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Pandemic Recovery Metrics to Drive Equity (PanREMEDY): Guidelines for State and Local Leaders in Anticipation of Future Catastrophic Outbreaks

Monica Schoch-Spana, Sanjana Ravi, AIshwarya Nagar, Christina Potter, and Tyrone Peterson

The Pandemic Recovery Metrics to Drive Equity – PanREMEDY project sought to give form to the least considered phase of a catastrophic outbreak of infectious disease, while applying an equity lens. The project inquired, “By what measures could local and state decision-makers know that efforts at holistic recovery were working, especially for the socially vulnerable individuals and communities hit hardest by COVID-19?”

To answer this question, the project team gathered and analyzed a wide range of evidence. They consulted disaster recovery and resilience experts, convened a scoping symposium, reviewed academic and gray literature on epidemic/pandemic recovery, and elicited input from diverse participants via listening sessions. Based upon thematic analyses of these inputs, the team generated an initial set of 44 indicators and distilled ethical and practical considerations concerning their implementation.

The PanREMEDY indicators were ordered into 2 categories—recovery system organization and operations and system outcomes, the latter of which could be thought of as community status:

Organization and Operations

  • Governance and Leadership: political authority, collective action, financing structures, public face

  • Planning: guiding framework, time horizons, technical expertise, aligned futures

  • Data Management: actionable data, disaggregated data, extant data, community contextualization

  • Public Involvement: representative bodies, feedback loops, community dashboards

Outcomes

  • Human Health: epidemiological curve, disrupted care, disease sequelae, healthcare infrastructure, health insurance

  • Human Development: healthy housing, adequate nutrition, safety/security, educational attainment, connectivity/mobility

  • Economic Vitality: earning power, entrepreneurship, work protections, neighborhood pulse, thriving grassroots

  • Political Integrity: power-sharing, equity structures, safety net, public trust, inventive policy

  • Social Fabric: connectedness, collective impact, stigma repair, caretaking

  • Emotional Wellbeing: truth-telling, public memorialization, psychological supports, self-medication, relief/resolution

Subsequently, a panel of practitioners, community advocates, subject matter experts, and local government leaders rated the indicators according to importance (ie, salience to holistic recovery) and feasibility (ie, ease of application).

Developed in the COVID-19 context, the PanREMEDY project’s findings can prompt further learning and actions specific to that pandemic. At the same time, the findings offer a more general framework with which to prepare communities for future pandemics. End-users are encouraged to tailor the indicators to their context, including local values, programmatic priorities, and political environments.

With the PanREMEDY indicators in hand, state and local leaders and other community members can better assess how well their jurisdictions are:

  • Rebounding from the worst effects of the COVID-19 pandemic

  • Targeting support to COVID-19 survivors who still need help

  • Engaging in pre-event planning for future post-pandemic recovery

  • Strengthening resilience to the increasing likelihood of future pandemics

  • Motivating non-traditional partners to join in pandemic preparedness efforts.

Baltimore MD: Johns Hopkins Center for Health Security; 2024.