Institute of Medicine 2006. Reusability of Facemasks During an Influenza
Pandemic: Facing the Flu. Washington, DC: The National Academies Press.
https://doi.org/10.17226/11637.

“…….First, of the forms of respiratory protection the committee was asked to
consider, N95 filtering facepiece respirators that are certified by the National
Institute for Occupational Safety and Health (NIOSH) and properly
fit-tested are likely to provide the best protection against influenza to the
extent that it may be spread via an airborne route. Similarly, a closely fitting
high-efficiency medical mask is likely to provide appropriate protection
against droplets, whereas a surgical N95 will provide protection against
both droplets and aerosols. While recognizing the methodological and data
limitations regarding the efficacy of medical masks as a form of respiratory
protection against avian influenza, and in the absence of data to the contrary,
the committee concluded that masks are likely to provide far less
protection against aerosols than an N95 filtering facepiece but may offer

better protection than cotton masks, homemade alternatives such as handkerchiefs
and scarves, or no protection at all. No device is fail-safe, and its
effectiveness depends on fit, level of exposures, and appropriate use. Finally,
none of these devices protects against contact transmission, and appropriate
hand hygiene is necessary when using and after removing these devices…..”

Study weighs value of antibiotics for resistant Staph in pandemic settings

An effective antibiotic that can treat secondary Staphylococcus aureus infections in a pandemic flu outbreak is worth more than $3 billion, according to a new study by researchers from the Center for Disease Dynamics, Economics, and Policy (CDDEP) and their colleagues in Scotland and the Netherlands.

Writing in Health Economics, the authors said though antibiotic reserves are part of pandemic preparedness plans, experts haven’t explores the value of stockpiling or conserving the effectiveness of antibiotics, despite the high morbidity of secondary bacterial infections and the growing ineffectiveness of antibiotics because of emerging antibiotic-resistant organisms.

Using a mathematical framework based on UK preparedness plan assumptions the scientists estimated the value of investing in developing and conserving an antibiotic to lessen the burden of bacterial infections from resistant S aureus during a pandemic flu outbreak.

The team found that the value of withholding an effective new oral antibiotic can be positive and significant unless the pandemic is mild, with few secondary illnesses involving the resistant strain or if most patients can be treated intravenously.

Ramanan Laxminarayan, PhD, MPH, CDDEP director and the study’s senior author, said in a CDDEP press release that secondary bacterial infections are a major cause of death and disability with flu, and antibiotic resistance is a major barrier to treating those infections. “This study shows that the value of an effective antibiotic against Staph infections, as an insurance policy against future pandemics, is between $3 [billion] and 4 billion at baseline,” he said.
Feb 11 Health Econ abstract
Feb 12 CDDEP press release

Investing in antibiotics critical to saving lives during pandemic influenza outbreaks

AJIC

Oxford University

“……there are over almost 500,000 deaths a year caused by influenza, with somewhere between three to five million severe cases of illness annually. The virus is estimated to cost $87.1 billion in absenteeism in the US alone...…

[T]he universal flu vaccine developed at Oxford University targets epitopes that are both naturally immunogenic and limited in variability, allowing for a vaccine that protects against all influenza strains and avoids the need to be regularly updated.

The vaccine, which covers all influenza A and B strains is, is approaching clinical studies and could feasibly enter Phase I trials by the end of 2019……….”

PharmaTimes

‘……The vaccine is designed to target components of the influenza virus that are common to all strains, and will therefore also be suitable to target the outbreak of a new flu pandemic caused by the emergence of a novel form of the virus at the time it moves from an animal species into humans, according to the firm.

The vaccine is 100 percent synthetic and delivers “highly conserved immunogenic peptide fragments from the flu virus to antigen presenting cells in the skin, eliciting a strong and long-lasting T-cell immune response”……’

PharmaTimes

“…..Unlike ordinary vaccines, which use proteins found on the surface of the virus that are susceptible to change, the universal vaccine uses the more stable proteins at the virus’ core. Instead of utilising antibodies, it works by stimulating the immune system to boost virus-killing T-cells, which research has shown such can help fight more than one type of flu virus...…”

Pandemic Response Box

About the Pandemic Response Box

The Pandemic Response Box contains 400 diverse drug-like molecules active against bacteria, viruses or fungi.

Request the Pandemic Response Box

The Pandemic Response Box is available free of charge. In return researchers are expected to share data resulting from research on the molecules from the box in the public domain within 2 years of its generation.

Supporting information

All the details related to requesting and conducting research on compounds in the Pandemic Response Box.

Terms & conditions

The agreement between MMV and the requesting institution for the transfer, handling and use of compounds contained in the box.

WEF

“……While potentially catastrophic outbreaks may occur only every few decades, highly disruptive regional and local outbreaks are becoming more common and pose a major threat to lives and livelihoods. Recent years have seen nearly 200 epidemic events per year. This trend is only expected to intensify due to increasing trade, travel, population density, human displacement, deforestation and climate change. Further, the number and diversity of epidemic events (e.g. influenza, Ebola, Zika, yellow fever, SARS, MERS-CoV and antibiotic-resistant bacteria, among other threats) have been increasing over the past 30 years.….”

EID

Taubenberger JK, Morens DM. 1918 Influenza: the Mother of All Pandemics. Emerging Infectious Diseases. 2006;12(1):15-22. doi:10.3201/eid1201.050979.

“The “Spanish” influenza pandemic of 1918–1919, which caused ≈50 million deaths worldwide, remains an ominous warning to public health. Many questions about its origins, its unusual epidemiologic features, and the basis of its pathogenicity remain unanswered. The public health implications of the pandemic therefore remain in doubt even as we now grapple with the feared emergence of a pandemic caused by H5N1 or other virus. However, new information about the 1918 virus is emerging, for example, sequencing of the entire genome from archival autopsy tissues. But, the viral genome alone is unlikely to provide answers to some critical questions. Understanding the 1918 pandemic and its implications for future pandemics requires careful experimentation and in-depth historical analysis.”

Science Direct