Discussion Topic for Seminar 2 (Presented by Kansiri)

[Kansiri Apinantanakul]

Discussion Topic for Seminar 2 (Presented by Kansiri):

Topic 1: In your opinion, which parameter(s) should be included in the model more to increase generalizability/predictive ability of the model.

Topic 2: If you are the policy maker of your own country, would you apply this risk assessment model to support decision making? why? or why not?

Article: Risk stratification and assessment framework for international travel and border measures amidst the COVID-19 pandemic – A Malaysian perspective

[Zarni Lynn Kyaw]

This is also a very interesting paper and I made a quick summary of it.

Methods

The risk stratification and assessment framework for international travel considers four key factors, which are categorized into four pillars:

(i) incidence of cases,
(ii) reliability of case data,
(iii) vaccination, and
(iv) variant surveillance.

These measures are combined based on weights that reflect their corresponding importance in risk assessment within the context of the pandemic to calculate the risk score for each country.

For each pillar, specific parameters are considered.

In Pillar 1 (incidence of cases), the parameter is the number of cases per million population over a 7-day average.

Pillar 2 (reliability of case data) includes parameters such as the number of tests conducted per 100 population and the test positivity rate, both based on a 7-day average.

Pillar 3 (vaccination) focuses on the percentage of the population that has received at least one dose of a COVID-19 vaccine and the percentage that has completed the recommended vaccine series.

Pillar 4 (variant surveillance) takes into account the proportion of COVID-19 cases sequenced over the preceding 14 days, the number of days since the last sequencing data was uploaded, and the presence of very high priority variants of concern.

Weights are assigned to each parameter and pillar based on the local and global landscape of the pandemic at the time the model is applied. These weights reflect the relative order of importance. The weights are determined by considering factors such as guidelines from organizations like the WHO, best practices observed in travel policies of other countries, and expert opinions from epidemiologists and public health specialists.

The risk assessment process involves two steps: intra-pillar risk value calculation and inter-pillar risk score calculation. In the intra-pillar step, parameters within each pillar are combined to obtain a risk score for that pillar. In the inter-pillar step, the risk scores from each of the four pillars are combined to obtain an overall country risk score.

It is important to note that the specific weights assigned to parameters and pillars may vary based on the evolving nature of the pandemic and the available data.

Results

The results section presents the risk scores for each of the four pillars and the overall country risk scores for 224 countries and territories. The risk scores are generated using the risk stratification and assessment framework described in the method section.

The results show that the overall country risk scores range from 0.00 to 1.00, with higher scores indicating higher risk. The countries with the highest overall risk scores are those with high incidence of cases, low vaccination rates, and poor reliability of case data and variant surveillance. The countries with the lowest overall risk scores are those with low incidence of cases, high vaccination rates, and good reliability of case data and variant surveillance.

The results also show that the risk scores for each pillar vary across countries and territories. For example, some countries have high incidence of cases but good vaccination rates, while others have low incidence of cases but poor reliability of case data and variant surveillance.

The authors note that the risk scores presented in the results section are based on data available as of October 2021 and may change as the pandemic evolves and new data becomes available. The risk assessment framework and the results presented in the PDF can be used as a tool to inform travel policies and decisions, but should be used in conjunction with other factors such as local regulations and guidelines.

Discussion

The discussion section of the PDF provides an analysis and interpretation of the findings presented in the results section. It begins by highlighting the importance of risk stratification and assessment in informing travel policies and decisions during the COVID-19 pandemic.

The authors discuss the significance of the four pillars used in the risk assessment framework: incidence of cases, vaccination rates, reliability of case data, and variant surveillance. They emphasize that considering these pillars collectively provides a comprehensive understanding of the risk associated with international travel.

The discussion also addresses the limitations of the study. The authors acknowledge that the risk scores are based on data available as of October 2021 and may not reflect the current situation. They also note that the risk assessment framework relies on publicly available data, which may vary in quality and consistency across countries.

Furthermore, the authors discuss the potential implications of the study’s findings for travel policies and measures. They suggest that countries with high risk scores should consider implementing stricter travel restrictions and quarantine measures, while countries with low risk scores may adopt more relaxed measures.

The discussion section concludes by emphasizing the need for ongoing monitoring and updating of risk assessments as the pandemic evolves. The authors highlight the importance of collaboration between countries and international organizations in sharing data and information to improve the accuracy and effectiveness of risk assessments.

My questions are

1. The paper discusses the importance of risk stratification and assessment in informing travel policies during the COVID-19 pandemic. How can countries balance the need to protect public health while also facilitating safe travel?

2. The study proposes a risk assessment framework based on four pillars: incidence of cases, reliability of case data, vaccination rates, and variant surveillance. Do you think these pillars adequately capture the key drivers of risk in international travel?

My answer to the discussion points are:

1)
The risk assessment framework proposed in the paper is based on four pillars: incidence of cases, reliability of case data, vaccination rates, and variant surveillance. While these pillars provide a comprehensive understanding of the risk associated with international travel, there may be additional factors that could be included to increase the generalizability and predictive ability of the model.

For example, some possible parameters that could be considered include the capacity of the healthcare system in each country, the availability of medical resources and supplies, and the effectiveness of public health measures such as contact tracing and isolation protocols. Including these parameters could provide a more nuanced understanding of the risk associated with international travel and help countries develop more effective travel policies and measures.

2)
If I were a policy maker, I would consider applying this risk assessment model to support decision making for several reasons:

1. Data-driven approach: The model is based on data and provides a systematic framework for assessing the risk associated with international travel. By utilizing this model, policy makers can make decisions based on objective and evidence-based information rather than relying solely on subjective judgments.

2. Comprehensive risk assessment: The model takes into account multiple factors such as incidence of cases, vaccination rates, reliability of case data, and variant surveillance. This comprehensive approach provides a more holistic understanding of the risk and can help policy makers make informed decisions that consider various aspects of the pandemic situation.

3. Adaptability and flexibility: The model is designed to accommodate the dynamic nature of the pandemic and evolving national priorities. It allows for adjustments based on emerging variants of concern or changes in the epidemiological situation. This adaptability can be valuable for policy makers who need to respond to changing circumstances and make timely decisions.

[Boonyarat Kanjanapongporn]

I do agree with K.Zarni on including the healthcare capacity as another parameter because it would be flexible to the situation when the country could have to weigh up between the ability to control the case and traveling. For topic 2, If I was the policy maker I would love to implement the risk assessment model to support policy design. It would be trustable and transparent if the decision will be evidence based and able to be traced back if needed. Moreover, Using models could reduce personal bias which possibly will create better, overall applicable policy.

[ABDILLAH FARKHAN]

This is a very good paper and you’ve presented it very well. In my opinion, the capacity at the points of entry to detect and prevent Covid-19 could be a potential parameter. Another potential indicator could be the density of airports/seaports/land borders in a country to the passengers. However, those parameters may be disproportionate as each entry point in a country has a different capacity level and different influx of travelers.

If I were the policymaker, of course, this risk stratification and assessment is one of the considerable steps. However, when deciding to disclose or keep close the border, other important socioeconomic aspects should also be considered as some areas in the country may have a strong dependency on economic activities and supply chains for food.

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