of Psychiatry and Dean, Aga Khan University Medical College of East Africa

PETER DASZAK, President and Chief Executive Officer, EcoHealth Alliance

ADOLFO GARCÍA-SASTRE, Director, Global Health and Emerging Pathogens Institute; Professor of Microbiology and Medicine, Department of Microbiology, Icahn School of Medicine at Mount Sinai

DENISE GRAY-FELDER, Founding President and Chief Executive Officer, Communication for Social Change Consortium

GABRIEL LEUNG, Dean of Medicine, Helen and Francis Zimmern Professor of Population Health, The University of Hong Kong

CHANDINI RAINA MacINTYRE, Professor, Kirby Institute, University of New South Wales Australia

LINSEY C. MARR, Professor, Department of Civil and Environmental Engineering, Virginia Polytechnic Institute and State University

TOLBERT NYENSWAH, Senior Research Associate, Department of International Health, Johns Hopkins Bloomberg School of Public Health

ROSANNA PEELING, Professor and Chair of Diagnostics Research, London School of Hygiene & Tropical Medicine

MARYBETH SEXTON, Assistant Professor of Infectious Diseases, Emory University School of Medicine; Medical Director of Antimicrobial Stewardship, Emory University Hospital; Epidemiologist, Emory Clinic

Consultant to the Committee

MARC LIPSITCH, Professor of Epidemiology, Harvard T.H. Chan School of Public Health

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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Study Staff

ELLEN SCHENK, Study Director (until July 2021)

EMILIE RYAN-CASTILLO, Senior Program Assistant

CLAIRE MOERDER, Research Associate (until June 2021)

ADRIENNE FORMENTOS, Research Associate (until July 2021)

PATRICIA A. CUFF, Senior Program Officer

JULIE A. PAVLIN, Senior Director, Board on Global Health

Consultants

ANNA NICHOLSON, Science Writer

MEGAN SNAIR, Consultant (from July 2021)

PEAK SEN CHUA, Research Consultant (from April 2021)

SARAH ANNE NEW, Research Consultant (from June 2021)

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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Reviewers

This Consensus Study Report was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published report as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process.

We thank the following individuals for their review of this report:

ROSHAN BASTANI, University of California, Los Angeles

LYDIA BOUROUIBA, Massachusetts Institute of Technology

CARRIE BYINGTON, University of California Health

BENJAMIN COWLING, The University of Hong Kong

EZEKIEL J. EMANUEL, University of Pennsylvania

BETSY FOXMAN, University of Michigan

MARY-LOUISE McLAWS, University of New South Wales Australia

ARTHUR REINGOLD, University of California, Berkeley

NELSON SEWANKAMBO, Makerere University

CHRIS SEYMOUR, University of Pittsburgh

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations of this report nor did they see the final draft before its release. The review of this report was overseen by SUSAN CURRY, The

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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University of Iowa, and SANDRO GALEA, Boston University. They were responsible for making certain that an independent examination of this report was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the authoring committee and the National Academies.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
×

National Academy of Medicine

Advancing Pandemic and Seasonal Influenza Vaccine Preparedness and Response Series

This study, Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19, provides recommendations on how public health interventions and countermeasures can be used to mitigate the spread and effects of influenza both before and after vaccines are available. It is one of four studies conducted under the Advancing Pandemic and Seasonal Influenza Vaccine Preparedness and Response Initiative, which explores how the scientific and technological breakthroughs throughout the COVID-19 pandemic could inform and advance future pandemic and seasonal influenza vaccine preparedness and response efforts.

The three companion studies to this study examine how the lessons learned from COVID-19 around vaccine research and development, vaccine distribution and supply chain, and global coordination, partnerships, and financing could be best utilized to improve the development and distribution of future pandemic and seasonal influenza vaccines. Together, the four consensus studies present a path toward better preparedness in addressing pandemic and seasonal influenza.

