Defining “success” in managing pandemic across disciplines: insights from an expert consultation

Abstract Background Learning from COVID-19 pandemic can improve future preparedness. A key question is how to define “success” in pandemic management. We aimed to establish a workable set of definitions for success over different distinct pandemic stages, as well as cumulatively from pandemic emergence to epidemic control. Methods We first developed through an iterative process of a structured brainstorm session and a pilot survey (20 project members from 7 EU countries) a set of success indicators for the entire pandemic and for six distinct COVID-19 pandemic stages: pre-pandemic, rising pandemic outside Europe, rising pandemic in other countries/regions inside Europe, within-country first wave, pre-vaccination waves, post-vaccination. These indicators were then validated by COVID-19 experts from different fields, including sociologists, psychologists, medical doctors, political scientists, economists, ethicists or philosophers, and policymakers, via an online survey. Experts ranked the indicators by importance and answered two open-ended and five background questions. Results The developed indicator lists differed according to the pandemic stages. A total number of 45 experts completed the survey (29% response rate). All 50 indicators were ranked by at least 70% of the respondents as important. Notably, experts from all disciplines agreed that mortality was the most important indicator over the entire pandemic and during pre-vaccination waves, while vaccination coverage was considered the most important indicator post-vaccination. There was broad agreement on top 5 indicators, though their ranking preferences differed slightly between disciplines. Conclusions The indicator list can serve to inform the design of further studies on their relative importance (eg discrete choice experiments), to guide the development of pandemic intelligence monitoring tools (eg mental wellbeing monitors), and to validate similar opinions of non-European experts, and the general public. Key messages • This study adopted an iterative method to develop and validate a comprehensive list of determinants of success in managing pathogen X based on the SARS-CoV-2 pandemic. • These indicators, including mortality and vaccination coverage, can guide pandemic intelligence in Europe, and will inform the design of further studies.