Create an external advisory group to prepare for the next pandemic

AAs the United States reels from more than one million reported deaths directly from the Covid-19 pandemic, another infectious disease – monkeypox – is beginning to spread. Cases of monkeypox, which scientists have been warning about for years, continue to rise around the world.

Covid-19 followed by monkeypox provides an opportunity to reflect on what can be done to reduce the impact of this pandemic and future ones.

One of the most important actions that can be taken now is to bring together an external advisory group – a public-private partnership – to address disease modeling and interventions (both pharmaceutical and non-pharmaceutical), as well as to be available before, during and after a pandemic, just as we have external advisory groups to make clinical recommendations on vaccines to the Centers for Disease Control and Prevention and the Food and Drug Administration. Bringing in experts to guide government planning and implementation in these situations will bring additional insights and strengthen strategies.

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As an operations research expert who has spoken regularly to the media and the public about the pandemic, I say this in part based on a question people have repeatedly asked me: who should I believe to understand what will (or could) happen with the pandemic?

Public-private partnerships that include modeling experts are the answer.

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Epidemics, especially those due to new viruses such as H1N1a, SARS-CoV-2 and Zika, have demonstrated the challenges associated with predicting and responding to contagions. US government agencies have made significant progress in this area in recent years, including:

Yet challenges remain to continually integrate new types of data sources, bring the latest computational approaches, improve public health messages, and ensure that a diversity of perspectives are integrated into decision-making. . This is particularly clear with monkeypox, a disease that has been active in Africa for years but is now spreading around the world.

A diversity of perspectives is especially important during a pandemic because the pandemic experiences of people in New York or Los Angeles are not necessarily the same as what is happening in the rural Southeast or in Africa. Specifically, academic and private industry experts can add a wealth of knowledge about logistics and technological innovations to support decision-making by government agencies. A diversity of backgrounds and participants around the world can also help ensure that a wide range of scenarios and modeling possibilities are considered, including new channels of disease spread, variants with new properties, rapid sequencing, and the interrelationships between disease spread and societal decisions related to schools. or supply chains.

Since the onset of Covid-19, my research group at North Carolina State University has been one of many chosen by the CDC and the Council of State and Territorial Epidemiologists to provide support for the modeling to state and local health agencies. Our group – and other similar modeling groups – provided advance notice of an increase in hospitalizations in the fall of 2021 due to the Delta variant and in January 2022 due to the Omicron variant. In December 2021, five modeling groups released a statement giving further power to the expectation of severe strain on common resources as a result of the Omicron variant and holiday behaviors of the population. In these and other examples, the information has given systems more time to prepare, including identifying additional medical personnel able to work, creating policy and process changes, and implementing other actions. to reduce hospitalizations and deaths.

Experiences in the UK have shown that its Scientific Advisory Group for Emergencies can use modeling as a powerful lever to quickly build scientific information in support of decision-making. In the UK, scientists found it helpful to ensure independence from government (leading to the independent group SAGE) and to ensure the process was transparent. Analysis by the independent Sage Group concluded that it was useful to draw insights and evidence from a broad and diverse base and to incorporate local participation of relevant stakeholders.

In a public-private partnership, an external advisory group can draw on experiences and expertise relevant to a particular issue while allowing for a neutral and non-political role. Such a group would also complement the expertise provided to the FDA on vaccines and biologics and to the CDC on immunization, with a particular focus on disease modeling and corresponding interventions, while ensuring a diversity of perspectives that may not be achievable by the government. only.

Since my involvement in the global H1N1 pandemic which began in 2009, I have seen positive changes in the use of disease modeling and advanced computing to improve decisions related to outbreaks, from the 2009 influenza pandemic -2010 to the Ebola epidemic from 2013 to 2016, the start of the Covid-19 pandemic, and the recent decision by the CDC to build a forecasting center. These positive changes can be further leveraged by creating an advisory group external to government to support disease modeling and pandemic response through a public-private partnership that draws on extensive backgrounds and perspectives from neutral external observers.

Julie Swann is Department Head and Professor Emeritus in the Edward P. Fitts Department of Industrial and Systems Engineering at North Carolina State University, and former CDC Advisor for the H1N1 Pandemic Response.

Shirlene J. Manley