|**Table 8:****_Effectiveness of policiesfor control in the US_**|**_pop_**<br>**_0_**<br>**_. of 3_**|**_0 mill_**<br>_Fer_<br>**_ion_**_(_|_guso_<br>_l_<br>_n et a_|_. 200_<br>_6)_|
|---|---|---|---|---|
|_Pe_<br>_on/effectiveness of policy_<br>_rcentage applicati_|_l_<br>_in_<br>_De_<br> _U_<br>_ay_|_ay_<br>_S peak_<br>_s)_<br> _(d_|_t_<br>_C_<br>_t_<br>_um.a_|_ack _<br>_rate %_|
||_R0_= .7<br>1|_R0_= .0<br>2|_R_<br>_0_<sup>=1.7</sup>|_R_<br>_0_<sup>=2.0</sup>|
|**_1._**No intervention|0|0|27%|34%|
|_Entry control and move_<br>|_men_<br>_tri_<br>_t res_<br>|_ction _<br>|||
|**_2_**.90% effective bordercontrol<sup>ξ</sup>|≈15|≈10|‐|**­**|
|**_3_**<br>ns<sup>*</sup><br>.99.9% effective bordercontrol<sup>ξ</sup>+air restrictio|≈50|≈42|‐|‐|
|**_4_**<br>m<br>. 99.9% effective border control<sup>ξ</sup>, BMR 20k<br>**|≈60|≈52|‐|‐|
|_Case detection, t_<br>_a_<br>_re tmen_<br><br><br><br>|_t, an isol_<br>_d_|_ation _|||
|**_5_**<br>e<br>.Sa<br>p rted cases<sup>***</sup><br>mday treatmentforall re o|‐|‐|≈25%|≈31%|
|**_6_**.<br>***<br>As**_5_**but 90% receive, and with 2 day delay|‐|‐|≈25%|≈31%|
|**_7_**_._As **_6 _**but same day treatment<sup>***</sup>|‐|‐|≈22%|≈29%|
|**_8._**<br> Same day caseisolation, 70% ofcases<sup>#</sup>|‐|‐|≈21%|≈28%|
|**_9._ ** Same d<br>#<br>ay caseisolation, 90% ofcases|‐|‐|≈<br>18%|≈25%|
|_Household policies & proph_<br><br><br>|_ylax_<br>_poli_<br>_is_<br>|_cies_<br>|||
|**_10_.**<br>tivi<br>An<br>ral treatment for 90% cases +<br>prophylaxis for their household contacts<sup>¶</sup>|8|6|17%|22%|
|**_11._**As **_10 _**plus prophylaxis ofschool/workcontacts|18|26|7.6%|13%|
|**_12._**<br>ouseholds witha case<sup>¶¶</sup><br>14‐day quarantinefor h|4|2|24%|30%|
|**_13._ **Combinationof**_10 _**and **_12_**|10|8|15%|20%|
|_Social distancing policies (sc_<br>|_hool/_<br>_rk_<br>_wo_<br>|_place)_<br>|||
|**_14_.**100%reactive school&10% workplace closure<sup>§</sup>|13|9|2<br>4%|3<br>2%|
|**_15._ **As<br> but with50% workplace closure<br>**_14_**|16|11|23%|31%|
|**_16_**<br>. Mass vaccination fromday 30 ofworld outbreakbe|nning w<br>gi|ith0‐16 y/o<sup>¤</sup>|0%|1%|
|**_17_**.<br>**_16_**<br>utbrea<br>As<br>, but with start from day 60 of world o|k<sup>¤</sup>||19%|31%|
|**_18_**.<br>do<br>tbrea<br>Ran<br>mvaccination fromday 60 ofworld ou|k<sup>¤</sup>||4%|16%|
|**_19_**_._As **_17_**, but beginning withthose over60 y/o<sup>¤</sup>|||21%|31%|
|_Profiled mixed strategies (as in_<br>|_Ferguson_<br>|_et al. 2006)_|||
|**_20_**. Household quarantine<sup>¶¶</sup>+ 100%reactive schoolclo|sure<sup>§</sup>||21%|29%|
|**_21_**.<br>**_20_**, plus 50%<br>t<br>As<br>next day case treatmen|||19%|27%|
|**_22_**. 100%react<br>re plus 90%next day ca<br>ive schoolclosu|se treatme|nt|2<br>2%|30%|
|**_23._**<br>**_22_**<br>As<br> plus household prophylaxis as in**_10_**|||1<br>3%|20%|
|**_24_**_._As **_23_**, plus _pre­vaccination_ of 20% ofpopulation, p|rioritizing|0‐16 y/o|7%|14%|
|**_25_**_._As**_23_**, plus 80% prophylaxis of school/work conta<br>bordercontrols|cts, plus 99|% effective|1%|10%|

ξ Targeted at inbound intl. travelers (air and land)

* Full closure of domestic air traffic

** Journeys over 20km from home are banned *** Delay between symptom onset and antiviral treatment # Assumed to cause 90% reduction in contacts<sup>¶</sup> Prophylaxis with delay of 1 day since symptoms of the case ¶¶  With 50% compliance § Only a % of schools/workplaces closed that have a detected case (reactive) ¤ Mass vaccination at the rate of 1% of the population per day since inception of policy

_Discussion_ : The authors try policies for the prevention of a large caseload in the US given that outbreaks are _inevitable_ (a specific critique of this follows further below). All policies **_2_** ‐ **_25_** are sensitive to _R0_ and policies **_5_** ‐ **_9_** and **_16_** ‐ **_19_** are sensitive to time delays. Even prompt and pervasive case detection (policy **_9_** ) or treatment (policy **_6_** ) does not offer substantial containment. An approximate 18% attack rate in the former will still be a major health event for the US. An intensive antiviral prophylaxis policy ( **_11_** ) will substantially contain the attack rate, but will require a stockpile sufficient to cover 72% of the population at _R0_ =1.7 (not shown in Table 8)<sup>48</sup> . Based on the delayed availability of a _pandemic_ vaccine (and assumed efficacy as noted above), substantial containment can be achieved if a mass vaccination program begins reasonably quickly and is targeted at children (policy **_16_** ). However, the 30‐day timeline (since a circulating pandemic virus strain is identified) for the 21