Better public decisions on COVID-19: A thought experiment in metrics

OBJECTIVES: Poor decision-making is a hallmark of the COVID-19 pandemic. Better metrics would help improve decision-makers' understanding of the scope of the pandemic and allow for better public understanding/review of these decisions. STUDY DESIGN: Two novel metrics of disease impact were compared with more commonly used standard metrics. METHODS: A multi-criteria decision analysis technique, used previously to support metric selection in solid waste planning, was adapted to compare number of deaths, hospitalisations, positive test results and positivity rates (standard COVID-19 impact metrics) with a simple model that estimates the total number of potentially infectious people in an area and an associated odds ratio for infectious people. RESULTS: The odds ratio and total infectious population estimate metrics scored better in a comparison analysis than number of deaths, hospitalisations, positive test results and positivity rates (in that order). CONCLUSIONS: The novel metrics provide a more effective means of communication than other more common measures of the outbreak. These superior metrics should support decision-making processes and result in a more informed population.