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Activity Number: 130 - Advances in Resource Allocation for Epidemic Control: Estimation, Optimization, and Counterfactuals
Type: Topic Contributed
Date/Time: Monday, August 3, 2020 : 1:00 PM to 2:50 PM
Sponsor: Section on Statistics in Epidemiology
Abstract #313370
Title: Dynamic Policy Counterfactuals: Evaluating Contact-Tracing in the EVD Outbreak in Liberia 2014-16
Author(s): Soheil Eshghi* and Forrest W. Crawford
Companies: Yale School of Public Health and Yale University
Keywords: epidemic response ; contact-tracing ; epidemic model; optimal control; resource allocation ; program evaluation

In an acute infectious disease outbreak, finding infectives is a necessary precursor to treatment administration and exposure mitigation. Enhanced surveillance (ES), i.e., expanding random testing above baseline, and contact-tracing (CT) are 2 prominent case-finding policies. Once an index case is found, CT involves testing their contacts and treating the infected. Evaluating their empirical effectiveness requires careful model calibration and cost-assessment of dynamic counterfactuals.

We use an epidemic model to show that the optimal dynamic coordinated case-finding policy that balances disease burden and policy-related expenditure only activates CT at maximal rate in a subset of the ES window, leading to a policy with up to 5 phases.

We use prevalence and contact-tracing data from the 2014-16 EVD outbreak in Liberia to build assumption-free estimators of the empirical case-finding policy and the optimal (counterfactual) one. We estimate infection and response costs using standard-of-care, wage, and disease progression data.

We find that the best such policy would have increased the ES window while curtailing CT. This finding is robust and matches on-the-ground observations.

Authors who are presenting talks have a * after their name.

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