The article by Ferguson et al. explores strategies to mitigate the severity of a new influenza pandemic, focusing on antiviral, vaccine, and non-pharmaceutical interventions. Using a large-scale epidemic simulation model, the authors examine the effectiveness of various measures in Great Britain and the United States, considering different levels of transmissibility and the impact of travel restrictions, school closures, case isolation, household quarantine, and treatment with antivirals. Key findings include: 1. **Border and Travel Restrictions**: Border restrictions and internal travel restrictions are unlikely to delay the spread of the pandemic by more than 2-3 weeks unless they are highly effective (99% or more). 2. **School and Workplace Closure**: School closure during the peak of the pandemic can reduce peak attack rates by up to 40%, but has little impact on overall attack rates. Closing 50% of workplaces can enhance the impact of school closures. 3. **Case Isolation and Household Quarantine**: Prompt treatment of clinical cases with antivirals can significantly reduce transmission, especially if treatment is given within one day of symptom onset. Household quarantine can also reduce attack rates, but compliance is crucial. 4. **Vaccination**: Pre-pandemic vaccination can significantly reduce attack rates, even if the vaccine is not perfectly matched to the pandemic strain. Vaccination must start within 2 months of the initial global outbreak to be effective. 5. **Combination Strategies**: Combining multiple interventions, such as household quarantine, reactive school closure, and targeted prophylaxis, can be highly effective. However, the success of these strategies depends on the transmissibility of the pandemic strain and the effectiveness of the interventions. The authors emphasize the importance of detailed data on transmission dynamics and the need for real-time analysis to tailor interventions to the specific characteristics of a new pandemic virus. They also highlight the limitations of current vaccine technologies and the potential for resistance to antiviral drugs.The article by Ferguson et al. explores strategies to mitigate the severity of a new influenza pandemic, focusing on antiviral, vaccine, and non-pharmaceutical interventions. Using a large-scale epidemic simulation model, the authors examine the effectiveness of various measures in Great Britain and the United States, considering different levels of transmissibility and the impact of travel restrictions, school closures, case isolation, household quarantine, and treatment with antivirals. Key findings include: 1. **Border and Travel Restrictions**: Border restrictions and internal travel restrictions are unlikely to delay the spread of the pandemic by more than 2-3 weeks unless they are highly effective (99% or more). 2. **School and Workplace Closure**: School closure during the peak of the pandemic can reduce peak attack rates by up to 40%, but has little impact on overall attack rates. Closing 50% of workplaces can enhance the impact of school closures. 3. **Case Isolation and Household Quarantine**: Prompt treatment of clinical cases with antivirals can significantly reduce transmission, especially if treatment is given within one day of symptom onset. Household quarantine can also reduce attack rates, but compliance is crucial. 4. **Vaccination**: Pre-pandemic vaccination can significantly reduce attack rates, even if the vaccine is not perfectly matched to the pandemic strain. Vaccination must start within 2 months of the initial global outbreak to be effective. 5. **Combination Strategies**: Combining multiple interventions, such as household quarantine, reactive school closure, and targeted prophylaxis, can be highly effective. However, the success of these strategies depends on the transmissibility of the pandemic strain and the effectiveness of the interventions. The authors emphasize the importance of detailed data on transmission dynamics and the need for real-time analysis to tailor interventions to the specific characteristics of a new pandemic virus. They also highlight the limitations of current vaccine technologies and the potential for resistance to antiviral drugs.