Launched by the National Academy of Medicine with support from the Office of Global Affairs, U.S. Department of Health and Human Services, the Advancing Pandemic and Seasonal Influenza Vaccine Preparedness and Response Initiative acknowledges that influenza is here to stay. The unprecedented scope of this initiative allowed for international experts to look at this issue from multiple angles and provide recommendations that set out a pathway to more effective influenza vaccines worldwide. Driven by international cooperation, this independent initiative provides a platform to highlight why we need to act as a global community to better prepare for pandemic and seasonal influenza.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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Acknowledgments

This study, very broad in scope yet on an extremely intense timeline, would not have been possible without the contributions and support from many. The committee would like to thank the speakers at the full committee meetings, whose names and affiliations are found in Appendix B. Many thanks are also extended to the Office of Global Affairs within the U.S. Department of Health and Human Services for sponsoring this effort, the international committee, coordinated by the National Academy of Medicine, for its thoughtfulness in developing the study’s Statement of Task, and Victor Dzau for his enthusiasm and support.

The study staff would like to express deep appreciation to Leslie Sim and Taryn Young for coordinating the review process, Tina Seliber for fielding many questions on formatting, and Lauren Shern for providing guidance throughout the course of the project. Thanks also go to Rebecca Morgan with the Research Center for advice on literature search/reduction methodologies and EndNote. Acknowledgments also extend to Liz Ashby and Arjun Venkatesh for their initial research involvement, and Kenisha Jefferson, Hoda Soltani, and Janelle Winters from the other three influenza consensus studies for their support throughout the process.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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Preface

The first signal that a single nation, or the entire world, is about to experience a major problem—in the economy, the environment, public health, or any sphere that can touch the lives of countless people—is commonly termed a “wake-up call.” Yet, the alarm sounded in this metaphor is unfortunately not one that brings a fire brigade to extinguish the flames but rather one that alerts us to the arrival of a peril that we knew—or could have anticipated—was coming but chose to disregard. In recent decades, as one novel infectious disease after another—H1N1 avian influenza, severe acute respiratory syndrome (SARS), Middle East respiratory syndrome, and Ebola virus disease—emerged as a grave threat to human health, any public awakening to the weaknesses in national and global public health systems was only partial and seems to have soon subsided once the immediate threat had passed. Simply put, when those wake-up calls came, we rolled over and went back to sleep.

At the end of December 2019, a cluster of cases of atypical pneumonia was reported in Wuhan, China. The people affected were believed to have patronized a seafood market where wild animals were sold for human consumption. Chinese scientists rapidly sequenced the RNA of the novel coronavirus responsible for these cases—later named SARS-CoV-2—and submitted results to the U.S. National Center for Biotechnology Information on January 5, 2020. While that information was not immediately noticed, virologists around the world took note when the sequence data were published online on January 11. Two days later, Thai officials reported the first patient outside of China with coronavirus disease 2019 (COVID-19), a visitor from Wuhan who had not been to the seafood market, and the following

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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week, the national government acknowledged human-to-human transmission in China. At the end of January, the World Health Organization (WHO) declared COVID-19 a Public Health Emergency of International Concern, by which time, all nations might have been expected to have begun taking steps to contain the virus. But repeatedly, around the world, complete, transparent data were not communicated in a timely manner. Even as the warning signs became unmistakable, some governments censored doctors and journalists who drew attention to the disease, while leaders in other countries denied or downplayed the risk to their populations, even objecting to testing because it could reveal infections among asymptomatic people and thus make the situation seem more dire. Yet, had basic public health measures been implemented more quickly, modeling shows that some of the 216 million cases of COVID-19—and more than 4.5 million deaths—that have occurred globally as of this writing would have been avoided.

Numerous observers have found further wake-up calls in the COVID-19 pandemic itself: for example, leading medical journals have told their readers that it has revealed everything from the special vulnerability of elderly patients with cardiovascular disease and the stark health inequities that exist based on wealth and race (as seen in the unequal distribution of death and serious illness from the virus) to the fragility of the global economy and from the need for better global disease surveillance systems to the effectiveness of global collaboration in tackling pandemics.

