Module 9: Non-Pharmaceutical Interventions
Trainee Guide
Exercise 1: Non-Pharmaceutical Interventions Group Discussion
Instructions. In this exercise you will consider non-pharmaceutical measures and how they
might be implemented in your area. The goal is to discuss with your group some of the practical
considerations for non-pharmaceutical interventions on a local level. You have 20 minutes to
discuss the following questions.
Question 1. What are some pros and cons of each of the following non-pharmaceutical
interventions (NPI)? Consider them in your local context. That is, what are some problems that
can arise or things that can facilitate use of the NPI based on the situation in your country?
a. cordon sanitaire
b. social distancing
c. daily health checks
Question 2. Describe how you and your team would enforce isolation and/or quarantine when
citizens are unwilling to follow your orders.
Question 3. What are some practical problems that you envision with implementing social
distancing measures? What are some ways to overcome these problems? Again consider these
questions in the context of your particular country’s situation.
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Exercise 2: Group discussion on legal, ethical, social and psychological aspects
of interventions
Instructions:
Break out into your smaller groups. Below are questions for group discussion. Answer as many
as you can in one hour, but don’t feel like you must cover all of them. Do not limit productive
discussion just to move to the next question. The moderator may want to assign the questions to
ensure that at least a few questions from each section (legal, ethical and psychological) are
covered by at least one group. Groups should reconvene, and designate one person to share
highlights of their discussion with the larger class. You have 20 minutes to complete this
exercise.
Legal Questions:
1. What legal provisions exist in your country/municipality to provide authorization to
implement isolation, quarantine and other social distancing measures? Ensure all group
members understand what the law says you can and cannot do.
2. Identify gaps in the law that may need to be addressed in order to facilitate a more
effective public health response to avian influenza.
3. Identify ways that the law as it currently stands facilitates or hampers your position as a
public health official trying to prevent the spread of AI?
4. Does the law provide for economic compensation for those who are quarantined or
isolated and unable to attend work? If not, discuss how to handle this. If so, is the
compensation fair?
Ethical
5. Do you personally think it is ethnical to restrict an individual’s daily movement through
quarantine, isolation or social distancing measures? Provide reasons for your position.
Be certain to get a response from each member of your group.
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6. Even if you disagree with restricting an individual’s movement, what would you say to
those who feel this type of a restriction impinges on their basic rights? How would you
justify your decision to implement such a measure?
7. Do all the NPI have ethical and moral implications? Discuss each one separately and list
what you think the ethnical problems are.
8. What if those enforcing quarantine are afraid of becoming ill and decide not to do their
jobs? Is this fair? Should they be forced to do their jobs?
Psychological and Social
9. How do you bury or cremate the dead without bringing people together? Discuss
culturally appropriate ways to do this.
10. Does quarantine and isolation impact children, elderly or other marginalized populations
differently from the general population? Discuss some potential mental health affects for
these groups.
11. How would you prevent any negative consequences such as depression or anxiety from
isolation or quarantine?
12. For those who have experienced a death of a family member or friend from AI, how
would you help alleviate their fears that they will die from it next?
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Exercise 3: Non-pharmaceutical interventions role-playing exercise
Instructions: The exercise is designed for several participants. If you have a smaller group you
can omit one or two of the roles. The goal of this exercise is to help you understand the
challenges of implementing these non-pharmaceutical interventions. You will only be given
limited information to set up the role-playing exercise; you should act as you think the person
you are playing would act. Improvise freely.
Before you begin, discuss with your group why you would or would not select the intervention
noted in the scenario. Be sure to discuss the objective of the particular intervention, why you
think it will help reduce spread of disease and what other potential interventions you would
consider. Then group members should choose roles listed in the scenario and practice explaining
the purpose of the NPI. You have 20 minutes to complete this exercise.
Background
The world is in pandemic phase 4. From January 2006 to today there have been 174 cases of avian
influenza reported, with about 8 to 10 clusters suggesting limited human-to-human spread. The meetings
and visits described below are occurring during your nation’s 2nd most important religious holiday, where
everyone will be off for the next 2 days.
Social distancing scenario: Health officials meet with factory owners to recommend closing a
factory for an unknown amount of time. The factory is located in a medium size town. So far
you are aware of only 1 – 2 potential (yet unconfirmed) cases of AI among the factories 150
employees. Roles to play are:
 factory owner
 factory financial officer/accountant
 factory workers representative
 2-3 provincial health officials (epidemiologist, health education specialist and
communications chief)
Quarantine of contact scenario: Health officials go to the home of person X who is the cousin of
person Y who is confirmed to have contracted AI. Person Y (a male) is currently in the hospital
receiving treatment. Person X went to visit his/her cousin 2 days prior to his admission into the
hospital. During the visit they talked and ate lunch together. Roles to play are:
 person X
 person X’s husband/wife
 2 provincial health officials
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