Essential information: Uncertainty and optimal control of Ebola outbreaks

• DOI: 10.1073/pnas.1617482114
• Publication Date: 2017-05-16T01:00:34Z
• Authors: Shou-Li Li; Ottar N. Bjørnstad; Matthew J. Ferrari; Riley Mummah; Michael C. Runge; Christopher J. Fo...; Michael J. Tildesley; William J. M. Pro...; Katriona Shea
• Keywords: 0301 basic medicine; Africa, Western; 03 medical and health sciences; Decision Making; Disease Management; Humans; Computer Simulation; Hemorrhagic Fever, Ebola; Models, Theoretical; Epidemics; Case Management; 3. Good health

SignificanceThe 2014 Ebola outbreak illustrates the complexities of decision making in the face of explosive epidemics; management interventions must be enacted, despite imperfect or missing information. The wide range in projected caseload generated attention as a source of uncertainty, but debate did not address whether uncertainty affected choice of action. By reevaluating 37 published models, we show that most models concur that reducing funeral transmission and reducing community transmission are robust and effective management actions to minimize projected caseload. Although models disagreed about absolute caseload, this measure has little relevance for evaluating candidate interventions. Our study highlights the importance of projecting the impact of interventions and is applicable to management of other epidemic outbreaks where rapid decision making is critical.