The question facing us now is whether we have truly heeded these calls and, like an errant schoolboy, “learnt our lesson”? That too, draws on a familiar metaphor for what a reasonable person would expect to occur as the world takes stock of the social, economic, and personal devastation wrought by this pandemic. But how confident can we be that the core public health “lessons” of COVID-19—to say nothing of the broader message about the everyday effects of health inequities within and between nations—will result in adequate plans being created and implemented globally before the next pandemic strikes? And, in drawing lessons, we can learn not only to avoid governmental mismanagement and denial, which created public distrust and dissension and exacerbated the harms created by the pandemic, but also to replicate positive actions—such as the international cooperation among laboratory scientists, the ingenuity of researchers in creating—or repurposing—international clinical trial platforms to speed up the discovery of effective therapies, the selfless dedication of doctors, nurses, and other frontline health care workers, and the candor and clarity of some national officials in responding to the pandemic and thus promoting solidarity and cooperation among their citizens.

Trusting that this time the alarm has really woken countries up and that the lessons from COVID-19 will be taken to heart, the Office of Global Affairs in the U.S. Department of Health and Human Services asked the

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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National Academies of Sciences, Engineering, and Medicine to convene four ad hoc committees to step back and see what knowledge can be gained from the response of various actors, from the local to the global, to the present pandemic. We were asked to provide guidance on how to improve national and global preparations for and response to seasonal influenza and, more important, to the next influenza pandemic, which public health experts describe in terms of “when,” not “if.”

Our particular committee was charged with examining a wide variety of issues, as detailed in the Statement of Task that appears in Chapter 1. This assignment led us to explore topics ranging from zoonotic and medical surveillance along the frontier where novel viruses typically enter human society to the methods of testing for, and responding to, their occurrence in the community; from the efficacy of the nonpharmaceutical interventions used against SARS-CoV-2 that might also be relevant for influenza to the means of, and barriers to, implementing these measures effectively; and from the care of COVID-19 patients, especially when health care systems, in high- as well as low-income nations, are overwhelmed by sudden surges in hospitalizations, to the ways that therapy and innovation can be aligned through innovative trial designs when a new respiratory disease arises for which no biologic or pharmaceutical cures are known.

Because COVID-19 is a problem for all of humankind, and under the premise that “No one is safe until everyone is safe,” the Office of Global Affairs requested that we produce advice that would be useful for all nations and the international organizations and other bodies that assist them in seeking to contain the spread, and mitigate the consequences, of novel—and potentially pandemic—strains of respiratory diseases. From the committee’s first meeting at the beginning of March 2021, it was apparent how very fortunate we were to have five members from outside the United States and another three who are foreign scientists working in the United States, which provided us with detailed knowledge of country- and region-specific capabilities and weaknesses in responding to public health emergencies. Given the breadth of topics in our mandate, we are also grateful for the wide range of disciplines represented—not only medicine, virology, clinical research, epidemiology, and public health but also engineering, law, ethics, and communication science. Furthermore, the five members who have held high positions in international and national health agencies, including as minister of health, brought to our deliberations their firsthand experience with the real-world challenges of preparing for and responding to outbreaks of infectious diseases. We also thank the experts and members of the public who contributed their knowledge and experience during our public meetings, our consultant Marc Lipsitch, and our project staff at the National Academies who, as always, deserve credit for what is good in this report but no blame for any shortcomings.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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As we finish our work, it is daunting to realize that increasing numbers of scholars are concurrently publishing new findings about various aspects of the ongoing pandemic, which necessarily lends a provisional cast to our conclusions. Still, we have been reassured when other bodies engaged in dissecting the pandemic arrive at points that align with our findings, conclusions, and recommendations. For example, regarding surveillance, the Independent Panel on Pandemic Preparedness and Response, appointed by WHO, recognized in May the need for both devising better means to regulate the forces that are causing zoonoses to become an increasing health threat to domestic animals and the humans who tend them and implementing the One Health strategy to ensure rapid identification of “spillovers” from wild animals that pose pandemic risks. Likewise, others have identified the need to revise the International Health Regulations to strengthen WHO’s ability to investigate outbreaks and share its findings and to recognize that, under certain conditions, controlling cross-border movement of people and goods can be effective in preventing the initial spread of a novel pathogen. As many groups have also acknowledged, the barriers that caused many people to suffer adverse health outcomes when they were unable to fully comply with recommended COVID-19 countermeasures did not arise solely from the lack of necessary supplies in many communities at the outset of the pandemic. Rather, whether the countermeasure depended on having effective face masks, living in housing that made physical distancing possible, or receiving income support that would permit quarantining or isolating, noncompliance resulted from the systemic factors in society that already prevent certain people from achieving “the highest attainable standard of health,” which is their right as human beings.

