Hypothetical emergence of poliovirus in 2020: part 1. Consequences of policy decisions to respond using nonpharmaceutical interventions

Objectives As efforts to control COVID-19 continue, we simulate hypothetical emergence of wild poliovirus assuming an immunologically naïve population. This differs from the current global experience with polio and serves as a model for responding future pandemics.Methods Applying established model, assume fully susceptible population polioviruses, independently introduce virus properties each three stable serotypes, explore impact strategies that range doing nothing seeking containment eradication.Results We show dynamics paralytic cases spreads globally. demonstrate difficulty eradication unless aggressive begin soon after initial disease detection. Different serotypes lead different trajectories burdens disease. In absence measures, would become globally endemic in 2–10 years, cumulative exceed 4–40 million depending on serotype, burden shifting younger ages.Conclusions The opportunity eradicate emerging infections represents important public policy choice. If world first observed 2020, adopting have been required prevent devastating pandemic.