(P1-79) Regional Medical Command and Control Management of Influenza A (H1N1) Mass-Vaccination in the County of Östergötland, Sweden

IntroductionOn 11 June 2009, an Influenza A (H1N1) pandemic was declared by the World Health Organization (WHO). The Major Medical Incident Regional Command and Control Protocol in the County Council of Östergötland, Sweden was activated. After vaccinations were competed, it was decided that the operation should be evaluated in a retrospective study. This study aims to increase knowledge regarding regional management of a pandemic flu.MethodsAll protocols from regional command meetings were studied together with central data regarding, logistics, vaccination site reports, incident reports, and all written correspondence between involved departments. Information from results of a questionnaire that was distributed to all vaccination site managers were summarized and studied. In addition, an interview was performed with the chief of medical operations.ResultsOut of the approximately 426,000 inhabitants of the county, a total of 224,780 (53%) were vaccinated during a five and a half month period. The mean pace was 1,246 vaccinated per day (range 0–9643). Regional command had 41 recorded meetings resulting in a collected number of about 740 working hours. Three hundred sixty-six employees were involved in the vaccination, working 38,741 hours. Twenty-eight safety and 52 security incidents were reported. Uncertainty about vaccine delivery and keeping the public's interest were reported to be of concern for the management.DiscussionEven with the large scale of the operation, there were only a few security and safety issues. Although the goal of vaccinating 75–80% of the inhabitants was not reached, it could be assumed that the pandemic was dampened. Given the public's high initial interest, it could be considered that vaccination should not start until a large number of doses have been delivered.ConclusionThe medical incident command structure and protocol successfully can be adapted to a mass vaccination event. Information from the Östergötland County Council operation yielded significant experience for future mass vaccinations.

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Progression and Trends in Virus from Influenza A to COVID-19: An Overview of Recent Studies

Viruses ◽

10.3390/v13061145 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1145

Author(s):

Hakimeh Baghaei Daemi ◽

Muhammad Fakhar-e-Alam Kulyar ◽

Xinlin He ◽

Chengfei Li ◽

Morteza Karimpour ◽

...

Keyword(s):

Influenza A ◽

H1n1 Virus ◽

World Health ◽

H1n1 Pandemic ◽

Global Pandemic ◽

First Case ◽

Influenza A H1n1 ◽

The World ◽

Novel Coronavirus ◽

Health Organization

Influenza is a highly known contagious viral infection that has been responsible for the death of many people in history with pandemics. These pandemics have been occurring every 10 to 30 years in the last century. The most recent global pandemic prior to COVID-19 was the 2009 influenza A (H1N1) pandemic. A decade ago, the H1N1 virus caused 12,500 deaths in just 19 months globally. Now, again, the world has been challenged with another pandemic. Since December 2019, the first case of a novel coronavirus (COVID-19) infection was detected in Wuhan. This infection has risen rapidly throughout the world; even the World Health Organization (WHO) announced COVID-19 as a worldwide emergency to ensure human health and public safety. This review article aims to discuss important issues relating to COVID-19, including clinical, epidemiological, and pathological features of COVID-19 and recent progress in diagnosis and treatment approaches for the COVID-19 infection. We also highlight key similarities and differences between COVID-19 and influenza A to ensure the theoretical and practical details of COVID-19.

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Optimal Control of an SIR Model with Delay in State and Control Variables

ISRN Biomathematics ◽

10.1155/2013/403549 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Mohamed Elhia ◽

Mostafa Rachik ◽

Elhabib Benlahmar

Keyword(s):

Optimal Control ◽

Influenza A ◽

Optimization Strategy ◽

Sir Epidemic Model ◽

Optimal Control Strategy ◽

Control Variables ◽

Sir Epidemic ◽

Influenza A H1n1 ◽

Using Data ◽

And Control

We will investigate the optimal control strategy of an SIR epidemic model with time delay in state and control variables. We use a vaccination program to minimize the number of susceptible and infected individuals and to maximize the number of recovered individuals. Existence for the optimal control is established; Pontryagin’s maximum principle is used to characterize this optimal control, and the optimality system is solved by a discretization method based on the forward and backward difference approximations. The numerical simulation is carried out using data regarding the course of influenza A (H1N1) in Morocco. The obtained results confirm the performance of the optimization strategy.