It is our hope that beyond specific lessons of the sort described in the pages that follow, the COVID-19 pandemic and the horrific human toll, economic devastation, and troubles for all sectors of society that it has wrought have finally convinced governments, civil society, the business community, and the general public the truth of the adage that, when it comes to public health, an ounce of prevention is unquestionably worth far more than a pound of cure. It would be folly indeed if we wait for another “wake-up call” before using what this pandemic has taught us to ready our societies for the next one.

Alexander M. Capron, Chair
Patricia J. García, Vice Chair
Committee on Public Health Interventions and Countermeasures for Advancing Pandemic and Seasonal Influenza Preparedness and Response

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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Acronyms and Abbreviations

ACTT-1 Adaptive COVID-19 Treatment Trial 1
AI artificial intelligence
AMR antimicrobial resistance
API active pharmaceutical ingredients
ARI acute respiratory infection
CFR case fatality ratio
CI confidence interval
COVID-19 coronavirus disease 2019
DNA deoxyribonucleic acid
ECDC European Centre for Disease Prevention and Control
EISN European Influenza Surveillance Network
EMS emergency medical services
EUA Emergency Use Authorization
FDA U.S. Food and Drug Administration
GHSI Global Health Security Index
GIS Global Influenza Strategy
GISRS Global Influenza Surveillance and Response System
GPHIN Global Public Health Intelligence Network
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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HEPA high-efficiency particulate air
HIV human immunodeficiency virus
HVAC heating, ventilation, and air conditioning
ICU intensive care unit
IHR International Health Regulations
ILI influenza-like illness
JEE Joint External Evaluations
LMIC low- and middle-income country
mAb monoclonal antibody
MERS Middle Eastern respiratory syndrome
MERS-CoV Middle Eastern respiratory syndrome-related coronavirus
NAM National Academy of Medicine
NIH National Institutes of Health
NPI nonpharmaceutical intervention
OECD Organisation for Economic Co-operation and Development
PAHO Pan American Health Organization
PANDORA-ID-NET Pan-African Network for Rapid Research, Response, Relief and Preparedness for Infectious Disease Epidemics
PCR polymerase chain reaction
PPE personal protective equipment
qPCR quantitative polymerase chain reaction
R0 basic reproduction number
R&D research and development
RCT randomized controlled trial
RECOVERY Randomized Evaluation of COVID-19 Recovery Therapy
REMAP-CAP Randomized, Embedded, Multifactorial Adaptive Platform Trial for Community-Acquired Pneumonia
RNA ribonucleic acid
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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Rt effective reproduction number
RT-PCR reverse transcription polymerase chain reaction
SARInet Severe Acute Respiratory Infections Network
SARS severe acute respiratory syndrome
SARS-CoV-2 severe acute respiratory syndrome coronavirus 2
SSA sub-Saharan Africa
UKAID UK Aid Direct
U.S. CDC U.S. Centers for Disease Control and Prevention
USDA U.S. Department of Agriculture
UV ultraviolet
UVGI ultraviolet germicidal irradiation
WHO World Health Organization
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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Page xxii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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Page xxiii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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Page xxiv Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine and National Academy of Medicine. 2022. Public Health Lessons for Non-Vaccine Influenza Interventions: Looking Past COVID-19. Washington, DC: The National Academies Press. doi: 10.17226/26283.
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The COVID-19 pandemic has challenged the world's preparedness for a respiratory virus event. While the world has been combating COVID-19, seasonal and pandemic influenza remain imminent global health threats. Non-vaccine public health control measures can combat emerging and ongoing influenza outbreaks by mitigating viral spread.

Public Health Lessons for Non-Vaccine Influenza Interventions examines provides conclusions and recommendations from an expert committee on how to leverage the knowledge gained from the COVID-19 pandemic to optimize the use of public health interventions other than vaccines to decrease the toll of future seasonal and potentially pandemic influenza. It considers the effectiveness of public health efforts such as use of masks and indoor spacing, use of treatments such as monoclonal antibodies, and public health communication campaigns.

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