Meta-synthesis of COVID-19 lessons: charting sustainable management of future pandemics

Development of the COVID-19 vaccines has been creating a lot of hope for an ultimate return to normality, but returning to normality as we had before would mean we will continue to ignore life-ravaging lessons, as we did for severe acute respiratory syndrome, Ebola, and Middle East respiratory syndrome. This meta-synthesis of COVID-19 lessons charts sustainable pandemic management in terms of choosing strategies that are situated in their contextual specifications and beginning preparations for future application of such strategies from now. To guide selection of a situated strategy, the paper provides a comprehensive list of epidemiological determinants (e.g. communicativeness, poverty, supply chain, density, wind, remoteness); consolidates knowledge about strategies of elimination, suppression and mitigation; and proposes a quantified SWOT analysis of epidemiological determinants that produces coordinates for strategy identification in a Cartesian plane divided into twelve strategy quarters. To guide prior preparations for future application of pandemic management strategies, the paper consolidates lessons learned in implementation of situated strategies and proposes preparations at the national level for elimination, at the local/community level for suppression, and at the regional level for mitigation.