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Leading in a VUCA World

Ushus - Journal of Business Management ◽

10.12725/ujbm.54.5 ◽

2021 ◽

Vol 20 (1) ◽

pp. 89-111

Author(s):

R Ramakrishnan

Keyword(s):

Critical Period ◽

Large Scale ◽

Command And Control ◽

Insufficient Information ◽

Control Structures ◽

The Future ◽

Entire World ◽

To Come ◽

And Control ◽

Crisis Leaders

The current COVID-19 virus has put the entire world in lockdown, creating one of the worst times of a VUCA world. The changes that are happening because of the pandemic are large scale and occur suddenly. There is a shortage of leadership everywhere. Leaders are unprepared to lead effectively. In this fast-changing and disruptive environment, command and control structures fail. Leaders are expected to act on incomplete or insufficient information. They do not know where to start to drive change as increased complexity makes it difficult. Leaders lack time to reflect and end up acting too quickly or acting too late as they get stuck in analysis paralysis. They are far removed from the source and are forced to act with a limited understanding of events and their meanings. The role and type of leadership are being tested as we are trying to come out of this crisis. Leaders cannot predict the future but need to make sense of it in order to thrive. This paper would analyse challenges that are being faced by leaders in this critical period and how these can be converted into opportunities like a vaccine for the virus.

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Cluster analysis of the origins of the new influenza A(H1N1) virus

Eurosurveillance ◽

10.2807/ese.14.21.19224-en ◽

2009 ◽

Vol 14 (21) ◽

Cited By ~ 14

Author(s):

A Solovyov ◽

G Palacios ◽

T Briese ◽

W I Lipkin ◽

R Rabadan

Keyword(s):

Cluster Analysis ◽

Influenza A ◽

H1n1 Virus ◽

Swine Influenza ◽

The United States ◽

Influenza Viruses ◽

World Health ◽

Influenza A H1n1 ◽

The World ◽

Health Organization

In March and April 2009, a new strain of influenza A(H1N1) virus has been isolated in Mexico and the United States. Since the initial reports more than 10,000 cases have been reported to the World Health Organization, all around the world. Several hundred isolates have already been sequenced and deposited in public databases. We have studied the genetics of the new strain and identified its closest relatives through a cluster analysis approach. We show that the new virus combines genetic information related to different swine influenza viruses. Segments PB2, PB1, PA, HA, NP and NS are related to swine H1N2 and H3N2 influenza viruses isolated in North America. Segments NA and M are related to swine influenza viruses isolated in Eurasia.

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Antigenic and genomic characterization of human influenza A and B viruses circulating in Argentina after the introduction of influenza A(H1N1)pdm09

Journal of Medical Microbiology ◽

10.1099/jmm.0.076208-0 ◽

2014 ◽

Vol 63 (12) ◽

pp. 1626-1637 ◽

Cited By ~ 3

Author(s):

Mara L. Russo ◽

Andrea V. Pontoriero ◽

Estefania Benedetti ◽

Andrea Czech ◽

Martin Avaro ◽

...

Keyword(s):

Southern Hemisphere ◽

Influenza A ◽

Vaccine Virus ◽

Influenza Viruses ◽

World Health ◽

Influenza Surveillance ◽

Human Influenza ◽

Surveillance Network ◽

Influenza A H1n1 ◽

Health Organization

This study was conducted as part of the Argentinean Influenza and other Respiratory Viruses Surveillance Network, in the context of the Global Influenza Surveillance carried out by the World Health Organization (WHO). The objective was to study the activity and the antigenic and genomic characteristics of circulating viruses for three consecutive seasons (2010, 2011 and 2012) in order to investigate the emergence of influenza viral variants. During the study period, influenza virus circulation was detected from January to December. Influenza A and B, and all current subtypes of human influenza viruses, were present each year. Throughout the 2010 post-pandemic season, influenza A(H1N1)pdm09, unexpectedly, almost disappeared. The haemagglutinin (HA) of the A(H1N1)pdm09 viruses studied were segregated in a different genetic group to those identified during the 2009 pandemic, although they were still antigenically closely related to the vaccine strain A/California/07/2009. Influenza A(H3N2) viruses were the predominant strains circulating during the 2011 season, accounting for nearly 76 % of influenza viruses identified. That year, all HA sequences of the A(H3N2) viruses tested fell into the A/Victoria/208/2009 genetic clade, but remained antigenically related to A/Perth/16/2009 (reference vaccine recommended for this three-year period). A(H3N2) viruses isolated in 2012 were antigenically closely related to A/Victoria/361/2011, recommended by the WHO as the H3 component for the 2013 Southern Hemisphere formulation. B viruses belonging to the B/Victoria lineage circulated in 2010. A mixed circulation of viral variants of both B/Victoria and B/Yamagata lineages was detected in 2012, with the former being predominant. A(H1N1)pdm09 viruses remained antigenically closely related to the vaccine virus A/California/7/2009; A(H3N2) viruses continually evolved into new antigenic clusters and both B lineages, B/Victoria/2/87-like and B/Yamagata/16/88-like viruses, were observed during the study period. The virological surveillance showed that the majority of the circulating strains during the study period were antigenically related to the corresponding Southern Hemisphere vaccine strains except for the 2012 A(H3N2) viruses.

