title: Modeling in Real Time During the Ebola Response.
abstract: To aid decision-making during CDC's response to the 2014-2016 Ebola virus disease (Ebola) epidemic in West Africa, CDC activated a Modeling Task Force to generate estimates on various topics related to the response in West Africa and the risk for importation of cases into the United States. Analysis of eight Ebola response modeling projects conducted during August 2014-July 2015 provided insight into the types of questions addressed by modeling, the impact of the estimates generated, and the difficulties encountered during the modeling. This time frame was selected to cover the three phases of the West African epidemic curve. Questions posed to the Modeling Task Force changed as the epidemic progressed. Initially, the task force was asked to estimate the number of cases that might occur if no interventions were implemented compared with cases that might occur if interventions were implemented; however, at the peak of the epidemic, the focus shifted to estimating resource needs for Ebola treatment units. Then, as the epidemic decelerated, requests for modeling changed to generating estimates of the potential number of sexually transmitted Ebola cases. Modeling to provide information for decision-making during the CDC Ebola response involved limited data, a short turnaround time, and difficulty communicating the modeling process, including assumptions and interpretation of results. Despite these challenges, modeling yielded estimates and projections that public health officials used to make key decisions regarding response strategy and resources required. The impact of modeling during the Ebola response demonstrates the usefulness of modeling in future responses, particularly in the early stages and when data are scarce. Future modeling can be enhanced by planning ahead for data needs and data sharing, and by open communication among modelers, scientists, and others to ensure that modeling and its limitations are more clearly understood. The activities summarized in this report would not have been possible without collaboration with many U.S. and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).
authors.affiliation: Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases, CDC.
authors.forename: Martin I
authors.initials: MI
authors.lastname: Meltzer
authors.forename: Scott
authors.initials: S
authors.lastname: Santibanez
authors.forename: Leah S
authors.initials: LS
authors.lastname: Fischer
authors.forename: Toby L
authors.initials: TL
authors.lastname: Merlin
authors.forename: Bishwa B
authors.initials: BB
authors.lastname: Adhikari
authors.forename: Charisma Y
authors.initials: CY
authors.lastname: Atkins
authors.forename: Caresse
authors.initials: C
authors.lastname: Campbell
authors.forename: Isaac Chun-Hai
authors.initials: IC
authors.lastname: Fung
authors.forename: Manoj
authors.initials: M
authors.lastname: Gambhir
authors.forename: Thomas
authors.initials: T
authors.lastname: Gift
authors.forename: Bradford
authors.initials: B
authors.lastname: Greening
authors.forename: Weidong
authors.initials: W
authors.lastname: Gu
authors.forename: Evin U
authors.initials: EU
authors.lastname: Jacobson
authors.forename: Emily B
authors.initials: EB
authors.lastname: Kahn
authors.forename: Cristina
authors.initials: C
authors.lastname: Carias
authors.forename: Lina
authors.initials: L
authors.lastname: Nerlander
authors.forename: Gabriel
authors.initials: G
authors.lastname: Rainisch
authors.forename: Manjunath
authors.initials: M
authors.lastname: Shankar
authors.forename: Karen
authors.initials: K
authors.lastname: Wong
authors.forename: Michael L
authors.initials: ML
authors.lastname: Washington
mesh_terms: D000354:Africa, Western / Q000453:epidemiology; D002487:Centers for Disease Control and Prevention, U.S. / Q000458:organization & administration*; D058872:Epidemics / Q000517:prevention & control*; D005544:Forecasting; D019142:Hemorrhagic Fever, Ebola / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007391:International Cooperation; D008962:Models, Theoretical; D024382:Professional Role; D014481:United States