Cover: Reopening California

Reopening California

Seeking Robust, Non-Dominated COVID-19 Exit Strategies

Published in: PLoS ONE, Volume 16, Issue 10 (2021). doi: 10.1371/journal.pone.0259166

Posted on Nov 5, 2021

by Pedro Nascimento de Lima, Robert J. Lempert, Raffaele Vardavas, Lawrence Baker, Jeanne S. Ringel, Carolyn M. Rutter, Jonathan Ozik, Nicholson Collier

The COVID-19 pandemic required significant public health interventions from local governments. Although nonpharmaceutical interventions often were implemented as decision rules, few studies evaluated the robustness of those reopening plans under a wide range of uncertainties. This paper uses the Robust Decision Making approach to stress-test 78 alternative reopening strategies, using California as an example. This study uniquely considers a wide range of uncertainties and demonstrates that seemingly sensible reopening plans can lead to both unnecessary COVID-19 deaths and days of interventions. We find that plans using fixed COVID-19 case thresholds might be less effective than strategies with time-varying reopening thresholds. While we use California as an example, our results are particularly relevant for jurisdictions where vaccination roll-out has been slower. The approach used in this paper could also prove useful for other public health policy problems in which policymakers need to make robust decisions in the face of deep uncertainty.

This report is part of the RAND external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.