1.P. Round table: How could a perfect monitoring and response system look like?

Abstract Robert FitzRoy, captain of the Beagle, was ridiculed when he started to assemble a network of telegraphs to be able to follow storms at sea: in the 19th century, predicting the weather, even in the short term, was considered impossible. 150 years later, meteorological institutes around the world may have helped prevent millions of deaths. Dynamic and complex systems are particularly difficult to predict: we still don’t know exactly when the glaciers will collapse, when the next variant of a virus will appear, how intense the next earthquake will be. In fact, and as the COVID-19 pandemic has shown, most services are unprepared to adjust to such fast evolving-situations: in general, we are limited to trying to react and adapt, but systematically fail at prediction and planning, with important consequences. Moreover, disease outbreaks, scientific research, public health response(s) and legislation happen at completely different time scales, and are not prepared to communicate with (or even understand) each other. Therefore, a fundamental question is how we can create structures that, similar to what FitzRoy imagined, are prepared to anticipate and respond to health threats, when they appear. During this round table, we will bring together experts that use different perspectives (One Health, Digital Epidemiology, Health Policy) and discuss what is needed to build the “perfect” system, in an ideal world. We will argue in favor of 1) creating efficient systems for collecting and processing good quality data, fundamental for any decision making; 2) training multidisciplinary teams to work on the full pipeline from performing complex analyses, using mathematical and computational tools, to communicating with the decision-makers and the population; 3) prepare institutions to network, nationally and internationally; and 4) simulate different scenarios and design medium-term strategies. We will recognize and highlight many of the challenges of such an integrated approach, from data availability and sharing, to communicating under uncertainty, but also the risks of not even trying to do so. We expect to make very brief presentations, to leave abundant time for audience feedback and discussion. Key messages • It is urgent to create structures prepared to anticipate and respond to health threats. These should be local but integrated at the international level. • Their creation faces many challenges, from data collection and sharing to decision making and communication, that should be recognized and tackled using multidisciplinary, integrative approaches. Speakers/Panelists Joana Gonçalves-Sá Social Physics and Complexity Lab, Lisbon, Portugal Ana Bento Cornell University, Ithaca, USA Daniela Paolotti ISI Foundation, Turin, Italy André Peralta-Santos ENSP, Lisbon, Portugal