Open AccessReopening California: Seeking robust, non-dominated COVID-19 exit strategies
Author(s) -
Pedro Nascimento de Lima,
Robert J. Lempert,
Raffaele Vardavas,
Lawrence Baker,
Jeanne S. Ringel,
Carolyn M. Rutter,
Jonathan Ozik,
Nicholson Collier
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0259166
Subject(s) - covid-19 , psychological intervention , robustness (evolution) , public health interventions , public health , pandemic , face masks , environmental health , medicine , business , risk analysis (engineering) , biology , virology , nursing , biochemistry , disease , pathology , outbreak , infectious disease (medical specialty) , gene
The COVID-19 pandemic required significant public health interventions from local governments. Although nonpharmaceutical interventions often were implemented as decision rules, few studies evaluated the robustness of those reopening plans under a wide range of uncertainties. This paper uses the Robust Decision Making approach to stress-test 78 alternative reopening strategies, using California as an example. This study uniquely considers a wide range of uncertainties and demonstrates that seemingly sensible reopening plans can lead to both unnecessary COVID-19 deaths and days of interventions. We find that plans using fixed COVID-19 case thresholds might be less effective than strategies with time-varying reopening thresholds. While we use California as an example, our results are particularly relevant for jurisdictions where vaccination roll-out has been slower. The approach used in this paper could also prove useful for other public health policy problems in which policymakers need to make robust decisions in the face of deep uncertainty.