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

Stratil, J. M.; Arnold, L.

Background: Decision-making on matters of public health requires the balancing of numerous, often conflicting factors. One approach to ensure relevancy and comprehensiveness of the criteria underpinning the decision is a broad societal discourse and participatory decision-making process. However, this often was not feasible within the time constraints imposed on by the SARS-CoV-2 pandemic. While not able or intended to replace stakeholder participation, evidence-to-decision frameworks can serve as a tool to approach relevancy and comprehensiveness of the criteria considered, even if not all voices of affected stakeholders could be heard in the process. Objective: The objective of this research project was to develop a decision-making framework adapted to the challenges decision-makers face when deliberating on national and sub-national level on non-pharmacological interventions (NPIs) measures to address the global SARS-CoV-2 pandemic. Methods: We used the WHO-INTEGRATE framework Version 1.0 as a starting point. In phase I, we adapted the framework through brainstorming exercises and application to exemplary case studies. In phase II, we used the best-fit framework synthesis technique with the output of phase I serving as a priori framework. We conducted a content analysis of comprehensive strategy documents intended to guide the policy makers on the phasing out of the lockdown measures in Germany. Based on factors and criteria identified in this process, we adapted previous versions into the WHO-INTEGRATE COVID framework (WICID framework) Version 1.0. Results: Twelve comprehensive strategy documents were included in the content analysis. The revised WICID framework consists of eleven criteria, which are expanded on through 49 aspects contained within them, and the metacriterion quality of evidence. The criteria cover implications for the health of individuals and populations due to and beyond COVID-19, infringement on liberties and fundamental rights, acceptability considerations, societal, environmental, and economic implications, as well as resource and feasibility considerations. Discussion: In a third phase, the framework will be expanded through a comprehensive document analysis focusing on key-stakeholder groups across the society. The WICID framework V1.0 can be a tool to support comprehensive evidence-informed decision-making processes.