Speaker
Description
Background: Identifying an optimal policy for a country that balances infection suppression and socioeconomic burden is critical during a pandemic \cite{c1}. Lacking global quantitative analysis for country-specific cost-optimal interventions \cite{c2, c3}, this study suggests tailored strategies and identifies national indicators to improve pandemic preparedness \cite{c4,c5}.
Methods: We analyzed 110 countries during the early COVID-19 pandemic using a framework combining transmission modeling and multi-objective optimization. We evaluated 12 indicators, including the Socio-demographic Index (SDI) and Global Health Security (GHS) Index, to assess their impact on optimal interventions.
Findings: Cost-optimal intervention intensity is lower in developed nations. Universal optimal strategies do not exist without considering economic factors. Income, SDI, and GHS are critical for stratifying countries and prescribing tailored, cost-effective strategies. We identified an economically unstable intermediate zone where marginal non-pharmaceutical intervention (NPI) adjustments trigger large epidemic costs.
Interpretation: Pandemic preparedness requires integrating socio-demographic determinants with health metrics. Policymakers must move beyond "one-size-fits-all" mandates, aligning NPI intensity with specific economic profiles to achieve cost-optimality, while accounting for the volatile intermediate zone to prevent severe societal burdens.
Bibliography
@article{c1,
title = {Disease-dependent interaction policies to support health and economic outcomes during the COVID-19 epidemic},
journal = {iScience},
volume = {24},
number = {7},
pages = {102710},
year = {2021},
issn = {2589-0042},
doi = {https://doi.org/10.1016/j.isci.2021.102710},
url = {https://www.sciencedirect.com/science/article/pii/S2589004221006787},
author = {Guanlin Li and Shashwat Shivam and Michael E. Hochberg and Yorai Wardi and Joshua S. Weitz},
keywords = {Virology},
abstract = {Summary
Lockdowns and stay-at-home orders have partially mitigated the spread of Covid-19. However, en masse mitigation has come with substantial socioeconomic costs. In this paper, we demonstrate how individualized policies based on disease status can reduce transmission risk while minimizing impacts on economic outcomes. We design feedback control policies informed by optimal control solutions to modulate interaction rates of individuals based on the epidemic state. We identify personalized interaction rates such that recovered/immune individuals elevate their interactions and susceptible individuals remain at home before returning to pre-lockdown levels. As we show, feedback control policies can yield similar population-wide infection rates to total shutdown but with significantly lower economic costs and with greater robustness to uncertainty compared to optimal control policies. Our analysis shows that test-driven improvements in isolation efficiency of infectious individuals can inform disease-dependent interaction policies that mitigate transmission while enhancing the return of individuals to pre-pandemic economic activity.}
}
@Article{c2,
author={Clarke, Lorcan
and Patouillard, Edith
and Mirelman, Andrew J.
