Leveraging the knowledge gained from the COVID-19 pandemic and advancing robust evidence is more critical than ever to strengthen respiratory pandemic preparedness following the end of the COVID-19 a public health emergency of international concern. For public health and social measures (PHSM) – interventions to reduce the risk and scale of infectious disease transmission– coordinated research efforts are vital in better understanding their effectiveness and impact during the COVID-19 pandemic but also in accelerating their applicability to diverse respiratory pathogens.  In this article, we share key findings from the first global survey on COVID-19 related research priorities for PHSM and how we plan to expand the agenda with a medium- to long-term scope.

Results of the urgent COVID-19 research priority setting

Through a multi-step consultation including the global technical consultation in 2021 followed by a public survey, these 24 research questions were prioritized across the six themes and listed in the order of priority:    

Theme 1: Mapping existing research to identify knowledge gaps

• What evidence exists on the efficacy of separate or combined PHSM in reducing disease transmission, and their direct and indirect impact on morbidity and mortality?
• What do we know about the effectiveness and the health, social and economic burden of PHSM on individual and societal level across different contexts and populations?
• Which factors influence uptake of and adherence to PHSM?

Theme 2: Measuring the direct effectiveness and impact of PHSM on transmission, morbidity and mortality

• What are the effects of PHSM on morbidity and mortality through reduced transmission?
• How can social norms and “cultures” be established (e.g. in workplaces, educational institutions, hospitality venues and shops) to support infection control practices?
• What are the key high-risk events and settings for viral transmission?

Theme 3a: Assessing the impact of PHSM on health, social and economic outcomes – health aspects

• What is the cost–benefit ratio of PHSM when comparing prevented morbidity and mortality with the intervention burden caused by PHSM?
• What are the mental health consequences of prolonged PHSM implementation?
• Do PHSM lead to a disruption of routine medical care (e.g. cancer screening) and, if so, what are the consequences for morbidity and mortality?

Theme 3b: Assessing the impact of PHSM on health, social and economic outcomes – socio-economic aspects

• What effect do PHSM have on the educational attainment of children and young adults?
• What are the individual and societal costs of prolonged business closures, travel restrictions and school closures?
• Do the benefits of implementing PHSM outweigh their costs?

Theme 4: Building preparedness for future health emergencies: resilience and response capacity

• Which measures can be put in place to mitigate the intervention burden (e.g. social security schemes, eviction bans and teleworking arrangements)?
• Which populations and settings are disproportionately affected by the intervention burden of PHSM?
• Which tools and guidance on PHSM monitoring, evaluation and implementation are useful in preparation for an outbreak?

Theme 5: Promoting uptake of and adherence to PHSM

• Understanding influences on PHSM uptake and adherence: What social, political, behavioural, cultural and economic factors influence the uptake and adherence of PHSM?
• Promoting evidence-informed policy formulation: How can the uptake of actionable and evidence-informed guidance for decisionmakers be improved?
• Promoting evidence-informed policy formulation: What are the best methods to develop partnerships and feedback loops between policy decision-makers and researchers to maximize the likelihood that research will have an impact?

Theme 6a: Methodological research to advance implementation and evaluation of PHSM – research infrastructure

• What global and regional research infrastructure is needed to support high-quality, timely and relevant research (e.g. data platforms and trial platforms)?
• How can we best conduct nationwide studies and foster international collaboration for comparisons among countries?
• What types of studies should be performed to evaluate the effect of separate or combined PHSM?

Theme 6b: Methodological research to advance implementation and evaluation of PHSM – research preparedness

• How can we best prepare study protocols, procedures and materials so that research that can only be undertaken during outbreaks can be rapidly initiated?
• How can we best evaluate different types of research to increase our understanding of potential contextual, ethnocultural and political effect modifiers?
• How can we develop a core outcome set (including adherence measures) for specific PHSM?

In addition, the respondents hailed the importance of including civil societies and communities especially marginalized, vulnerable groups in PHSM research and implementation, development of transdisciplinary research methodologies and validation of models.

Next steps

In summer 2023, WHO will launch a second online survey as the final stage of this process to identify medium- to long-term research priorities for PHSM in the context of respiratory pathogens beyond COVID-19. The findings of the survey will be discussed at the second global expert consultation on PHSM in November 2023 and the global PHSM research agenda 2021-2030 will subsequently be published to raise commitment, resources and evidence needed to inform effective PHSM decisions for diverse hazards and ultimately strengthen the Global Architecture for Health Emergency Preparedness, Response and Resilience.  

You can find out more about the WHO multi-year PHSM initiative in the High Impact Events Preparedness (IEP) unit in the Department of Epidemic and Pandemic Preparedness and Prevention (EPP) here.