Identifying indicators of “success” in managing the COVID-19 pandemic in Europe: insights from an interdisciplinary expert consultation

Abstract

Background Reflecting on what we have been through and learned during the COVID-19 pandemic can help prepare for similar challenges in the future. A quintessential question is what may indicate "success" in pandemic management. We aimed to establish a workable set of indicators for success over different distinct pandemic stages, as well as cumulatively from pandemic emergence to epidemic control. Methods First, using an iterative brainstorm and a pilot survey process, we developed a set of indicators of success for the entire pandemic (from late 2019 to date) and for six distinct COVID-19 pandemic stages: (1) pre-pandemic, (2) rising virus prevalence outside Europe, (3) rising virus prevalence in other countries or regions within Europe, (4) within-country first wave of virus, (5) subsequent virus waves pre-vaccination, (6) post-vaccination. Secondly, these indicators were validated by COVID-19 experts from different fields through an online survey. Experts were asked to rank the proposed indicators according to importance, along with answering two open-ended questions 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, during the first wave and subsequent waves pre-vaccination, while vaccination coverage was considered the most important indicator post-vaccination. Experts had different ranking preferences for the remaining indicators. Conclusion Reflecting on the COVID-19 pandemic, this list could serve as a valuable resource to point towards which indicators are most crucial to monitor, informing future pandemic response strategies. Meanwhile, as this study currently only relied on input from European experts, it could serve as a validation set for experts outside Europe as well as the general public.