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

Introduction

Decision-making on matters of public health and health policy requires the balancing of numerous, often conflicting factors. However, a broad societal discourse and a participatory decision-making process on the criteria underpinning the decision was often not feasible within the time constraints imposed on by 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.

Objective

To develop a decision-making framework adapted to the challenges of decision-making on national and sub-national level implementation of non-pharmacological interventions (NPIs) measures to contain the global SARS-CoV-2 pandemic.

Methods

We employed the “best-fit” framework synthesis technique and used the WHO-INTEGRATE framework Version 1.0 as a starting point. In a first phase adapted the framework through brainstorming exercises and application to exemplary case studies (e.g. school reopening). In a second phase 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 adapted previous framework versions into the WICID (WHO-INTEGRATE COVID-19) framework Version 1.0.

Results

Twelve comprehensive strategy documents were included in the content analysis. The revised WICID framework consists of eleven criteria, supported by 48 aspects, the metacriterion quality of evidence and embraces a complexity and 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 resource and feasibility considerations.

Discussion

In a third phase, the 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.

Key-questions