Ethical dilemma arises from optimizing interventions for epidemics in heterogeneous populations

Area of Science:

• Epidemiology
• Public Health Policy
• Mathematical Modeling

Background:

• Infectious disease interventions incur significant economic and social costs, limiting their application.
• Mitigation strategies aim to reduce disease spread but face constraints on duration and intensity.

Purpose of the Study:

• To determine the optimal strength of interventions that minimize the final epidemic size for immunity-inducing infections.
• To analyze the ethical implications of optimal intervention strategies in heterogeneous populations.

Main Methods:

• Modeling interventions that reduce the basic reproduction number (R0).
• Analyzing epidemic dynamics to eliminate the overshoot phase and prevent secondary waves.
• Incorporating population heterogeneity and real-world pandemic data.

Main Results:

• Identified an optimal intervention strength that minimizes the final epidemic size.
• Demonstrated that optimal strategies in heterogeneous populations can lead to an ethical dilemma.
• The dilemma is analogous to the trolley problem, highlighting trade-offs in decision-making.

Conclusions:

• Optimizing interventions for minimizing epidemic size presents ethical challenges for policymakers.
• The study underscores the need to consider ethical trade-offs when implementing public health measures.
• Real-world data from three pandemics illustrate the practical relevance of these ethical considerations.