Identifying essential resources for pandemic response: an international delphi study within the EU-PANDEM-2 project
The ongoing COVID-19 pandemic highlights the crucial role of healthcare and public health resource management, where shortages impair the immediate response to a pandemic resulting in increased transmission and delayed patient care. In the European PANDEM-2 project, we aimed to identify essential resources for pandemic planning in the context of an emerging viral respiratory illness. We performed a Delphi study consisting of a systematic literature review, a structured questionnaire and two international consensus rounds. Resources were categorized as material, human or pharmaceutical. A panel of public health experts (PHEs) and a panel of clinicians participated in the questionnaire (53 resources: 23 material, 18 human and 12 pharmaceutical) and a consensus round. We performed descriptive analyses for both panels. Seventeen PHEs and 16 clinicians from nine and four countries respectively participated in the study. Consensus between the two panels was observed on 40 resources (16 material, 14 human, 10 pharmaceutical; 33 included and seven rejected). Notably, clinicians selected three home care resources while PHEs did not, and PHEs included two pharmaceutical resources which clinicians did not. No consensus was observed on 13 resources. Eleven additional resources were suggested (five by PHEs and six by clinicians) and included amongst which personal protective equipment for mobile teams, resources for primary care and resources related to mechanical ventilation. There was consensus on 40 resources, of which 33 were included and seven rejected. There was no consensus on 13 resources, notably regarding home care and pharmaceutical resources, which reflects the different priorities of PHEs and clinicians in pandemic planning. This study highlights a set of resources to prioritize for pandemic preparedness activities, and shows the importance of including experts from varied backgrounds. Including these resources in pandemic models and preparedness exercise scenarios allows training on resource gaps and supports evidence-based decision making during future outbreaks.