TY - JOUR

T1 - Anticipating future learning affects current control decisions

T2 - A comparison between passive and active adaptive management in an epidemiological setting

AU - Atkins, B.D.

AU - Jewell, C.P.

AU - Runge, M.C.

AU - Ferrari, M.J.

AU - Shea, K.

AU - Probert, W.J.M.

AU - Tildesley, M.J.

PY - 2020/12/7

Y1 - 2020/12/7

N2 - Infectious disease epidemics present a difficult task for policymakers, requiring the implementation of control strategies under significant time constraints and uncertainty. Mathematical models can be used to predict the outcome of control interventions, providing useful information to policymakers in the event of such an epidemic. However, these models suffer in the early stages of an outbreak from a lack of accurate, relevant information regarding the dynamics and spread of the disease and the efficacy of control. As such, recommendations provided by these models are often incorporated in an ad hoc fashion, as and when more reliable information becomes available. In this work, we show that such trial-and-error-type approaches to management, which do not formally take into account the resolution of uncertainty and how control actions affect this, can lead to sub-optimal management outcomes. We compare three approaches to managing a theoretical epidemic: a non-adaptive management (AM) approach that does not use real-time outbreak information to adapt control, a passive AM approach that incorporates real-time information if and when it becomes available, and an active AM approach that explicitly incorporates the future resolution of uncertainty through gathering real-time information into its initial recommendations. The structured framework of active AM encourages the specification of quantifiable objectives, models of system behaviour and possible control and monitoring actions, followed by an iterative learning and control phase that is able to employ complex control optimisations and resolve system uncertainty. The result is a management framework that is able to provide dynamic, long-term projections to help policymakers meet the objectives of management. We investigate in detail the effect of different methods of incorporating up-to-date outbreak information. We find that, even in a highly simplified system, the method of incorporating new data can lead to different results that may influence initial policy decisions, with an active AM approach to management providing better information that can lead to more desirable outcomes from an epidemic. © 2020 The Authors

AB - Infectious disease epidemics present a difficult task for policymakers, requiring the implementation of control strategies under significant time constraints and uncertainty. Mathematical models can be used to predict the outcome of control interventions, providing useful information to policymakers in the event of such an epidemic. However, these models suffer in the early stages of an outbreak from a lack of accurate, relevant information regarding the dynamics and spread of the disease and the efficacy of control. As such, recommendations provided by these models are often incorporated in an ad hoc fashion, as and when more reliable information becomes available. In this work, we show that such trial-and-error-type approaches to management, which do not formally take into account the resolution of uncertainty and how control actions affect this, can lead to sub-optimal management outcomes. We compare three approaches to managing a theoretical epidemic: a non-adaptive management (AM) approach that does not use real-time outbreak information to adapt control, a passive AM approach that incorporates real-time information if and when it becomes available, and an active AM approach that explicitly incorporates the future resolution of uncertainty through gathering real-time information into its initial recommendations. The structured framework of active AM encourages the specification of quantifiable objectives, models of system behaviour and possible control and monitoring actions, followed by an iterative learning and control phase that is able to employ complex control optimisations and resolve system uncertainty. The result is a management framework that is able to provide dynamic, long-term projections to help policymakers meet the objectives of management. We investigate in detail the effect of different methods of incorporating up-to-date outbreak information. We find that, even in a highly simplified system, the method of incorporating new data can lead to different results that may influence initial policy decisions, with an active AM approach to management providing better information that can lead to more desirable outcomes from an epidemic. © 2020 The Authors

KW - Infectious disease outbreaks

KW - Optimal control

KW - Real-time decision-making

KW - Uncertainty resolution

KW - adaptive management

KW - decision making

KW - disease control

KW - disease incidence

KW - epidemic

KW - future prospect

KW - infectious disease

KW - learning

KW - planning method

KW - policy approach

KW - policy making

KW - real time

U2 - 10.1016/j.jtbi.2020.110380

DO - 10.1016/j.jtbi.2020.110380

M3 - Journal article

VL - 506

JO - Journal of Theoretical Biology

JF - Journal of Theoretical Biology

SN - 0022-5193

M1 - 110380

ER -