WICID framework version 1.0: criteria and considerations to guide evidence-informed decision-making on non-pharmacological interventions targeting COVID-19

Abstract

IntroductionPublic health decision-making requires the balancing of numerous, often conflicting factors. However, participatory, evidence-informed decision-making processes to identify and weigh these factors are often not possible- especially, in the context of the SARS-CoV-2 pandemic. While evidence-to-decision frameworks are not able or intended to replace stakeholder participation, they can serve as a tool to approach relevancy and comprehensiveness of the criteria considered.ObjectiveTo develop a decision-making framework adapted to the challenges of decision-making on non-pharmacological interventions to contain the global SARS-CoV-2 pandemic.MethodsWe employed the ‘best fit’ framework synthesis technique and used the WHO-INTEGRATE framework as a starting point. First, we adapted the framework through brainstorming exercises and application to case studies. Next, we conducted a content analysis of comprehensive strategy documents intended to guide policymakers on the phasing out of applied lockdown measures in Germany. Based on factors and criteria identified in this process, we developed the WICID (WHO-INTEGRATE COVID-19) framework version 1.0.ResultsTwelve comprehensive strategy documents were analysed. The revised framework consists of 11+1 criteria, supported by 48 aspects, and embraces a complex systems perspective. The criteria cover implications for the health of individuals and populations due to and beyond COVID-19, infringement on liberties and fundamental human rights, acceptability and equity considerations, societal, environmental and economic implications, as well as implementation, resource and feasibility considerations.DiscussionThe proposed framework will be expanded through a comprehensive document analysis focusing on key stakeholder groups across the society. The WICID framework can be a tool to support comprehensive evidence-informed decision-making processes.

Unintended health and societal consequences of international travel measures during the COVID-19 pandemic: a scoping review

“…During data extraction and mapping, we faced difficulties classifying some outcomes according to our a priori defined and inductively adapted categories. 12 Some unintended consequences may fit into several categories, whereas others did not neatly fit into any of these. For example, a ‘lack of social cohesion’ could be understood as affecting both ‘quality of life’ and ‘social consequences’ .…”

“…The present review focuses on a subset of outcomes only, namely the unintended health and societal consequences and adverse effects of these measures. This understanding was informed by (i) three methodological publications on the use of logic models, 28–30 (ii) two frameworks to facilitate evidence-based decision-making during the COVID-19 pandemic, 12 , 31 (iii) a Cochrane rapid review assessing the effectiveness of travel-related control measures in the context of COVID-19 32 and (iv) discussions within the research team. During the review process, some adaptations were made to the logic model, notably we split ‘social and environmental implications’ into two separate outcome categories, and identified an additional distinct outcome category, namely ‘interaction with and implications for the health system’ .…”

“…The implementation of international travel measures directly impinges on the right to freedom of movement and therefore places limitations on the enjoyment of many other human rights, 11 and may result in a range of other unintended and potentially harmful consequences. 10 , 12 The targeted closure of national borders—for instance, to travellers from specific countries—may stoke stigma and xenophobia, leading to discrimination and harassment of people from (or thought to be from) the targeted countries. 13 , 14 The potential negative impact of quarantine on mental health is well established, with the most commonly reported psychological effects including anger, anxiety, boredom, confusion, loneliness and symptoms of post-traumatic stress.…”

COVID-19 response: mitigating negative impacts on other areas of health

“…Tools including evidence-to-decision frameworks and systematic trade-off appraisal can also be leveraged to support better informed short-term decision-making. 26 27 …”

Politikberatung durch Expert*innenräte in der SARS-CoV-2-Pandemie in Deutschland: Eine Dokumentenanalyse aus Public-Health-Perspektive

“…Neben der Anhörung von Vertreter*innen diverser Gruppen oder Nutzung von Primär- oder Sekundärdaten (z.B. Bevölkerungsbefragungen), können auch Entscheidungshilfeframeworks wie beispielsweise das sogenannten WICID-Framework nützliche Werkzeuge sein [36] .…”