How prepared are we? The organizational network responses in two infectious disease outbreak scenarios in the Netherlands

The paper will report results of a research project on the organizational network response to prevent or contain an outbreak of an infectious disease in the Netherlands. The paper is one of the first to present an attempt to conduct an ex ante evaluation of a response network in a likely future scenario. The analysis is based on complete network data of the Dutch public health response system that is formed around the National Institute for Public Health and the Environment (RIVM) which functions as the National Coordination Authority (NCA) (the Dutch equivalent to the American CDC). Data collection was conducted via questionnaires and interviews on the basis of two scenarios. One scenario is an outbreak of a new corona virus characterized by human-to- human transmission. A second scenario is an outbreak of the West Nile Virus, transmitted by mosquitoes. Both viruses can have severe health consequences, including death. Key for the response is a quick mobilization of the relevant actors and resources based on the transmission characteristics of the disease and an effective and efficient distribution of information. Equally important, after a successful mobilization of actors and resources, is sustained coordination in the network, in order to allow for adaptation of the response as the outbreak evolves. The major challenge for a national coordinator during outbreak management is the inclusion of a large number of heterogeneous actors in a complex process (outbreak management) consisting of several varying sub-processes (e.g. integration of scientific knowledge about the pathogen and risk groups with laboratory and epidemiological processes to understand the actual outbreak, developing and supporting the implementation of context specific control measures, risk communication to health care professionals and general public, etc). The analysis shows that potentially up to 150 actors are involved in such a response and the paper presents the potential collaboration and information diffusion structure. In the paper, we use the framework on organizational forms developed by Puranam et al. (2014) who identify four challenges each organizational form needs to address, i.e. task division, task allocation, reward and information provision, as a general framework to evaluate the organizational preparedness of these networks on the basis of network data and the special role a national coordination authority within the response network. We discuss to what extent relational data is sufficient for an ex ante evaluation or what other data and measures we should develop and collect in order to come to a better ex ante assessment of the organizational preparedness of goal directed networks.