Objectives To investigate that given a fixed amount of financial resources,what is the optimal combination of vaccine and antiviral stockpiles in terms of minimizing the attack rate.Methods Mathematic modeling was use...Objectives To investigate that given a fixed amount of financial resources,what is the optimal combination of vaccine and antiviral stockpiles in terms of minimizing the attack rate.Methods Mathematic modeling was used to simulate the dynamics that with fixed influenza pandemic budget.Different budget conditions were observed if the combination changed.Framework between vaccines and antivirals was introduced by taking into account the uncertainty in vaccine and antiviral efficacy.Results Given a fixed budget,different budget allocations between vaccines and antivirals stockpile gave different attack rates.When the price of vaccine was lower than or similar with the antivirals,the attack rate increased with increasing investment in antiviral.But if the price of the vaccine was higher than the antivirals,the attack rate may not decrease with increasing investment in vaccine.Fixed the vaccine effectiveness,higher effectiveness of antiviral got a lower attack rate.When both antiviral and vaccine were with 50%probability of effectiveness,the attack rate changed by antiviral stockpile with a same pattern as they were with 100%efficacy probability,even it has a higher attack rate.Conclusions Assume the antivirals have 100%probability to be effective,budget was limited to a fix number,then in any event,population should stockpile a small amount of antivirals such that if the post-vaccination reproductive number turns out to be near 1,the additional intervention may further reduce the reproductive number to <1 and prevent the epidemic.Under the fixed budget,the price of the vaccines and antivirals will strongly affect the strategy of the stockpile allocation.When the price of vaccine is comparative lower,more investment of vaccine is better for the pandemic control,but if the vaccine price is too high then more investment in antiviral may be better.We found that attack rates and the optimal budget allocation depend on the probability to be effective of vaccine and antivirals.展开更多
Recent developments in computational sciences and computer modeling have allowed emergency preparedness exercises to include simulation models as supporting tools. These simulation models are generally built for predi...Recent developments in computational sciences and computer modeling have allowed emergency preparedness exercises to include simulation models as supporting tools. These simulation models are generally built for predicting temporal and geographic patterns of disease spread. However sole use of simulation models in exercise design falls short in terms of incorporating policy decision makers＇ preferences into decision-making processes. In this paper, a general framework for exercising public health preparedness plans with a decision support system is presented to integrate estimation of key epidemiological parameters with a system dynamics model of an outbreak. A multi-criteria decision making framework, an Analytical Hierarchy Process model, is then developed and integrated with the simulation model to help public health policy makers prioritize their response goals and evaluate mitigation strategies in a table-top exercise environment.展开更多
文摘Objectives To investigate that given a fixed amount of financial resources,what is the optimal combination of vaccine and antiviral stockpiles in terms of minimizing the attack rate.Methods Mathematic modeling was used to simulate the dynamics that with fixed influenza pandemic budget.Different budget conditions were observed if the combination changed.Framework between vaccines and antivirals was introduced by taking into account the uncertainty in vaccine and antiviral efficacy.Results Given a fixed budget,different budget allocations between vaccines and antivirals stockpile gave different attack rates.When the price of vaccine was lower than or similar with the antivirals,the attack rate increased with increasing investment in antiviral.But if the price of the vaccine was higher than the antivirals,the attack rate may not decrease with increasing investment in vaccine.Fixed the vaccine effectiveness,higher effectiveness of antiviral got a lower attack rate.When both antiviral and vaccine were with 50%probability of effectiveness,the attack rate changed by antiviral stockpile with a same pattern as they were with 100%efficacy probability,even it has a higher attack rate.Conclusions Assume the antivirals have 100%probability to be effective,budget was limited to a fix number,then in any event,population should stockpile a small amount of antivirals such that if the post-vaccination reproductive number turns out to be near 1,the additional intervention may further reduce the reproductive number to <1 and prevent the epidemic.Under the fixed budget,the price of the vaccines and antivirals will strongly affect the strategy of the stockpile allocation.When the price of vaccine is comparative lower,more investment of vaccine is better for the pandemic control,but if the vaccine price is too high then more investment in antiviral may be better.We found that attack rates and the optimal budget allocation depend on the probability to be effective of vaccine and antivirals.
文摘Recent developments in computational sciences and computer modeling have allowed emergency preparedness exercises to include simulation models as supporting tools. These simulation models are generally built for predicting temporal and geographic patterns of disease spread. However sole use of simulation models in exercise design falls short in terms of incorporating policy decision makers＇ preferences into decision-making processes. In this paper, a general framework for exercising public health preparedness plans with a decision support system is presented to integrate estimation of key epidemiological parameters with a system dynamics model of an outbreak. A multi-criteria decision making framework, an Analytical Hierarchy Process model, is then developed and integrated with the simulation model to help public health policy makers prioritize their response goals and evaluate mitigation strategies in a table-top exercise environment.
