A Pandemic Playbook: Guiding Decision-Making under Uncertainty

The COVID-19 crisis has exposed how much the global scientific community knows about novel pandemics and how different countries have been prepared to respond to novel pandemic diseases. One of the greatest challenges in managing COVID-19 has been uncertainty. Since COVID-19's discovery and spread, the global community has learned about its incubation period, transmission, treatment, and preventative actions often at the same time as the scientific community. The urgency of need and the speed of scientific research, application, and change has created conditions in which mistakes are amplified and successes can be inconsistent. This uncertainty has forced governments to make radical decisions in an effort to buy time: lockdowns, curfews, and closure of businesses have been regular features of the response. However, it is becoming apparent that these actions are unsustainable because the uncertainty of research outcomes and government response are taking a large toll on public trust, patience, and resources. Given that novel pandemic diseases are expected to continue to increase in frequency and danger, the challenges faced in the initial management of COVID-19 present an opportunity to re-examine national systems and provide the evidence that could initiate a mindset shift in leaders regarding how they communicate to and support the public in times of uncertainty and crisis. Given the urgency and threat of COVID-19, the level of preparedness of governments has been reflected in the wide array of approaches and results. Some countries have enjoyed a great deal of success and global support (e.g. South Korea, Taiwan), other countries have seen a complete erosion in compliance and faith in public institutions (e.g. United States), and others are rapidly going from success stories to rapidly concerning ones (e.g. Uganda). With such rapid change, profound negative impacts on the individual, community, national and regional levels particularly for sub Saharan Africa, are placing great strain on formal and informal social protection systems and their respective strengths and weaknesses. The slow erosion of compliance with public health provisions is revealing existing cracks and opportunities for leaders to re-examine and re-think how best to sustain and earn public trust through communication and awareness of the feelings of the public. The grant from the COVID-19 Africa Rapid Grant Fund would provide the financial resources to collate background evidence, mobilize a diversity of highly respected subject experts to analyse the evidence to guide the development of the playbook, convene stakeholders for feedback and dissemination, and conduct the technical drafting of the playbook. Expected Outputs The major output of this project shall be a pandemic playbook, focusing on socio-cultural aspects of disease transmission, science communication, and mental health resilience during pandemics on the continent using case studies on specific countries as applicable. While some of the playbook's contents may be shaped by the stakeholders in pre-drafting, we anticipate the following components will be present: The pre-conditions for success (a situational analysis); key knowledge and data necessary to determine your situation (best practices on data gathering and evidencebased guidance on which to prioritize); specific guidance on socio-cultural aspects of transmission, science communication, and mental health in communities during novel pandemics; and recommendations on both present and future action.