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Perceiving the effects of scale on command and control: A conceptual metaphor approach

Journal of Emergency Management ◽

10.5055/jem.2020.0453 ◽

2020 ◽

Vol 18 (2) ◽

pp. 91-104

Author(s):

Tony McAleavy, BA (Hons), MSc, PhD

Keyword(s):

Command And Control ◽

Resource Depletion ◽

The United States ◽

Incident Command ◽

Emergency Managers ◽

Golden Thread ◽

Gold Silver ◽

The Usa ◽

The Uk ◽

And Control

Objective: This study investigates emergency manager’s perceptions of Command and Control to answer the question “how do emergency managers metaphorically interpret Command and Control?”Design: An interpretivist paradigm, verbatim transcription, and content and linguistic metaphor analysis were used within this study.Setting: Fifteen interviews per country, three per selected organization were conducted in the United Kingdom and the United States of America.Subjects: Purposive sampling identified suitable participants from key organizations engaged in emergency management at local, subnational, and national levels.Interventions: The study consisted of 30 semi-structured face-to-face interviews conducted within the work-place.Main Outcome Measure(s): The inductive and qualitative nature of the study resulted in a 300,000-word corpus of data from which the two posited theories emerged.Results: The UK Gold, Silver, Bronze model and the USA Incident Command System were considered tried and tested although they are conceptually misunderstood. Moreover, they are believed to be essential, scalable, and flexible. Able to manage the perceived chaos of increasing scales of disaster which contradicts the existing literature.Conclusions: Two conceptual metaphors are theorized to create flexible learning tools that challenge the entrenched nature of these findings. Command and Control as a Candle demonstrates the effects of increasing disaster scale on systemic efficacy. Command and Control as a Golden Thread illustrates problems caused by time, distance, resource depletion, and infrastructure degradation. These tools engender deeper more critical perspectives by linking theory to practice through metaphor to engender perceptual change.

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Influenza Project in Myanmar

Journal of Disaster Research ◽

10.20965/jdr.2014.p0842 ◽

2014 ◽

Vol 9 (5) ◽

pp. 842-847

Author(s):

Reiko Saito ◽

◽

Yadanar Kyaw ◽

Yi Yi Myint ◽

Clyde Dapat ◽

...

Keyword(s):

Influenza A ◽

Drug Susceptibility ◽

Influenza Viruses ◽

World Health ◽

Influenza Surveillance ◽

Influenza B ◽

Laboratory Capacity ◽

Influenza A H1n1 ◽

Resistant Strains ◽

Health Organization

The epidemiological study of influenza in Southeast Asia is limited. We surveyed influenza in Myanmar from 2007 to 2013. Nasopharyngeal swabs were collected from patients in the two cities of Yangon and Nay Pyi Taw. Samples were screened using rapid influenza diagnostic kits and identified by virus isolation. Isolates were characterized by cyclingprobe-based real-time PCR, drug susceptibility assay, and sequencing. Samples collected numbered 5,173, from which 1,686 influenza viruses were isolated during the seven-year study period. Of these, 187 strains were of seasonal influenza A(H1N1), 274 of influenza A(H1N1)pdm09, 791 of influenza A(H3N2), and 434 of influenza B. Interestingly, two zanamivir and amantadine-resistant strains each were detected in 2007 and 2008. These rare dual-resistant strains had a Q136K mutation in the NA protein and S31N substitution in the M2 protein. Our collaboration raised the influenza surveillance laboratory capacity in Myanmar and led Yangon’s National Health Laboratory – one of the nation’s leading research institutes – to being designated a National Influenza Center by the World Health Organization.

