Professor Neil Ferguson: Plagues, Prediction and Preparedness - modelling the next global pandemic
The avian epidemic of H5N1 influenza poses a unquantifiable but ongoing risk of causing a human pandemic with potentially much more severe consequences – in terms of human mortality – than other candidate avian influenza viruses. Reducing this risk – via policies designed to contain or mitigate the spread of a new pandemic virus has been a key policy priority in many countries in the last 2 years. Epidemic modelling provides a powerful tool for understanding the dynamics of past pandemics, projecting the likely pattern of spread of future pandemics, and assessing the likely benefits of different control measures – though uncertainties about the biological and epidemiological properties of the next pandemic virus limit our ability to precisely predict the speed of spread and health impact of a pandemic.
After introducing some basic epidemiological concepts, I will review what modelling has told us about the feasibility of containing a pandemic at source, before it has the chance to spread globally. If containment at source fails, an often discussed policy option is to try to slow spread by restricting international travel. I will present the results of modelling studies which indicate that significant delays are only possible if travel restrictions are almost completely effective at preventing population movement. Modelling has also been influential in forming opinion about the relative effectiveness of different options for mitigating the consequences of a pandemic in any one country. I will discuss the likely effectiveness of the two categories of control measures: medical interventions – including antiviral treatment and vaccination, and non-medical interventions – such as public health measures intended to increase social distance, such as school closure, household quarantine and case isolation. I will conclude with a discussion of how analyses of historical data influenza transmission can provide key data for refining estimates of control policy effectiveness.
Professor Neil Ferguson OBE is Director of the newly founded MRC Centre for Outbreak Analysis and Modelling and holds a Chair in Mathematical Biology at the Dept. of Infectious Disease Epidemiology, Imperial College. He uses mathematical and statistical models to investigate the processes shaping infectious disease pathogenesis, evolution and transmission. A key practical focus is advising on disease control policies in public health, clinical and veterinary contexts. As well as basic theoretical work on evolutionary and epidemiological dynamics, Professor Ferguson also applies his work to a range of pathogens, including influenza, SARS, BSE/vCJD, HIV, foot-and-mouth disease and smallpox. He was educated at Oxford University, held a Royal Society University Research Fellowship at Oxford, then a readership at the University of Nottingham before moving to Imperial College. He was awarded an OBE in 2001 by the UK Government for his contribution to advising on the control of the foot-and-mouth epidemic in the UK that year, and was awarded Fellowship of the Academy of Medical Sciences in 2005. His current research focus is on the use of models as contingency planning tools for emerging infections (pandemic influenza in particular) and bioterrorism. He is a member of the World Health Organisation Pandemic Influenza Task Force, the UK Dept. of Health Pandemic Influenza Science Advisory Group, and the DEFRA Science Advisory Council, and DEFRA’s National Expert Group on Epidemic Diseases (covering Avian Influenza and Foot and Mouth Disease). He also advises the US Homeland Security Council and DHHS on pandemic planning.
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