Nonhuman primates represent a small fraction of animals used in biomedical research, but they remain important research models due to their similarities to humans with respect to genetic makeup, anatomy, physiology, and behavior. Limitations in the availability of nonhuman primates have been exacerbated by the COVID-19 pandemic and recent restrictions on their exportation and transportation, impacting National Institutes of Health (NIH)-funded research necessary for both public health and national security. Additionally, there is continued interest in understanding whether and how nonanimal models can be used to answer scientific questions for which nonhuman primates are currently used. At the direction of the U.S. Congress, NIH asked the National Academies of Sciences, Engineering, and Medicine to convene an expert committee to conduct a landscape analysis of current and future use of nonhuman primates in NIH-supported biomedical research, as well as opportunities for new approach methodologies to complement or reduce reliance on nonhuman primate models. This report provides the committee findings and conclusions. Table of Contents Front Matter Summary 1 Introduction 2 Contribution of Nonhuman Primate Models to Advances in Human Health 3 Current Landscape of Use and Availability of Nonhuman Primates for NIH-Supported Biomedical Research 4 The Landscape of New Approach Methodologies 5 Future Needs and Opportunities for Nonhuman Primate Models in Biomedical Research Appendix A: Study Approach and Methods Appendix B: Data on Nonhuman Primate Use in NIH-Supported Biomedical Research Appendix C: Biographical Sketches of Committee Members and Staff Appendix D: Disclosure of Unavoidable Conflicts of Interest

In the wake of a large-scale disaster, from the initial devastation through the long tail of recovery, protecting the health and well-being of the affected individuals and communities is paramount. Accurate and timely information about mortality and significant morbidity related to the disaster are the cornerstone of the efforts of the disaster management enterprise to save lives and prevent further health impacts. Conversely, failure to accurately capture mortality and significant morbidity data undercuts the nation's capacity to protect its population. Information about disaster-related mortality and significant morbidity adds value at all phases of the disaster management cycle. As a disaster unfolds, the data are crucial in guiding response and recovery priorities, ensuring a common operating picture and real-time situational awareness across stakeholders, and protecting vulnerable populations and settings at heightened risk. A Framework for Assessing Mortality and Morbidity After Large-Scale Disasters reviews and describes the current state of the field of disaster-related mortality and significant morbidity assessment. This report examines practices and methods for data collection, recording, sharing, and use across state, local, tribal, and territorial stakeholders; evaluates best practices; and identifies areas for future resource investment. Table of Contents Front Matter Summary 1 Introduction 2 Value and Use of Mortality and Morbidity Data 3 Operational Considerations for Individual Counts of Mortality and Morbidity 4 Analytical Considerations for Population Estimates of Mortality and Morbidity 5 Meeting the Mission Appendix A: Preliminary Literature Review Strategy Appendix B: Public Workshop Agendas Appendix C: Assessing Morbidity and Mortality Associated with the COVID-19 Pandemic: A Case Study Illustrating the Need for the Recommendations in This Report Appendix D: Integrating Community Vulnerabilities into the Assessment of Disaster-Related Morbidity and Mortality: Two Illustrative Case Studies Appendix E: Committee and Staff Biographical Sketches

Protecting the health and safety of health care workers is vital to the health of each of us. Preparing for and responding to a future influenza pandemic or to a sustained outbreak of an airborne transmissible disease requires a high-level commitment to respiratory protection for health care workers across the wide range of settings in which they work and the jobs that they perform. Keeping health care workers healthy is an ethical commitment both in terms of addressing the occupational risks faced by health care workers and of providing for the continuity of patient care and services needed to maintain the health of individuals and communities. During a public health emergency, challenges will arise concerning the availability of respiratory protective devices (i.e., respirators). Reusable respirators (specifically, reusable half-facepiece elastomeric respirators) are the standard respiratory protection device used in many industries, and they provide an option for use in health care that has to date not been fully explored. The durability and reusability of elastomeric respirators make them desirable for stockpiling for emergencies, where the need for large volumes of respirators can be anticipated. However, they are used infrequently in health care. Reusable Elastomeric Respirators in Health Care explores the potential for the use of elastomeric respirators in the U.S. health care system with a focus on the economic, policy, and implementation challenges and opportunities. This report examines the practicability of elastomeric use in health care on a routine basis and during an influenza pandemic or other large aerosol-transmissible outbreak, when demand for respiratory protective devices by U.S. health care personnel may be larger than domestic supplies. The report also addresses the issues regarding emergency stockpile management of elastomeric respiratory protective devices. Table of Contents Front Matter Summary 1 Introduction 2 Elastomeric Respirators 3 Implementing Reusable Elastomeric Respirators in Health Care Settings: Routine and Surge Use 4 Research and Development 5 Next Steps and Recommendations Appendix A: Meeting Agendas Appendix B: Committee Biographical Sketches