Disease X simulation exercises for interdisciplinary scientific advice

Background

Effective pandemic response requires scientific advice that integrates biomedical, societal and economic perspectives. However, how such integrated advice is produced in practice, particularly under time pressure and across outbreak phases, remains insufficiently understood. This study uses scenario-based simulation exercises to examine how integrated scientific advice is produced.

Methods

Within the BePrepared project, we conducted three scenario-based simulation exercises in the Netherlands, modelling advisory processes during a fictional Disease X outbreak across alert, pandemic, and transition phases. Approximately 20–25 experts from biomedical and social-economic sciences first developed discipline-specific advice, followed by integrated advice in mixed groups using a structured assessment framework. Observations, discussion notes, and advisory outputs were analysed using thematic analysis.

Results

Integrated advice was feasible but depended on pre-existing institutional structures. Topics involving competing perspectives (e.g. public health measures affecting children, proportionality of interventions, and risks of stigmatisation) benefited most from interdisciplinary deliberation. Integration required explicit articulation of assumptions, alignment of problem framing, and translation across disciplines. The exercises revealed how data needs and time pressure differed across outbreak phases, shaping the feasibility of integration. Structured deliberation and prior collaboration facilitated integration, while disciplinary separation limited cross-domain interpretation.

Conclusions

Simulation exercises provide a practical approach to testing and strengthening interdisciplinary scientific advice. Their value lies in enabling cross-disciplinary interaction under realistic outbreak conditions and across phases. Investing in such preparedness infrastructures may improve the coherence and usability of scientific advice in infectious disease crises.

Key messages

• Simulation exercises show that integrated scientific advice is feasible but depends on structured collaboration and alignment of disciplinary perspectives.

• Testing advisory processes across outbreak phases can strengthen preparedness for interdisciplinary decision-making in infectious disease crises.