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\"A fascinating window into the secret life of epidemiology, weaving together stories of triumph and tragedy, with a boots-on-the-ground perspective on how we can avert the next public health crisis There are few visible markers of the accomplishments of public health. If epidemiologists do their jobs, nothing happens. An outbreak does not grow into an epidemic. A child does not go hungry. A would-be smoker never lights up. These achievements are rarely noticed or celebrated, but Caitlin Rivers lives for such victories. By making sure that things don't happen, she and legions of scientists, practitioners, and policymakers change the course of history. We have many of the tools and experiences needed to prevent the next crisis, but countless challenges remain, including constantly emerging pathogens, the rapid growth of biotechnology, and the inconsistent cycles of funding for government organizations like the CDC. Progress can be slow, even with the next pandemic potentially right around the corner, but the unsung heroes in public health remain focused on their missions. Crisis Averted is their story-from the eradication of smallpox in the 20th century to today's safeguards against extraterrestrial germs. By taking a candid look at how we solve problems in public health, Caitlin Rivers illuminates the role of epidemiology in all our lives and lays out the case for what can be accomplished, given sufficient vision, leadership, and resources. Crisis Averted is an inspiring and galvanizing clarion call for us to work together towards a healthier, more resilient future\"-- Provided by publisher.

An Ebola outbreak of unprecedented scope emerged in West Africa in December 2013 and presently continues unabated in the countries of Guinea, Sierra Leone, and Liberia. Ebola is not new to Africa, and outbreaks have been confirmed as far back as 1976. The current West African Ebola outbreak is the largest ever recorded and differs dramatically from prior outbreaks in its duration, number of people affected, and geographic extent. The emergence of this deadly disease in West Africa invites many questions, foremost among these: why now, and why in West Africa? Here, we review the sociological, ecological, and environmental drivers that might have influenced the emergence of Ebola in this region of Africa and its spread throughout the region. Containment of the West African Ebola outbreak is the most pressing, immediate need. A comprehensive assessment of the drivers of Ebola emergence and sustained human-to-human transmission is also needed in order to prepare other countries for importation or emergence of this disease. Such assessment includes identification of country-level protocols and interagency policies for outbreak detection and rapid response, increased understanding of cultural and traditional risk factors within and between nations, delivery of culturally embedded public health education, and regional coordination and collaboration, particularly with governments and health ministries throughout Africa. Public health education is also urgently needed in countries outside of Africa in order to ensure that risk is properly understood and public concerns do not escalate unnecessarily. To prevent future outbreaks, coordinated, multiscale, early warning systems should be developed that make full use of these integrated assessments, partner with local communities in high-risk areas, and provide clearly defined response recommendations specific to the needs of each community.

Abbreviations: ICMJE, International Committee of Medical Journal Editors; NIH, National Institutes of Health; WHO, World Health Organization Provenance: Not commissioned; externally peer-reviewed Summary Points * The recent outbreaks caused by Ebola and Zika viruses highlighted the importance of medical and public health research in accelerating outbreak control and prompted calls for researchers to share data rapidly and widely during public health emergencies. * Effective preparation for emergencies requires the routine practice of data sharing in scientific research. * Key impediments to data sharing, such as long-standing academic norms and human and technical resource limitations, cannot immediately be surmounted when an emergency occurs. * Ongoing research that does not directly relate to an emergency now may be critical for the next unpredictable outbreak. * As part of emergency preparedness, the scientific community should support ongoing initiatives that address major obstacles to data sharing and should embrace open science practices in both emergency and nonemergency research. In 2003, the United States National Institutes of Health (NIH) began requiring a data-sharing plan for grant applications with annual costs over US$500,000; a 2013 national survey found that 65% of life science researchers thought the NIH policies had been influential in increasing data sharing [10].

Infectious disease modeling has played a prominent role in recent outbreaks, yet integrating these analyses into public health decision-making has been challenging. We recommend establishing ‘outbreak science’ as an inter-disciplinary field to improve applied epidemic modeling.

Forecasting is beginning to be integrated into decision-making processes for infectious disease outbreak response. We discuss how technologies could accelerate the adoption of forecasting among public health practitioners, improve epidemic management, save lives, and reduce the economic impact of outbreaks.

Although case counts might be dropping, the public-health community must focus on containing the epidemic completely. Although case counts might be dropping, the public-health community must focus on containing the epidemic completely. Portrait of Caitlin Rivers

About the Authors: Caitlin Rivers * E-mail: crivers6@jhu.edu Affiliation: Johns Hopkins Center for Health Security, Maryland, United States of America ORCID logo http://orcid.org/0000-0001-8265-0629 Simon Pollett Affiliations Viral Diseases Branch, Walter Reed Army Institute of Research, Marlyand, United States of America, Uniformed Services University of the Health Sciences, Maryland, United States of America, Marie Bashir Institute, University of Sydney, New South Wales, Australia Cecile Viboud Affiliation: National Institutes of Health, Maryland, United States of America Citation: Rivers C, Pollett S, Viboud C (2020) The opportunities and challenges of an Ebola modeling research coordination group. In response to the protracted Ebola virus outbreak in the Democratic Republic of Congo, the international public health community called for increased attention, coordination, and resources to support the response. [...]it allowed resources such as open access data and parameter estimates to be shared, thereby improving model quality, comparability, and efficiency of the modeling process. [...]we have demonstrated how this model coordination framework could readily be adopted by other groups for future epidemics and indeed has been so in the current COVID-19 outbreak [17].