As of 16:00 GMT, 5 May 2009, 21 countries have officially reported 1490 cases of influenza A (H1N1) infection. If you haven’t been going to the map section at WHO – bookmark it! It is most helpful to get the global view.

WHO Triggers to Plan

Pandemic plans use a series of triggers to move from one phase to another. All of the plans we have done are based on the WHO levels. This still continues to make sense. As we have witnessed with the current H1N1 spread it can be rapid. WHO 1 – 3 has been traditionally a time of planning, WHO 4 – 6 is about plan execution. Thanks to our good fortune, at this moment, even those we have sustained human-to-human transmission the illness for the most part has been mild. It could have been the other way as well.

Local Planning

To that end, when we move from one WHO trigger level to another it is critical that you evaluate each aspect of the plan and the actions you have included in that trigger. An example might be travel restrictions written in your travel policy. At a WHO 4 your plan says to restriction all but essential travel to the country where the WHO 4 occurred. Based on the current situation, does that still make sense? My point is that you need to plan on a global scale and your actions, your response needs to be in concert with local conditions – your eyes and ears always on full alert.

Local Phases
Local phases

In plans we have crafted we added this act locally evaluation step as noted by this color chart noted above. As we reach a trigger, assess what actions you have noted in that trigger. Does it make sense given local conditions? Examples of plans that might call for social distancing or the release of PPE at a phase five are for the most part not appropriate in a majority of the US. So in that case, you note what wasn’t done, parking lot it, and review on a regular basis to see if you need to add it on the next phase change. Always evaluate your local situation, in concert with your local Department of Health.