Multiple models for outbreak decision support in the face of uncertainty.

Shea, KatrionaORCID logo; Borchering, Rebecca KORCID logo; Probert, William JMORCID logo; Howerton, EmilyORCID logo; Bogich, Tiffany LORCID logo; Li, Shou-LiORCID logo; van Panhuis, Willem G; Viboud, Cecile; Aguás, RicardoORCID logo; Belov, Artur A; +68 more...Bhargava, Sanjana HORCID logo; Cavany, Sean MORCID logo; Chang, Joshua CORCID logo; Chen, CynthiaORCID logo; Chen, Jinghui; Chen, ShiORCID logo; Chen, YangQuanORCID logo; Childs, Lauren MORCID logo; Chow, Carson CORCID logo; Crooker, Isabel; Del Valle, Sara YORCID logo; España, GuidoORCID logo; Fairchild, GeoffreyORCID logo; Gerkin, Richard CORCID logo; Germann, Timothy CORCID logo; Gu, QuanquanORCID logo; Guan, XiangyangORCID logo; Guo, LihongORCID logo; Hart, Gregory R; Hladish, Thomas JORCID logo; Hupert, NathanielORCID logo; Janies, Daniel; Kerr, Cliff CORCID logo; Klein, Daniel J; Klein, Eili YORCID logo; Lin, GaryORCID logo; Manore, Carrie; Meyers, Lauren AncelORCID logo; Mittler, John EORCID logo; Mu, Kunpeng; Núñez, Rafael C; Oidtman, Rachel JORCID logo; Pasco, RemyORCID logo; Pastore Y Piontti, Ana; Paul, Rajib; Pearson, Carl ABORCID logo; Perdomo, Dianela RORCID logo; Perkins, T AlexORCID logo; Pierce, KellyORCID logo; Pillai, Alexander NORCID logo; Rael, Rosalyn CherieORCID logo; Rosenfeld, KatherineORCID logo; Ross, Chrysm WatsonORCID logo; Spencer, Julie AORCID logo; Stoltzfus, Arlin B; Toh, Kok Ben; Vattikuti, ShashaankORCID logo; Vespignani, AlessandroORCID logo; Wang, Lingxiao; White, Lisa JORCID logo; Xu, PanORCID logo; Yang, Yupeng; Yogurtcu, Osman NORCID logo; Zhang, Weitong; Zhao, Yanting; Zou, Difan; Ferrari, Matthew J; Pannell, DavidORCID logo; Tildesley, Michael J; Seifarth, JackORCID logo; Johnson, Elyse; Biggerstaff, MatthewORCID logo; Johansson, Michael AORCID logo; Slayton, Rachel BORCID logo; Levander, John DORCID logo; Stazer, Jeff; Kerr, Jessica; and Runge, Michael CORCID logo (2023) Multiple models for outbreak decision support in the face of uncertainty. Proceedings of the National Academy of Sciences of the United States of America, 120 (18). e2207537120-. ISSN 0027-8424 DOI: 10.1073/pnas.2207537120
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Policymakers must make management decisions despite incomplete knowledge and conflicting model projections. Little guidance exists for the rapid, representative, and unbiased collection of policy-relevant scientific input from independent modeling teams. Integrating approaches from decision analysis, expert judgment, and model aggregation, we convened multiple modeling teams to evaluate COVID-19 reopening strategies for a mid-sized United States county early in the pandemic. Projections from seventeen distinct models were inconsistent in magnitude but highly consistent in ranking interventions. The 6-mo-ahead aggregate projections were well in line with observed outbreaks in mid-sized US counties. The aggregate results showed that up to half the population could be infected with full workplace reopening, while workplace restrictions reduced median cumulative infections by 82%. Rankings of interventions were consistent across public health objectives, but there was a strong trade-off between public health outcomes and duration of workplace closures, and no win-win intermediate reopening strategies were identified. Between-model variation was high; the aggregate results thus provide valuable risk quantification for decision making. This approach can be applied to the evaluation of management interventions in any setting where models are used to inform decision making. This case study demonstrated the utility of our approach and was one of several multimodel efforts that laid the groundwork for the COVID-19 Scenario Modeling Hub, which has provided multiple rounds of real-time scenario projections for situational awareness and decision making to the Centers for Disease Control and Prevention since December 2020.


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