Challenges in evaluating risks and policy options around endemic establishment or elimination of novel pathogens
C. Jessica E. Metcalf,
Soa Fy Andriamandimby,
Rachel E. Baker,
Emma E. Glennon,
Katie Hampson,
T. Deirdre Hollingsworth,
Petra Klepac,
Amy Wesolowski
Affiliations
C. Jessica E. Metcalf
Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA; Princeton School of Public and International Affairs, Princeton University, Princeton, USA; Corresponding author at: Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA.
Soa Fy Andriamandimby
Institut Pasteur de Madagascar, Antananarivo, Madagascar
Rachel E. Baker
Department of Ecology and Evolutionary Biology, Princeton University, Princeton, NJ, USA; Princeton High Meadows Environmental Institute, Princeton University, Princeton, NJ, USA
Emma E. Glennon
Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge CB3 0ES, UK
Katie Hampson
Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow, Glasgow, UK
T. Deirdre Hollingsworth
Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, UK
Petra Klepac
London School of Hygiene and Tropical Medicine, London, UK
Amy Wesolowski
Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
When a novel pathogen emerges there may be opportunities to eliminate transmission - locally or globally - whilst case numbers are low. However, the effort required to push a disease to elimination may come at a vast cost at a time when uncertainty is high. Models currently inform policy discussions on this question, but there are a number of open challenges, particularly given unknown aspects of the pathogen biology, the effectiveness and feasibility of interventions, and the intersecting political, economic, sociological and behavioural complexities for a novel pathogen. In this overview, we detail how models might identify directions for better leveraging or expanding the scope of data available on the pathogen trajectory, for bounding the theoretical context of emergence relative to prospects for elimination, and for framing the larger economic, behavioural and social context that will influence policy decisions and the pathogen’s outcome.
