Optimal epidemic control under uncertainty: trade-offs between information collection and other actions

BackgroundRecent 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 trade-off between information collection and other uses of resources. Whether this trade-off is solved explicitly or implicitly, the concept of value of information is central in order to inform policy makers in an uncertain environment. MethodWe use a deterministic SIR disease emergence and transmission model with vaccination that can be administered as one or two doses. The disease parameters and vaccine characteristics are uncertain. We study the trade-offs between information acquisition and two 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. ResultsWe 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 ConclusionIn the present methodological paper, we show in an abstract setting how clearly defining and treating the trade-off between information acquisition and the relaxation of constraints can improve public health decision making. HighlightsO_LIUncertainties can seriously hinder epidemic control, but resolving them is costly. Thus there are trade-offs between information collection and alternative uses of resources. C_LIO_LIWe use a generic SIR model with vaccination and a value of information framework to explore these trade-offs. C_LIO_LIWe 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. C_LIO_LIWe show in which cases vaccinating with less 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. C_LI