Biosecurity Briefing

Subscribe | About | Current Issue | RSS | Archive

ASTHO Releases Draft Guidance for Protecting At-Risk Populations during a Pandemic

By Jennifer Nuzzo, April 18, 2008

On April 15, 2008, the Association of State and Territorial Health Officials (ASTHO) released draft planning guidance to help state, local, tribal, and territorial health departments address the needs of at-risk populations during an influenza pandemic. The 105-page document, which was developed with funding from the U.S. Centers for Disease Control and Prevention (CDC), is intended to provide health departments with “sound, evidence-based guidance on the protection of at-risk populations during an influenza pandemic, including considerations for infection control, social distancing, school closure, cessation of mass gatherings, disruptions of essential community services, isolation, quarantine, community mitigation strategies, and distribution of antivirals and vaccine.”1

The ASTHO guidance defines “at-risk” populations as those who are “most at-risk of severe consequences” from either the direct effects of being infected with pandemic influenza or the “secondary and tertiary effects that at-risk populations may experience without being infected with the virus.”1 According to the document “factors that increase the risk of harm during an influenza pandemic include:

1. Economic disadvantage (e.g., having too little money to stockpile supplies, or to stay home from work for even a short time)
2. Absence of a support network (e.g., children; homeless; travelers; and the socially, culturally, or geographically isolated)
3. Needing support to be independent in daily activities because of:
   i. Physical disability
   ii. Developmental disability
   iii. Mental illness or substance abuse/dependence
   iv. Difficulty seeing or hearing
   v. Medical conditions
4. Trouble reading, speaking, or understanding English.”1

Using that definition of at-risk populations, ASTHO “worked with state, local, tribal, and territorial health agencies; federal entities including CDC; and other key stakeholders” to develop the planning recommendations.1 The document outlines some of the ethical and legal considerations of addressing the needs of at-risk populations during a pandemic and contains 5 chapters with specific guidance for planning in the following areas:

1. “Collaboration with and Engagement of At-Risk Populations”
2. “Identifying At-Risk Populations”
3. “Communications with and Education of At-Risk Populations”
4. Provision of Clinical and Non-Clinical Services
5. “How to Test, Exercise, Measure, and Improve Preparedness of At-Risk Populations”1

ASTHO is seeking public comment on the draft guidance until May 15, 2008, and is asking those who submit comment to consider specific points that are outlined at the following URL: http://www.astho.org/templates/display_pub.php?pub_id=3062&admin=1.

Comments may be submitted here: arpp@astho.org.

References

1. Association of State and Territorial Health Officials. At-risk populations and pandemic influenza: planning guidance for state, territorial, tribal, and local health departments. http://www.astho.org/pubs/ARPP_Guidance_041508.pdf. Accessed April 18, 2008.