The framework of ‘Prevention’, ‘Detection’, and ‘Response’ as described in the EOI form leaps from an early warning system to sophisticated technological response approaches.
However, there is a step in between these, which is best described as ‘exclusion/elimination’, where jurisdictions with geographical and governance favourable conditions can keep a threat out. This approach could be used by the many island nations of the world, which make up a large fraction of human population. I find that continent dwellers underplay the role of islands in solutions and funding decisions, eg Japan, Australia, Taiwan, New Zealand making up several percentage points of global population.
Jurisdictions that used an exclusion/elimination strategy had net negative age-standardised cumulative excess mortality in 2020-21 through the Covid-19 pandemic (see papers below). With pre-planned border protocols it is possible to keep a pathogen out once early detection flags the risk. Exclusion was also cost-effective, with broadly no statistical difference in GDP growth (admittedly a blunt metric, but ripe now for more in-depth analysis) between jurisdictions that did/didn’t use this approach.
Unfortunately, there was a lot of too-eager science done in the early pandemic that incorrectly flagged things like democracy, exclusion, border closures, preparedness based on eg GHSI metrics, etc as positively correlated with deaths, when actually, after the dust has settled and with gold standard metrics, appropriate statistical transformations and so on, rather than messy in-the-heat-of-the-moment data, these things are all protective. Much more research is needed to reverse the harmful science that was done in haste, and to provide decision makers with robust information to plan future response strategies.
I would strongly advocate for including a work stream on ‘strategies’ not just ‘technologies’ in response, eg exclusion/elimination along with your other projects. See two accepted and forthcoming peer-reveiwed papers of ours which give the flavour of this issue: 1. Boyd, M., Baker, M. G., Kvalsvig, A., & Wilson, N. (2025). Impact of Covid-19 Control Strategies on Health and GDP Growth Outcomes in 193 Sovereign Jurisdictions. Forthcoming in PLOS Global Public Health. Preprint here: https://www.medrxiv.org/content/10.1101/2025.04.08.25325452v1 2. Boyd M, Baker M, Wilson N. (2025). Global Health Security Index and Covid-19 pandemic mortality 2020–2021: A comparative study of islands and non-islands across 194 jurisdictions. Forthcoming in BMJ Open. Preprint here: https://www.medrxiv.org/content/10.1101/2024.09.02.24312964v2
We are currently working on the interaction of democratic institutions, governance quality and exclusion/elimination—which are a critical piece of the puzzle too.
The framework of ‘Prevention’, ‘Detection’, and ‘Response’ as described in the EOI form leaps from an early warning system to sophisticated technological response approaches.
However, there is a step in between these, which is best described as ‘exclusion/elimination’, where jurisdictions with geographical and governance favourable conditions can keep a threat out. This approach could be used by the many island nations of the world, which make up a large fraction of human population. I find that continent dwellers underplay the role of islands in solutions and funding decisions, eg Japan, Australia, Taiwan, New Zealand making up several percentage points of global population.
Jurisdictions that used an exclusion/elimination strategy had net negative age-standardised cumulative excess mortality in 2020-21 through the Covid-19 pandemic (see papers below). With pre-planned border protocols it is possible to keep a pathogen out once early detection flags the risk. Exclusion was also cost-effective, with broadly no statistical difference in GDP growth (admittedly a blunt metric, but ripe now for more in-depth analysis) between jurisdictions that did/didn’t use this approach.
Unfortunately, there was a lot of too-eager science done in the early pandemic that incorrectly flagged things like democracy, exclusion, border closures, preparedness based on eg GHSI metrics, etc as positively correlated with deaths, when actually, after the dust has settled and with gold standard metrics, appropriate statistical transformations and so on, rather than messy in-the-heat-of-the-moment data, these things are all protective. Much more research is needed to reverse the harmful science that was done in haste, and to provide decision makers with robust information to plan future response strategies.
I would strongly advocate for including a work stream on ‘strategies’ not just ‘technologies’ in response, eg exclusion/elimination along with your other projects. See two accepted and forthcoming peer-reveiwed papers of ours which give the flavour of this issue:
1. Boyd, M., Baker, M. G., Kvalsvig, A., & Wilson, N. (2025). Impact of Covid-19 Control Strategies on Health and GDP Growth Outcomes in 193 Sovereign Jurisdictions. Forthcoming in PLOS Global Public Health. Preprint here: https://www.medrxiv.org/content/10.1101/2025.04.08.25325452v1
2. Boyd M, Baker M, Wilson N. (2025). Global Health Security Index and Covid-19 pandemic mortality 2020–2021: A comparative study of islands and non-islands across 194 jurisdictions. Forthcoming in BMJ Open. Preprint here: https://www.medrxiv.org/content/10.1101/2024.09.02.24312964v2
We are currently working on the interaction of democratic institutions, governance quality and exclusion/elimination—which are a critical piece of the puzzle too.
More than happy to chat.