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

Shea, KORCID logo; Borchering, RKORCID logo; Probert, WJORCID logo; Howerton, EORCID logo; Bogich, TLORCID logo; Li, SORCID logo; van Panhuis, WG; Viboud, C; Aguás, RORCID logo; Belov, AA; +68 more...Bhargava, SHORCID logo; Cavany, SMORCID logo; Chang, JCORCID logo; Chen, CORCID logo; Chen, J; Chen, SORCID logo; Chen, YORCID logo; Childs, LMORCID logo; Chow, CCORCID logo; Crooker, I; Del Valle, SYORCID logo; España, GORCID logo; Fairchild, GORCID logo; Gerkin, RCORCID logo; Germann, TCORCID logo; Gu, QORCID logo; Guan, XORCID logo; Guo, LORCID logo; Hart, GR; Hladish, TJORCID logo; Hupert, NORCID logo; Janies, D; Kerr, CCORCID logo; Klein, DJ; Klein, EYORCID logo; Lin, GORCID logo; Manore, C; Meyers, LAORCID logo; Mittler, JEORCID logo; Mu, K; Núñez, RC; Oidtman, RJORCID logo; Pasco, RORCID logo; Pastore Y Piontti, A; Paul, R; Pearson, CAORCID logo; Perdomo, DRORCID logo; Perkins, TAORCID logo; Pierce, KORCID logo; Pillai, ANORCID logo; Rael, RCORCID logo; Rosenfeld, KORCID logo; Ross, CWORCID logo; Spencer, JAORCID logo; Stoltzfus, AB; Toh, KB; Vattikuti, SORCID logo; Vespignani, AORCID logo; Wang, L; White, LJORCID logo; Xu, PORCID logo; Yang, Y; Yogurtcu, ONORCID logo; Zhang, W; Zhao, Y; Zou, D; Ferrari, MJ; Pannell, DORCID logo; Tildesley, MJ; Seifarth, JORCID logo; Johnson, E; Biggerstaff, MORCID logo; Johansson, MAORCID logo; Slayton, RBORCID logo; Levander, JDORCID logo; Stazer, J; Kerr, J; Runge, MCORCID logo and (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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