Presentation (CTI)

OBJECTIVES: The COVID-19 pandemic underscored the necessity of timely, evidence-informed policy responses to emerging infectious disease outbreaks. In South Korea, crisis management protocols define decision-making structures but often rely on qualitative judgments rather than data-informed indicators. This study aimed to develop a structured, consensus-based framework using quantifiable indicators to classify epidemic phases of emerging respiratory infectious diseases (ERIDs).
METHODS: A two-round Delphi survey was conducted with 39 multidisciplinary experts representing clinical medicine, public health, and health policy. Participants rated the importance and prioritization of 15 candidate indicators derived from the guidance of the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC). Consensus and stability of indicators were assessed using statistical thresholds, and key indicators were selected based on expert agreement.
RESULTS: Key indicators identified for assessing epidemic phases of ERIDs included: (1) Incidence rate per 100,000 population per week, (2) Case fatality rate per week, (3) Reproduction number (Rt), and (4) New ERID ICU admissions per 100,000 population per week. Experts recommended classifying each selected indicator into three levels of intensity (low/moderate/high), and determining the overall epidemic phase through an aggregate scoring method based on the WHO framework. Evaluation intervals of 3 to 4 weeks were recommended to enable timely detection of epidemiological changes and inform policy adjustments. This framework provides a structured approach based on quantifiable indicators to classify epidemic phases. It facilitates transparent, repeatable policy decisions and can be adapted to local health system capacities and epidemiological contexts.
CONCLUSIONS: This indicator-based framework offers a structured foundation to enhance national preparedness and decision-making in future ERID outbreaks. It contributes to improved data-informed situational awareness, optimized resource allocation, and more ethical, equitable, and coordinated public health responses. Future work will focus on validating threshold levels, fostering community deliberation, and incorporating diverse public input into infectious disease preparedness and response systems.