Federal Response Stages

Below is a table that maps the World Health Organization (WHO) pandemic phases to the U.S. federal response stages. Following the table is more detailed information for each of the federal response stages, including goals, actions, and policy decisions based on the outbreak situation and the risk posed to the U.S.

Stage 0 New Domestic Animal Outbreak in At–Risk Country Goals Provide coordination, support, technical guidance Track outbreaks to resolution Monitor for reoccurrence of disease Actions Support coordinated international response Prepare to deploy rapid response team and materiel Offer technical assistance, encourage information sharing Policy Decisions Deployment of countermeasures	Stage 1 Suspected Human Outbreak Overseas Goals Rapidly investigate and confirm or refute Coordination and logistical support Actions Initiate dialogue with WHO Deploy rapid response team Amplify lab-based and clinical surveillance to region Prepare to implement screening and/or travel restrictions from affected area Policy Decisions Pre-positioning of U.S. contribution to international stockpile assets Use of pre-pandemic vaccine	Stage 2 Confirmed Human outbreak Overseas Goals Contain outbreak and limit potential for spread Activate domestic medical response Actions Declare Incident of National Significance Support international deployment of countermeasures Implement layered screening measures; activate domestic quarantine stations Prepare to limit domestic ports of entry Prepare to produce monovalent vaccine Policy Decisions Contribution to countermeasures for affected region Entry/exit screening criteria; isolation/quarantine protocols Diversion of trivalent vaccine production to monovalent Revise prioritization and allocation of pandemic vaccine and antiviral medications WHO Phase 4 or 5 Pandemic Alert Period
WHO Phase 1 or 2 Inter-Pandemic Period	WHO Phase 3 Pandemic Alert Period

Stage 3 Widespread Outbreaks Overseas Goals Delay emergence in North America Ensure earliest warning of first case(s) Prepare domestic containment and response mechanisms Actions Activate domestic emergency medical personnel plans Maintain layered screening measures at borders Deploy pre-pandemic vaccine and antiviral stockpiles; divert to monovalent vaccine production Real-time modeling; heighten hospital-based surveillance Prepare to implement surge plans at Federal medical facilities Policy Decisions Prioritize efforts for domestic preparedness and response	Stage 4 First Human Case in North America Goals Contain first cases in North America Antiviral treatment and prophylaxis Implement national response Actions Ensure pandemic plans activated across all levels Limit non-essential domestic travel Deploy diagnostic reagents for pandemic virus to all laboratories Continue development of pandemic vaccine Antiviral treatment and targeted antiviral prophylaxis Policy Decisions Revision of prioritization and allocation scheme for pandemic vaccine	Stage 5 Spread throughout United States Goals Support community response Preserve critical infrastructure Mitigate illness, suffering, and death Mitigate impact to economy and society Actions Maintain overall situational awareness Evaluate epidemiology; provide guidance on community measures Deploy vaccine if available; prioritization guidance Sustain critical infrastructure, support health and medical systems, maintain civil order Provide guidance on use of key commodities Policy Decisions Federal support of critical infrastructure and availability of key goods and services Lifting of travel restrictions
WHO Phase 6 Pandemic Period