A new paper in Nature Health calls for behavioural experimentation to become a core pillar of pandemic preparedness, arguing that digital tools can help scientists test how people respond to outbreaks before the next global health crisis begins.

An international team of researchers, including Professor Melinda Mills and Professor Christophe Fraser, has proposed an imaginative idea to address one of the most significant gaps exposed by COVID-19, bringing together expertise from the Oxford Martin School’s Digital Pandemic Preparedness programme, the Leverhulme Centre for Demographic Science (LCDS), and Oxford Population Health at the University of Oxford, in collaboration with colleagues from the Pandemic Sciences Institute and international partners. 

While scientific advances now allow researchers to sequence a novel virus within weeks and develop vaccines at unprecedented speed, we still lack robust, scalable ways to study how human behaviour shapes disease transmission.

Respiratory pathogens such as influenza and coronaviruses spread through social contact. Yet epidemic models often rely on simplified assumptions about behaviour, partly because high-quality empirical data about the structure of contact networks and patterns of social interactions, attitudes and real-world decisions remain limited.

COVID-19 demonstrated how profoundly human choices influence the course of an outbreak. Decisions about isolating, testing, mask-wearing and vaccination altered transmission patterns worldwide. However, researchers had few experimental tools to rigorously test which behavioural interventions would work best, and under what conditions.

The paper proposes a new digital research infrastructure built around what the authors call “epigames” – smartphone-based, gamified epidemic simulations conducted in real-world settings.

Participants would download an app and join a simulated outbreak unfolding in their everyday environment, such as a university campus, workplace or conference. Bluetooth signals between smartphones would capture proximity and contact duration, enabling researchers to construct high-resolution maps of social contact networks.

At the same time, participants would make decisions within the app, such as whether to self-isolate after exposure, take a test or accept a vaccine. Incentives built into the game would reflect real-world trade-offs, creating measurable consequences for different choices. Surveys conducted before, during and after the simulation would capture attitudes and perceptions, allowing researchers to compare what people say they would do with what they actually do when faced with simulated risk.

By experimentally varying incentives and social information, including messages about peer behaviour, researchers could test which strategies most effectively encourage protective action and reduce transmission. The resulting data would link real-life contact networks with behavioural and attitudinal insights at a level of detail not currently possible.

The authors argue that this type of integrated, digital experimentation could provide the empirical foundation needed to improve epidemic modelling. High-resolution behavioural and network data could be used to calibrate more realistic agent-based models and to evaluate interventions before they are deployed in a real crisis.

The paper concludes that behavioural and network experimentation via digital technology should be elevated to a strategic priority in pandemic preparedness. Just as genome sequencing became a global capability during COVID-19, the authors contend that understanding how behaviour drives transmission must now become a core component of preparing for future threats, so that we better understand not only how pathogens evolve, but how people respond.