‘Clustering of exemptions’ as a collective action threat to herd immunity

Abstract

The Intensive Care Unit (ICU) has the highest annual mortality rate (4.4M) of any hospital unit or 25% of all clinical admissions. Studies show a relationship between clinician cognitive load and workflow, and their impact on patient safety and the subsequent occurrence of medical mishaps due to diagnostic error -in spite of advances in health information technology, e.g., bedside and clinical decision support (CDS) systems. The aim of our research is to: 1) investigate the root causes (underlying mechanisms) of ICU error related to the effects of clinical workflow: medical cognition, team communication/collaboration, and the use of diagnostic/CDS systems and 2) construct and validate a novel workflow model that supports improved clinical workflow, with goals to decrease adverse events, increase safety, and reduce intensivist time, effort, and cognitive resources. Lastly, our long-term objective is to apply data from aims one and two to design the next generation of diagnostic visualization-communication (VizCom) system that improves intensive care workflow, communication, and effectiveness in healthcare.

The effect of opinion clustering on disease outbreaks

“…If an unvaccinated individual is more likely to be in contact with other unvaccinated individuals than would be expected by chance, clusters of susceptible individuals will form and thus constitute a subpopulation in which the disease can spread and cause local outbreaks. Such susceptibility clusters have been observed in the USA (May & Silverman 2003;Parker et al 2006) and are thought to play a major role in the current outbreaks in Europe (Richard et al 2008;Schmid et al 2008).…”

Countering Vaccine Hesitancy

“…Control of many vaccinepreventable diseases is contingent on a significant proportion of the population in a community being immune. 26 Depending on the disease, the percentage of individuals required to achieve herd immunity in a community ranges from 30% to 95%. 27 Traditionally, immunization rates have been maintained in the United States through mandatory vaccination requirements for entry into and advancement through licensed child care centers and schools.…”

The Challenges in Measuring Local Immunization Coverage: A Statewide Case Study

“…4 Unimmunized individuals can spread VPDs by living in the same neighborhood, 5 going to the same school, 6,7 attending the same church 8 or in the case of the Disneyland outbreak, frequenting the same tourist attraction. 9 Existing surveillance systems often do not have enough granularity to detect these clusters of unvaccinated individuals.…”