PROJECT TRANSFORM

Improving the Speed and Efficacy of Outbreak Investigation Capabilities across the U.S.

Effective outbreak response depends on timely insights into pathogen transmission. Historical

lessons—from Ebola and smallpox to COVID-19—show that understanding transmission

dynamics enables faster, more effective, and less disruptive interventions. However, generating

these insights in real time requires rigorous outbreak investigations (OIs): coordinated efforts to

trace cases, map transmission chains to collect key pieces of intelligence: source, route, time-course of infectiousness, the environmental and behavioral drivers and mitigators of spread, and the effectiveness of countermeasures in decreasing transmission.

In the U.S., conducting and synthesizing OI findings remains a significant operational challenge. States vary in how public health responsibilities are organized, making it difficult to adapt successful approaches across jurisdictions. As a result, the U.S. often lags behind peer countries in producing and using “transmission intelligence” during outbreaks.

The Transmission-informed Outbreak Response & Mitigation Project (Project TransFORM) seeks

to strengthen the speed and effectiveness of outbreak investigations across U.S. jurisdictions.

Our approach is to develop a set of universal exercises and simulations that test the speed and effectiveness of each step of outbreak investigations of a variety of pathogens and contexts. The outcomes of these exercises provides baseline cross-jurisdiction comparable measurements of OI speed and effectiveness, that can help public health leaders optimize their processes, improve coordination across jurisdictions and facilitate collective learning.