2.2.4: Determine the date of early response completion

The 7-1-7 approach identifies seven early response actions that should be completed within seven days of notification. The date of early response completion is defined as the latest date on which any of these seven early response actions are completed:

Initiate investigation or deploy investigation/response team;
Conduct epidemiologic analysis of burden, severity and risk factors, and perform initial risk assessment;
Obtain laboratory confirmation of the outbreak etiology;
Initiate appropriate case management and infection prevention and control (IPC) measures in health facilities;
Initiate appropriate public health countermeasures in affected communities;
Initiate appropriate risk communication or community engagement activities;
Establish a coordination mechanism.

All seven early response actions may not be applicable for some public health events. For example, an event may be determined to be low risk, such that countermeasures and establishment of a coordination mechanism are not necessary. For events where some response actions are not applicable, the latest date among the applicable actions should be used as the date of early response completion.

In addition to the date of early response completion, it is also recommended to review the date of early response initiation: the date when the first of the seven early response actions was completed. While date of early response initiation is not used to calculate the 7-1-7 metrics, this date is useful to identify bottlenecks to response initiation. It is suggested to aim to initiate the early response within 1 day of notification. The initiation of response actions (i.e., the first action taken) within 1 day can support monitoring of existing guidance for response initiation, as well as monitoring towards WHO’s GPW 13 targets.

The early response actions, defined below, indicate initiation rather than completion of a response, and provide a framework to ensure that the relevant pillars of a response have been activated. They provide simple indicators, modified through pilot testing, to clearly identify a date when actions were taken. Some countries have found that expanding the early response actions into event or disease-specific job aids that outline detailed, specific response actions enhances performance improvement and improves accountability.

Early response actions	Examples*
Initiate investigation or deploy investigation/response team	Date the district initiated an investigation of a suspected outbreak or in response to a signal Date a rapid response team was deployed
Conduct epidemiologic analysis of burden, severity and risk factors, and perform initial risk assessment	Date when the first results of the epidemiologic analyses were published and the risk assessment was completed Date when the first situation report was published and the risk assessment level was indicated
Obtain laboratory confirmation of the outbreak etiology	Date when laboratory confirmation of the pathogen was completed Date when the etiology of a toxicological or chemical poisoning event was confirmed
Initiate appropriate case management and infection prevention and control (IPC) measures in health facilities	Date when a facility IPC assessment was initiated in affected health facilities Date when appropriate case management procedures were assessed at affected health facilities Date when IPC or case management training was initiated Date when appropriate therapeutics, vaccines, or personal protective equipment were distributed to health facilities Date when known cases were transferred to a specialty center or isolation unit with known capacity for case management and IPC for the etiology
Initiate appropriate public health countermeasures in affected communities	Date when procurement or distribution of commodities to prevent outbreak spread in communities was initiated (e.g., vaccines, ORS sachets, antimicrobial agents, water treatment, soap, insect repellants, bed nets, or personal protective equipment) Date when a food recall or boil water advisory was announced Date when a public health or social measure was instituted (e.g., masking, travel restrictions, or quarantine)
Initiate appropriate risk communication and community engagement activities	Date when a local or public health official announced the outbreak Date when messaging to reduce risk or prevent spread was published or communicated Date when two-way dialogue with communities was initiated Date when community sentiment or knowledge, attitudes, or perceptions of the event were assessed
Establish a coordination mechanism	Date when an incident management system (IMS) was activated Date when the emergency operations center (EOC) was activated Date when a task force or technical working group was initiated Date when an incident action plan was drafted

*The earliest date should be used for 7-1-7 purposes; these examples are not comprehensive

2.2.4: Determine the date of early response completion

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