Transdisciplinary training to address challenges in genomic epidemiology of infectious diseases

Samuel L. Hong^1*Marie Stockman²Jorge Ricardo Nova Blanco²Casper Van Cleemput²Ambroise AHOUIDI³Blas Armien⁴Ana Bento⁵Nena Bollen¹César Conde Pereira⁶Carla Freitas⁷Marije Hofstra⁸Michael R. Jordan^10,11,9Simone Kashima^12,13Crhistinne Cavalheiro Maymone Gonçalves¹⁴Carlos Frederico Campelo de Albuquerque e Melo¹⁵Kanika Nahata¹Elaine Cristina de Oliveira¹⁶Liz Parra¹⁷Carlos Saenz¹⁸Walban de Souza¹⁹Maja Stanojevic²⁰Peter MacGarr Rabinowitz^{21,22,23,24,25}Anne-Mieke Vandamme^11,2*

• ¹KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Laboratory of Evolutionary and Computational Virology, Leuven, Belgium
• ²KU Leuven, Department of Microbiology, Immunology and Transplantation, Rega Institute for Medical Research, Clinical and Epidemiological Virology, Institute for the Future, Leuven, Belgium
• ³IRESSEF: Institut de Recherche en Santé, de Surveillance Epidemiologique et de Formations, Dakar, Senegal
• ⁴Departamento de Investigación de Enfermedades Emergentes y Zoonóticas - DIEEZ-ICGES, Instituto Conmemorativo Gorgas de Estudios de la Salud, Ciudad de Panamá, Panama
• ⁵Department of Public and Ecosystem Health, Cornell University, Ithaca, New York, United States
• ⁶Dirección del Laboratorio Nacional de Salud, Ministerio de Salud Pública y Asistencia Social, Ciudad de Guatemala, Guatemala
• ⁷General Coordination of Public Health Laboratories, Health and Environmental Surveillance Secretariat, Ministry of Health of Brazil, Brasilia, Brazil
• ⁸Centre for Epidemic Response Innovation (CERI), School for Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa
• ⁹Collaboratory for Emerging Infectious Diseases and Response, Tufts University, Boston, Massachusetts, United States
• ¹⁰Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, United States
• ¹¹Center for Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
• ¹²Blood Center of Ribeirão Preto, São Paulo, Brazil
• ¹³Medical School of Ribeirão Preto, São Paulo, Brazil
• ¹⁴Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil
• ¹⁵Panamerican Health Organization, World Health Organization, Brasilia, Brazil
• ¹⁶Central Public Health Laboratory, Mato Grosso State Health, Mato Grosso, Brazil
• ¹⁷Panamerican Health Organization, World Health Organization, Guatemala City, Guatemala
• ¹⁸Nicaragua Ministry of Health, Managua, Nicaragua
• ¹⁹Labor – Health Supply, São Paulo, Brazil
• ²⁰University of Belgrade Faculty of Medicine, Institute of Microbiology and Immunology, Belgrade, Serbia
• ²¹University of Washington, Department of Environmental and Occupational Health Science, Seattle, Washington, United States
• ²²University of Washington, Department of Global Health, Seattle, Washington, United States
• ²³University of Washington, Department of Family Medicine, Seattle, Washington, United States
• ²⁴Division of Allergy and Infectious Disease, University of Washington, Department of Medicine, Seattle, Washington, United States
• ²⁵University of Washington, Center for One Health Research, Seattle, Washington, United States

During the COVID-19 pandemic, the emergence and detection of SARS-CoV-2 variants of concern highlighted the pivotal role of genomic epidemiology in public health decision and policy making. The pandemic also revealed a need for genomic epidemiologists to effectively engage with a broader audience, including policymakers and the public. To address this need, we introduced a new transdisciplinary training workshop, "From Trees to Public Health Policy", at the Virus Evolution and Molecular Epidemiology (VEME) 2022 workshop in Panama City, designed to foster an enhanced understanding of the current challenges translating the results of genomic epidemiology into public health decision-making. Transdisciplinarity provides a collaborative problem-solving approach that integrates multiple disciplines and stakeholders to address complex and difficult to define problems, often referred to as "wicked problems". We argue that training in transdisciplinary approaches within genomic epidemiology will more effectively prevent, prepare for, and mitigate future pandemic risks. Here, we introduce this new module and methodology, along with detailed output, reflections on its implementation and outcomes, as well as areas for improvement for future iterations of the workshop. Workshop participants (n=19) were selected across multiple levels of the genomic surveillance-to-policy continuum and split into two groups to engage in a four-day transdisciplinary learning process using the Designing Feasible Futures Framework (DF3). Through iterative exercises, participants mapped the complexity of the genomic surveillance for public health system, identifying leverage points for intervention, multi-sectoral stakeholders involved, and exploring futures scenarios following the proposed interventions. The two working groups developed complementary approaches: one prioritizing data infrastructure in low-resource settings, and the other emphasizing community trust and engagement. Evaluation of the workshop included pre-and post-workshop questionnaires, group self-evaluations, and confidential feedback. Group evaluations revealed varying levels of happiness and frustration throughout the iterative activities, and pre-post assessments showed statistically significant improvements in participants' self-reported confidence in understanding wicked problems, systems thinking, and transdisciplinary collaboration. The proportion of participants endorsing shared decision-making across scientists, policymakers, and other stakeholders increased from 50% to 82%. Overall, this pilot workshop showed the feasibility and value of transdisciplinary training for practitioners of genomic epidemiology.