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Models for managing surge capacity in the face of an influenza epidemic.

机译:面对流行性感冒时管理容量激增的模型。

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摘要

Influenza pandemics pose an imminent risk to society. Yearly outbreaks already represent heavy social and economic burdens. A pandemic could severely affect infrastructure and commerce through high absenteeism, supply chain disruptions, and other effects over an extended and uncertain period of time. Governmental institutions such as the Center for Disease Prevention and Control (CDC) and the U.S. Department of Health and Human Services (HHS) have issued guidelines on how to prepare for a potential pandemic, however much work still needs to be done in order to meet them. From a planner's perspective, the complexity of outlining plans to manage future resources during an epidemic stems from the uncertainty of how severe the epidemic will be. Uncertainty in parameters such as the contagion rate (how fast the disease spreads) makes the course and severity of the epidemic unforeseeable, exposing any planning strategy to a potentially wasteful allocation of resources.;Our approach involves the use of additional resources in response to a robust model of the evolution of the epidemic as to hedge against the uncertainty in its evolution and intensity. Under existing plans, large cities would make use of networks of volunteers, students, and recent retirees, or borrow staff from neighboring communities. Taking into account that such additional resources are likely to be significantly constrained (e.g. in quantity and duration), we seek to produce robust emergency staff commitment levels that work well under different trajectories and degrees of severity of the pandemic.;Our methodology combines Robust Optimization techniques with Epidemiology (SEIR models) and system performance modeling. We describe cutting-plane algorithms analogous to generalized Benders' decomposition that prove fast and numerically accurate. Our results yield insights on the structure of optimal robust strategies and on practical rules-of-thumb that can be deployed during the epidemic. To assess the efficacy of our solutions, we study their performance under different scenarios and compare them against other seemingly good strategies through numerical experiments. This work would be particularly valuable for institutions that provide public services, whose operations continuity is critical for a community, especially in view of an event of this caliber. As far as we know, this is the first time this problem is addressed in a rigorous way; particularly we are not aware of any other robust optimization applications in epidemiology.
机译:流感大流行给社会带来了迫在眉睫的风险。每年的暴发已经给社会和经济造成沉重负担。大流行可能会在旷日持久且不确定的时间内通过高缺勤率,供应链中断以及其他影响严重影响基础设施和商业。政府机构,如疾病预防控制中心(CDC)和美国卫生与公共服务部(HHS)已发布了有关如何为可能的大流行做好准备的指南,但是,要满足这一要求,仍需做大量工作他们。从计划者的角度来看,概述在流行病期间管理未来资源的计划的复杂性源于流行病的严重程度尚不确定。诸如传染率(疾病传播的速度)之类的参数的不确定性使该流行病的病程和严重性无法预料,从而使任何规划策略都面临资源的潜在浪费分配;我们的方法涉及使用额外的资源来应对流行病演变的鲁棒模型,以对付其演变和强度的不确定性。根据现有计划,大城市将利用志愿者,学生和最近退休的人的网络,或从邻近社区借用人员。考虑到此类额外资源可能会受到严重限制(例如,数量和持续时间),我们力求产生强大的应急人员承诺水平,使其在大流行的不同轨迹和严重程度下都能很好地工作。流行病学技术(SEIR模型)和系统性能建模。我们描述了类似于广义Benders分解的切面算法,该算法证明了快速且数值准确。我们的结果得出了关于最佳鲁棒策略的结构以及在流行期间可以部署的实际经验法则的见解。为了评估我们解决方案的有效性,我们研究了它们在不同情况下的性能,并通过数值实验将它们与其他看似好的策略进行了比较。这项工作对于提供公共服务的机构特别有价值,因为公共机构的运营连续性对于社区至关重要,尤其是考虑到这种能力的事件。据我们所知,这是第一次以严格的方式解决这个问题。特别是我们不知道流行病学中还有其他强大的优化应用程序。

著录项

  • 作者单位

    Columbia University.;

  • 授予单位 Columbia University.;
  • 学科 Health Sciences Public Health.;Operations Research.
  • 学位 Ph.D.
  • 年度 2013
  • 页码 115 p.
  • 总页数 115
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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