Better public decisions on COVID-19: A thought experiment in metrics

Public Health Pract (Oxf). 2021 Nov:2:100208. doi: 10.1016/j.puhip.2021.100208. Epub 2021 Oct 29.

Abstract

Objectives: Poor decision-making is a hallmark of the COVID-19 pandemic. Better metrics would help improve decision-makers' understanding of the scope of the pandemic and allow for better public understanding/review of these decisions.

Study design: Two novel metrics of disease impact were compared with more commonly used standard metrics.

Methods: A multi-criteria decision analysis technique, used previously to support metric selection in solid waste planning, was adapted to compare number of deaths, hospitalisations, positive test results and positivity rates (standard COVID-19 impact metrics) with a simple model that estimates the total number of potentially infectious people in an area and an associated odds ratio for infectious people.

Results: The odds ratio and total infectious population estimate metrics scored better in a comparison analysis than number of deaths, hospitalisations, positive test results and positivity rates (in that order).

Conclusions: The novel metrics provide a more effective means of communication than other more common measures of the outbreak. These superior metrics should support decision-making processes and result in a more informed population.

Keywords: Decision support; Disease metrics; Infectious population; Odds ratio; Public involvement.