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A Hybrid Strategy Against Pandemics

In the absence of multilateral or national-level leadership early in the pandemic, social entrepreneurs, academics, and non-profits stepped in to provide decision-makers with the information they needed to protect the public. This new hybrid approach to public health should now be fully realized.

BOSTON – Even before the pandemic, global health systems were overextended, data-poor, and buckling under increasing demand. It is thus little wonder that, despite the best intentions of medical professionals, many governments struggled to respond effectively to the COVID-19 crisis.

The initial lack of leadership on basic issues such as mask mandates and travel restrictions proved catastrophic, allowing both the virus and disinformation about it to spread widely. Equally disappointing, vaccine delivery has been piecemeal, with contradictory guidelines and tragic geographical disparities. Despite having a year to plan for the initial vaccine rollout, we are only now holding debates about vaccine passports, equity, and access. Weak global surveillance infrastructure and slow, uncoordinated decision-making have left the world in a state of deep vulnerability, desperate for new ideas and new leadership.

Fortunately, human ingenuity can help to offset these failures, with the social, civil, and private sectors filling the vacuum created by government inaction. Many social entrepreneurs and non-profits are more agile and risk-tolerant than government agencies, and, using data science and artificial intelligence, they have introduced new, streamlined methods of gathering, curating, and distributing information and scientific data. This has enabled them to develop novel population-surveillance mechanisms and early-intervention strategies, which support individuals and communities in making real-time decisions and modifying their behaviors.

Recall that when the pandemic began, many governments failed to provide vulnerable citizens with the information they needed to protect themselves and slow the spread of the virus. Worse, we now know that many governments had access to data that could have helped. The problem is that these assets were not readily accessible, because they were stored within localized health systems or agencies of regional governments.

In the absence of clear, real-time information, platforms like Covid Act Now and the Johns Hopkins Coronavirus Resource Center were quickly rolled out to track COVID-19 infections and other data that people needed to assess risks. By deploying available technologies, these platforms were able to aggregate and analyze data collected from the US Department of Health and Human Services, the US Centers for Disease Control and Prevention, media outlets, and state, county, and local dashboards. Similarly, The Atlantic’s COVID Racial Data Tracker compiled data from across the United States to call attention to the pandemic’s disproportionate impact on people of color.

These platforms have created opportunities to engage more populations at an individual level. For example, the New York Times’s widely used digital tool took data predictions from Ariadne Labs and created a virtual vaccine queue, allowing users to enter basic demographic information to determine their place in line.

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Such successes should spur more government investment in hybrid partnerships with non-profits and social entrepreneurs, as these will remain necessary to rebuild and modernize today’s health systems. Initiatives such as the Collective and Augmented Intelligence Against COVID-19 (CAIAC) platform and The Trinity Challenge have brought together different sectors, capabilities, and data sets to start monitoring and preparing for future outbreaks.

These kinds of anticipatory functions are generally the preserve of government, but they are increasingly being undertaken by civil society. Through wastewater analysis, the private company Biobot has offered early warnings to communities that are about to experience spikes in COVID-19 cases. Similarly, by monitoring antibodies and immunological responses, immunologist Galit Alter at the Ragon Institute has examined the critical question of whether and to what extent COVID-19 exposure confers immunity. Needless to say, such insights will have far-reaching implications for the recovery and for vaccine development and administration.

Much of this work has attracted government attention. But while this has sometimes led to integrated responses, such initiatives have offered too little, too late. We desperately need a more robust multilateral and multisectoral approach to preparing for future global challenges. By combining the state’s funding and organizational capacity with the tech sector’s creativity and speed and civil society’s expertise, we can vastly improve our health systems and build mechanisms capable of tackling – or even preventing – future threats.

But this will not come easy. Governments must engage with civil society much earlier in the innovation process, by investing in research and infrastructure and establishing prize pots. There are a number of models for how this can be done. MIT Solve, for example, hosts innovation challenges in which social entrepreneurs, experts, and funders come together to devise tech-driven solutions to some of the world’s hardest problems.

Similarly, grants from the US Defense Advanced Research Projects Agency have long encouraged the creation of novel technology. Just imagine what could be accomplished if this highly successful model for improving military capabilities was brought to bear on social and health challenges.

Governments also should play a greater role in the development of public-interest technology and data management. By fostering technical expertise and data-driven mechanisms that can be deployed immediately, governments can respond much faster to the next crisis. A search engine that aggregates data from vaccine platforms, for example, could both connect people to available immunization services and identify underserved or vaccine-hesitant populations.

All of the problems of health equity, access, and innovation that predated the pandemic have now become even more pervasive and urgent. But the COVID-19 crisis has shown what could be accomplished if governments engaged fully with civil society. With a robust, hybrid model of innovation and crisis management, we can architect more resilient global health systems as we build back from the pandemic.

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