A complementary response to pandemic management, COVID-19, and beyond.

Written by SciCulture Organisor and Tutor, Maarten van der Sanden from TU Delft.

Now the discussion on impact management has started, we see how big the gap is between outbreak management (curation of patients / flatten the curve) and the impact management (get society ready to hang on). The experts involved talk a different language, have different backgrounds, and actually are not teaming up, as far as I know.

For the future I would say, we need to create a partnership between outbreak/impact management to take into account what we have learned from this pandemic and how we would hope to deal with a future outbreak. We need to learn that these go hand-in-hand, it is like our DNA; if you imagine a strand of DNA you will probably see a long spiral ladder. This is actually two strands moving in parallel and in opposite directions with arms that join in between, creating the ladder. Each of these steps consists of two arms which link in the middle, there are four arms (nucleotides) A, C, G, T, but they are very particular, A’s will only partner with T’s, and G’s only with C’s.

In this analogy, the left side of the DNA strand, is the outbreak and the right side is the impact, but they are as closely related as AT and GC. If we look at the pandemic as a partnership between managing the current outbreak and mitigating the future impacts, they are intimately related and every single decision on outbreak management has a strong connection with an element of the future impact. If we can keep these both in mind, we can eventually begin to create outbreak measures for future crises that contain vital parts of future impact measures and with this holistic approach, we can prime and prune aspects of the future impact management. And, vice versa, any future decision made about impact management contains elements of future outbreak management.

Here is a visual impression of how I see that outbreak management and impact management are intertwined and the distinction between them blurs with time and function (the passage of time going from right to left). The yellow (outbreak) is spotted with green (impact) but becomes more intensely green, while maintaining traces of yellow and vice versa.

Our immune system contains this DNA machinery and a memory of previous infections. The DNA can mitigate for outside dangers, leading to, for example, specific cells that can protect against future threats. This system is quite adaptive and remembers its strategy from former invasions of viruses. Imagining,  that our future integrated management functions as the immune system, based on the DNA-machinery, we can design a future decision-making strategy, that is:

·        integrated (double-stranded outbreak and management all together)

·        adaptive (rolling, looping and splicing management that can easily put elements of current outbreak management next to future impact management)

·        experienced (Management)-memory system)

This immune system analogy immediately brings the members of the integrated outbreak/impact management team to the core of the solution, slowly but certainly increasing group immunity where the larger audience slowly understands what is happening or could happen within their body since they saw it replicated in reality in outbreak and impact management measures: a social immune system. The funny thing is that you need a critical mass (i.e. group immunity) that behaves responsibly in order to flatten the curve and hang on.

This analogy and its visualization (to be developed) could function as a platform that is based on the evidence we find and the insights we gain  which requires a process of continual re-examination and that we criticize this future idea continuously and rethink and redo the future integrated decision-making strategy.