and Ho, Zheng Jie Marc
and Edejer, Tessa Tan-Torres
and Kandel, Nirmal},
title={The costs of improving health emergency preparedness: A systematic review and analysis of multi-country studies},
journal={eClinicalMedicine},
year={2022},
month={Feb},
day={01},
publisher={Elsevier},
volume={44},
abstract={BackgroundInvesting in health emergency preparedness is critical to the safety, welfare and stability of communities and countries worldwide. Despite the global push to increase investments, questions remain around how much should be spent and what to focus on. We conducted a systematic review and analysis of studies that costed improvements to health emergency preparedness to help to answer these questions.},
issn={2589-5370},
doi={10.1016/j.eclinm.2021.101269},
url={https://doi.org/10.1016/j.eclinm.2021.101269}
}
@article{c3,
title={Cost-effectiveness of preventive COVID-19 interventions: a systematic review and network meta-analysis of comparative economic evaluation studies based on real-world data},
author={Tang, Xiaoyu and Sun, Sun and Memedi, Mevludin and Hiyoshi, Ayako and Montgomery, Scott and Cao, Yang},
journal={Journal of Global Health},
volume={15},
pages={04017},
year={2025}
}
@Article{c4,
author={Kentikelenis, Alexander
and Seabrooke, Leonard},
title={Organising knowledge to prevent global health crises: a comparative analysis of pandemic preparedness indicators},
journal={BMJ Global Health},
year={2021},
month={Aug},
day={24},
volume={6},
number={8},
pages={e006864},
abstract={Preparing for the possibility of a global pandemic presents a transnational organisational challenge: to assemble and coordinate knowledge over institutionally diverse countries with high fidelity. The COVID-19 pandemic has laid these problems bare. This article examines the construction of the three main cross-national indicators of pandemic preparedness: a database with self-reported data by governments, external evaluations organised by the WHO and a global ranking known as the Global Health Security Index. Each of these presents a different model of collecting evidence and organising knowledge: the collation of self-reports by national authorities; the coordination of evaluation by an epistemic community authorised by an intergovernmental organisation and on the basis of a strict template; and the cobbling together of different sources into a common indicator by a transnational multi-stakeholder initiative. We posit that these models represent different ways of creating knowledge to inform policy choices, and each has different forms of potential bias. In turn, this shapes how policymakers understand what is `best practice' and appropriate policy in pandemic preparedness.},
doi={10.1136/bmjgh-2021-006864},
url={https://doi.org/10.1136/bmjgh-2021-006864}
}
@article {c5,
author = {Eshete, Million Tesfaye and Shrestha, Pami and Ang, Charmaine and Valderas, José María and Heymann, David L. and Nordström, Anders and Lee, Kelley and Cook, Alex and Wenham, Clare and Perel, Pablo and Miranda, J. Jaime and Garcia-Basteiro, Alberto L. and Clark, Helen and Legido-Quigley, Helena and Engebretsen, Eivind},
title = {Exploring Grassroots Indicators for Pandemic Prevention, Preparedness, and Response: A Systematic Narrative Review},
journal = {International Journal of Health Policy and Management},
volume = {14},
number = {1},
pages = {1-17},
year = {2025},
publisher = {Kerman University of Medical Sciences},
issn = {2322-5939},
eissn = {2322-5939},
doi = {10.34172/ijhpm.8886},
abstract = {Background The COVID-19 pandemic has revealed how conventional top-down, expert-driven indicators often fail to align with local community realities, marginalising their perspectives, concerns, knowledge, and narratives. However, the limitations of pandemic-related and global health security indicators are not unique but reflect recurring patterns across major social metrics. In response, an alternative paradigm advocates for grassrootsinclusive approaches to developing indicators. Our objective is to assess how and why grassroots-inclusive approaches complement top-down approaches to developing indicators, and to synthesise their theoretical and practical contributions to public health. Methods We conducted a scoping review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. We systematically searched six databases (MEDLINE, Embase, CINAHL, Web of Science, Scopus, and PsycINFO), as well as Google Scholar, to identify relevant articles published from their inception to September 1, 2024. We included peer-reviewed articles, opinion pieces, and book chapters, narratively synthesising their findings. Results This review included 43 studies from various disciplines. Across these studies, communities co-produced indicators through participatory workshops, interviews, and consensus exercises in areas such as environmental sustainability, disaster resilience, public health, well-being, and local development. The reported strengths included greater local relevance, community ownership, and accountability, alongside challenges in sustaining participation, integrating into top-down systems, and addressing data gaps. Notably, no study applied grassroots-inclusive indicators to health security or pandemic preparedness. Conclusion Despite retrieving and analysing articles from various disciplines, no study has specifically applied grassroots-inclusive indicators to health security or pandemic preparedness. However, the evidence clearly shows that it is both feasible and practical to integrate expert and non-expert perspectives when developing indicators.},
keywords = {Pandemic Preparedness,Health Security,Grassroots Indicators,Community Engagement,Participatory Approaches,Bottom-up Approach},
url = {https://www.ijhpm.com/article_4826.html},
eprint = {https://www.ijhpm.com/article_4826_11576c6cf29b67ccbd8b549f6e79cd03.pdf}
}
