Public Health Emergency Preparedness – A revised Logic Model for Europe after the COVID-19 pandemic

Abstract Background The 2017 Logic Model for Public Health Emergency Preparedness (PHEP) by ECDC provided a strategic framework for assessing public health capacities and capabilities across the European Union (EU). The COVID-19 pandemic, however, exposed critical challenges and prompted a reassessment of preparedness strategies and structures. Methods A comparative qualitative analysis was conducted using documents, interviews, and rapid literature reviews from five EU Member States (Croatia, Finland, Germany, Italy, and Spain), focusing on the pre-vaccination phase of the pandemic. This review evaluated the performance and relevance of the original Logic Model and informed the development of a revised version. Results The core structure of the original model organized into five high-level capability domains remains valid. However, significant revisions were made in three areas. A new capability in the area of Detection and Assessment, “epidemiological intelligence”, was introduced, integrating incident recognition, epidemiological investigation, and risk characterization. “Preventive medicine” under the domain of Health Services was reframed as the “coordination of preventive, primary care, and outpatient services” emphasizing the importance of population-based medicine in crisis response. Finally, Emergency Risk Communication Capabilities were refined to address communication inequalities, manage infodemics, and foster clear, consistent, and empathetic public messaging. Conclusions Incorporating lessons learned during the COVID-19 pandemic, the revised Logic Model enhances the ability of public health systems to assess and strengthen preparedness by helping them defining key areas of interventions. Though developed in a European context, it offers valuable insights for global preparedness frameworks aiming for resilience, coordination, and rapid adaptability. Key messages • The revised PHEP Logic Model strengthens EU’s ability to assess and improve preparedness, especially in epidemiological intelligence, health services coordination, and emergency risk communication. • Effective preparedness requires not only robust capabilities but also the flexibility to adapt policies, coordinate across systems, and manage complex communication challenges during evolving crises.