Optimal Epidemic Control under Uncertainty: Tradeoffs between Information Collection and Other Actions

Abstract

Background

Recent epidemics and measures taken to control them—through vaccination or other actions—have highlighted the role and importance of uncertainty in public health. There is generally a tradeoff between information collection and other uses of resources. Whether this tradeoff is solved explicitly or implicitly, the concept of value of information is central to inform policy makers in an uncertain environment.

Method

We use a deterministic SIR (susceptible, infectious, recovered) disease emergence and transmission model with vaccination that can be administered as 1 or 2 doses. The disease parameters and vaccine characteristics are uncertain. We study the tradeoffs between information acquisition and 2 other measures: bringing vaccination forward and acquiring more vaccine doses. To do this, we quantify the expected value of perfect information (EVPI) under different constraints faced by public health authorities (i.e., the time of the vaccination campaign implementation and the number of vaccine doses available).

Results

We discuss the appropriateness of different responses under uncertainty. We show that, in some cases, vaccinating later or with less vaccine doses but more information about the epidemic, and the efficacy of control strategies may bring better results than vaccinating earlier or with more doses and less information, respectively.

Conclusion

In the present methodological article, we show in an abstract setting how clearly defining and treating the tradeoff between information acquisition and the relaxation of constraints can improve public health decision making.

Highlights

• Uncertainties can seriously hinder epidemic control, but resolving them is costly. Thus, there are tradeoffs between information collection and alternative uses of resources.

• We use a generic SIR model with vaccination and a value-of-information framework to explore these tradeoffs.

• We show in which cases vaccinating later with more information about the epidemic and the efficacy of control measures may be better—or not—than vaccinating earlier with less information.

• We show in which cases vaccinating with fewer vaccine doses and more information about the epidemic and the efficacy of control measures may be better—or not—than vaccinating with more doses and less information.