How can we ensure better decision-making during pandemic outbreaks? The Pandemic and Disaster Preparedness Center has been working on integrated advisory approaches to improve crisis response. Our research highlights the need for cross-disciplinary collaboration—combining biomedical, social, and economic perspectives—to prevent fragmented decision-making.

In 2024, PDPC organized simulation exercises on Avian Influenza, exploring how interdisciplinary teams can develop integrated advice. Key findings show that open dialogue and diverse expertise are crucial for effective crisis management. Building on this, we are launching Disease X simulation exercises in 2025, expanding participation to policymakers and decision-makers.

By refining frameworks for integrated advisory, PDPC aims to enhance pandemic preparedness. Explore our reports, conference presentations, and upcoming workshops here.

Learning from a Crisis – COVID-19

“The more complete the picture, the better you can combat a crisis.” [1] With these words, the government acknowledged the need for more comprehensive advice during pandemics. This was in response to the first OVV report, which highlighted the dominant perspective of infectious disease control at the beginning of the COVID-19 pandemic.[2]

Despite the establishment of the Societal Impact Team (MIT), the current advisory structure is not optimally organized. The MIT, Outbreak Management Team (OMT), and other advisory bodies provide advice almost exclusively from their own fields of expertise. This prevents well-balanced recommendations that integrate multiple perspectives. As a result, the risk of a dominant perspective remains present.

The report Learning from a Crisis and the white paper Contours of Integrated Pandemic Advisory describe the path and obstacles toward integrated advisory processes. Integrated advisory has significant advantages, including:

• It can reveal interactions between parameters from different domains. For example, economic contraction may worsen due to fear of a virus, or reduced public support for measures may increase infection spread.
• It provides insight into necessary complementary policies to mitigate the negative effects of measures.
• It enables the creation of broad, long-term scenarios.
• It makes the societal trade-offs of measures explicit by assessing their effects on various collective values.

Utilizing these advantages is possible but requires new policies and research. There is a lack of a cross-domain organization for advising and a knowledge infrastructure that connects different fields. This could include a broad cohort to gather both biomedical, social, and economic knowledge during a crisis. Additionally, the report includes a pandemic knowledge agenda outlining unanswered research questions. This agenda identifies key issues that should lead to better-integrated advice and greater pandemic preparedness.

The report and white paper are initiatives of the Pandemic and Disaster Preparedness Center, the Netherlands Institute for Social Research (SCP), the Council for Public Health & Society (RVS), UMC Utrecht, and TU Delft. These publications are the result of extensive desk research, interviews with leading experts, and working sessions with scientists from various domains.

The key lessons from this research are:

Lesson 1: Integrated advisory does not happen automatically; it requires action and investment from scientists and policymakers.
Lesson 2: A shared framework for weighing advice from different scientific disciplines is feasible and can serve as a guideline—even if advisory processes remain partially separate.
Lesson 3: There are still unanswered questions regarding various aspects of integrated advisory and how they come together in a broadly supported decision-making framework.

For the report and white paper and the webinar, see the download links below.

Questions about this research and report? Email Dr. Anja Schreijer, Medical Director of  the PDPC, pdpc@erasmusmc.nl.

[1] Parliamentary document 25 295, no. 1827
[2] Approach to the COVID-19 crisis – Part 1: until September 2020, OVV:

Simulation Exercises 2024: Avian Influenza 

Following the 2023 reports, the PDPC decided to further research if and how integrated advice would be possible during a pandemic outbreak, and what the possible advantages of integral advice would be.

The PDPC organized two simulation exercises focusing on a pandemic outbreak of Avian Influenza in the Netherlands on April 17 and May 24. The simulation exercises were based on a scenario depicted a variant of the highly pathogenic Avian Influenza virus spreading through pigs, triggering significant health impacts for both humans and animals. The participants, an interdisciplinary team of scientists, spanning biomedical (veterinary and human), social, and economic sciences, started to explore the development of integrated advice, crucial for going through such crises.

It was evident that various disciplines brought forth insights gleaned from their respective sectors, informed by hard-earned lessons from past experiences, for example with outbreaks in livestock farming, human health crises, and the social repercussions of measures like COVID-related school closures. These diverse backgrounds not only influenced the values and priorities emphasized but also colored the discussions with discipline-specific vocabularies. Overall, promoting open dialogue and cultivating curiosity for alternative disciplinary perspectives emerged as critical factors for achieving integral advice.

Conclusions

Separate advice shows that interpretations of an emergency situation can differ, leading uncoordinated disciplinary advice​.

Interdisciplinary discussions are crucial to uncovering blind spots in disciplinary recommendations and overcoming differences in assessment and interpretation.

Simulation exercises provide invaluable opportunities to prepare for national crisis responses, promote understanding across disciplines, and further develop and refine integrated approaches to advice.  ​

Identifying knowledge and know-how gaps is key to pandemic preparedness so that decisive action can be taken in the event of an outbreak.

Output

Currently the PDPC is finishing up writing two publications about the focusing on the process and frameworks of interdisciplinary advice and on the output of the separate and interdisciplinary advice and the emerging knowledge gaps about Avian Influanza and Pandemic Preparedness. These publications will be shared on the website once they have been published.

Additionally, we’ve presented the results of our simulation exercises at two international conferences: ESCAIDE & ISID. These presentations are included here below.

Furthermore, workshop versions of this simulation exercise have been given at various conferences and congresses to share the results and to let participants experience the complexities and values of integrated advice during pandemic outbreaks. If you are interested in hosting such a workshop, don’t hesitate to contact us at pdpc@erasmusmc.nl!

Simulation Exercises 2025: Disease X in a Prepared World 

Currently, the PDPC is working on a new series of simulation exercises regarding integrated science for policy. These simulation exercises will continue the research lines that have been included in the simulation exercises on Avian Influenza, but will also involve new elements:

• The exercise focuses on an outbreak of a hypothetical, as yet unknown virus with pandemic potential (Disease X).
• In addition to scientific experts, we are now also inviting policy makers and implementers to participate in the exercises, in order to create an exercise in which the demand for advice, scientific advice and decision-making can be aligned and practiced.
• The simulation exercises take place in a context in which the world is optimally prepared world for a pandemic.

We have set the dates for three simulation exercises, each focusing on a different phase within a pandemic outbreak. On April 16 the first simulation exercise will take place, focusing on the alert phase of a pandemic outbreak, when the first signs of a new disease with pandemic potential has just been uncovered. May 21 the second exercise will focus on the acute phase, where we are at the start of a pandemic outbreak. Finally on June 20 we focus on the transition phase where the pandemic spread and outbreak is starting to diminish again.

More updates and information about the simulation exercises and its output will soon follow!