The COVID-19 pandemic highlighted that effective pandemic response requires input from a wide range of scientific disciplines, not just traditional biomedical expertise, to fully inform government decision-making on the broad impacts of possible measures. However, scientific advice originating from separate disciplinary advisory bodies, such as the Outbreak Management Team (OMT) and Societal Impact Team (MIT), is not necessarily balanced multi-perspective scientific advice. Therefore, PDPC researchers explored the potential of integrated advising among biomedical, societal and economic experts into pandemic response, using a simulation of a highly pathogenic avian influenza (HPAI) outbreak. Additionally, they aimed to identify cross-cutting gaps in knowledge and expertise relevant for HPAI pandemic preparedness.

The researchers conducted two table-top simulation exercises in April/May 2024, based on a fictitious HPAI outbreak originating in the Netherlands and associated with severe disease among children. In total, 22 and 19 experts participated, representing biomedical, societal and economic sciences. Participants first drafted scientific advice in separate biomedical and societal teams, followed by integrated deliberations and advice in mixed groups.

Separate advisory processes differed in perceived urgency, situation assessment, and the drafted best- and worst-case scenarios. Mixed groups deliberations exposed disciplinary blind spots and helped build mutual understanding. In particular, school closure was discussed extensively due to conflicting perspectives. The discussions also revealed gaps in knowledge and practical know-how, particularly around the coordination of outbreak responses and the availability of guidelines, surveillance structures and infrastructures for a new outbreak.

The simulation exercises suggest that an integrated advisory approach, alongside separate advisory committees, may have an added value in overcoming conflicting advice during pandemics. Further research is needed to explore whether this observed added value extends to an integrated advisory body.

This study was performed by researchers from the Pandemic and Disaster Preparedness Center (PDPC), and was first published on August 26, 2026 in PLoS One:

Overbosch, F. W., Waltz, C. N., Cesuroglu, T., Blokland, B., De Boer, J., Dykstra, P. A., … & Schreijer, A. J. (2026). Exploring integrated advice and avian influenza knowledge gaps by using a Highly Pathogenic Avian Influenza outbreak simulation. PLoS One, 21(8), e0354920.

Read the full publication here.

You can also read more about these simulation exercises in our paper from Waltz et al. in Social Science & Medicine, and the reports of the first and second exercise!

Interested in the follow-up research? Read about the UNITY project!