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Community transmission of influenza A (H1N1)v virus at a rock festival in Belgium, 2-5 July 2009

Eurosurveillance ◽

10.2807/ese.14.31.19294-en ◽

2009 ◽

Vol 14 (31) ◽

Cited By ~ 18

Author(s):

I Gutiérrez ◽

A Litzroth ◽

S Hammadi ◽

H Van Oyen ◽

C Gérard ◽

...

Keyword(s):

Surveillance System ◽

Influenza A ◽

Influenza Pandemic ◽

Control Measures ◽

Influenza Like Illness ◽

Health Authorities ◽

Influenza A H1n1 ◽

Community Transmission ◽

And Control

On 6 July 2009 the Belgian enhanced surveillance system for influenza-like illness among travellers returning from influenza A(H1N1)v affected areas detected a case linked to a rock festival which took place on 2-5 July. The health authorities implemented communication and control measures leading to the detection of aditional cases. This paper describes the outbreak and its impact on the management of the influenza pandemic in Belgium.

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Clinical impact of influenza – lessons learnt from the pandemic influenza A (H1N1) 2009

Microbiology Australia ◽

10.1071/ma11029 ◽

2011 ◽

Vol 32 (1) ◽

pp. 29

Author(s):

Alex Dierig ◽

Gulam Khandaker ◽

Robert Booy

Keyword(s):

Clinical Features ◽

Pandemic Influenza ◽

Influenza A ◽

Influenza Pandemic ◽

Gastrointestinal Symptoms ◽

H1n1 Influenza ◽

World Health ◽

Pandemic H1n1 ◽

Pandemic H1n1 Influenza ◽

Influenza A H1n1

Influenza is generally an acute, self-limiting, febrile illness without further complications in the majority of people. However, it can be associated with severe morbidity and mortality and the burden of the disease on society is likely to be underestimated. In 2009 an outbreak of H1N1 influenza A virus infection was detected in Mexico with further cases soon observed worldwide. Subsequently, in June 2009, the first influenza pandemic of the 21st century due to influenza A (H1N1) was declared by the World Health Organization (WHO). There were many uncertainties regarding the virulence, clinical symptoms and epidemiological features of this newly evolved influenza A strain. Over time, many similarities, but also some differences between the pandemic H1N1 influenza A and seasonal influenza were identified. We recently performed a systematic review of the literature, looking at articles published between 1 April 2009 and 31 January 2010, to identify the epidemiological and clinical features of the pandemic H1N1 influenza. In this current article we compare our findings with others from the international literature. There was more severe impact on young and healthy adults, children, pregnant women and the obese. Clinical features in general were similar between seasonal and pandemic influenza; however, there were more gastrointestinal symptoms associated with pandemic H1N1 influenza. Shortness of breath was characteristic of more severe pH1N1 2009 infection with a higher possibility of being admitted to an intensive care unit (ICU).

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Co-circulation of influenza A(H1N1)pdm09 and influenza A(H3N2) viruses, World Health Organization (WHO) European Region, October 2018 to February 2019

Eurosurveillance ◽

10.2807/1560-7917.es.2019.24.9.1900125 ◽

2019 ◽

Vol 24 (9) ◽

Cited By ~ 9

Author(s):

Hannah Segaloff ◽

Angeliki Melidou ◽

Cornelia Adlhoch ◽

Dmitriy Pereyaslov ◽

Emmanuel Robesyn ◽

...

Keyword(s):

World Health Organization ◽

Influenza A ◽

Influenza Season ◽

Age Groups ◽

World Health ◽

European Region ◽

Influenza A H1n1 ◽

Health Organization ◽

Surveillance Specimens ◽

Increased Susceptibility

In the World Health Organization European Region, the 2018/19 influenza season started in week 49 2018, crossing 10% virus-positivity in sentinel surveillance specimens. At week 5 2019, activity remained elevated with positivity rates at 55%. Both A(H1N1)pdm09 and A(H3N2) viruses circulated widely and detection levels in primary care and hospital settings were similar to past seasons. Hospitalisation data may suggest an increased susceptibility to A(H1N1)pdm09 virus in older age groups.

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