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The authors reflect on the need to strengthen the evidence base for decision making on public health and social measures to effectively fight the COVID-19 pandemic and pandemic influenza. Also cited are some public health and social measures like school and business closures, physical distancing, and travel restrictions, and the study launched by the World Health Organization in June 2021 to measure the effects of said strategies during health emergencies.

Problem In 2003, China's handling of the early stages of the epidemic of severe acute respiratory syndrome (SARS) was heavily criticized and generally considered to be suboptimal. Approach Following the SARS outbreak, China made huge investments to improve surveillance, emergency preparedness and response capacity and strengthen public health institutions. In 2013, the return on these investments was evaluated by investigating China's early response to the emergence of avian influenza A(H7N9) virus in humans. Local setting Clusters of human infection with a novel influenza virus were detected in China--by national surveillance of pneumonia of unknown etiology--on 26 February 2013. Relevant changes On 31 March 2013, China notified the World Health Organization (WHO) of the first recorded human infections with A(H7N9) virus. Poultry markets--which were rapidly identified as a major source of transmission of A(H7N9) to humans--were closed down in the affected areas. Surveillance in humans and poultry was heightened and technical guidelines were quickly updated and disseminated. The health authorities collaborated with WHO in risk assessments and risk communication. New cases were reported promptly and publicly. Lessons learnt The relevant infrastructures, surveillance systems and response capacity need to be strengthened in preparation for future emergencies caused by emerging or existing disease threats. Results of risk assessments and other data should be released promptly and publicly and such release should not jeopardize future publication of the data in scientific journals. Coordination between public health and veterinary services would be stronger during an emergency if these services had already undertaken joint preparedness planning. [ABSTRACT FROM AUTHOR]

Objective To estimate influenza-associated mortality in urban China. Methods Influenza-associated excess mortality for the period 2003-2008 was estimated in three cities in temperate northern China and five cities in the subtropical south of the country. The estimates were derived from models based on negative binomial regressions, vital statistics and the results of weekly influenza virus surveillance. Findings Annual influenza-associated excess mortality, for all causes, was 18.0 (range: 10.9-32.7) deaths per 100 000 population in the northern cities and 11.3 (range: 7.3-17.8) deaths per 100 000 in the southern cities. Excess mortality for respiratory and circulatory disease was 12.4 (range: 7.4-22.2) and 8.8 (range: 5.5-13.6) deaths per 100 000 people in the northern and southern cities, respectively. Most (86%) deaths occurred among people aged ≥ 65 years. Influenza-associated excess mortality was higher in B-virus-dominant seasons than in seasons when A(H3N2) or A(H1N1) predominated, and more than half of all influenza-associated mortality was associated with influenza B virus. Conclusion Between 2003 and 2008, seasonal influenza, particularly that caused by the influenza B virus, was associated with substantial mortality in three cities in the temperate north of China and five cities in the subtropical south of the country. [ABSTRACT FROM AUTHOR]