Modeling the Effect of Herd Immunity and Contagiousness in Mitigating a Smallpox Outbreak

Graeden, Ellie; Fielding, Russel; Steinhouse, Kyle E.; Rubin, Ilan N.

doi:10.1177/0272989x14561681

Cited by 14 publications

(14 citation statements)

References 35 publications

(55 reference statements)

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“…On the other hand, the model allows to set the initial distribution of infected individuals, which could be a point of interest for governments in order to evaluate the impact of bioterrorist attacks in megacities. In recent years, bioterrorism has increased the interest in the development of mathematical models of spread of infectious diseases [31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Stochastic Lattice gas Cellular Automata Model for Epidemics

Gualtieri¹,

Hecht²

2016

JLS

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The aim of this study was to develop and explore a stochastic lattice gas cellular automata (LGCA) model for epidemics. A computer program was development in order to implement the model. An irregular grid of cells was used. A susceptible-infected-recovered (SIR) scheme was represented. Stochasticity was generated by Monte Carlo method. Dynamics of model was explored by numerical simulations. Model achieves to represent the typical SIR prevalence curve. Performed simulations also show how infection, mobility and distribution of infected individuals may influence the dynamics of propagation. This simple theoretical model might be a basis for developing more realistic designs.

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Section: Discussionmentioning

confidence: 99%

Stochastic Lattice gas Cellular Automata Model for Epidemics

Gualtieri¹,

Hecht²

2016

JLS

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“…National and state stockpiles Drive-through vaccination clinics, ad hoc clinics Combined medical and nonpharmaceutical countermeasures (33 studies) 8, 23, 31, 39, 45, 46, 54, 69, 73, 76, 77, 79, 86, 92, 96, 114, 121, 123, 131, 136, 145, 156, 162, 163, 168, 182, 186-188, 190, 191, 193, 196 • 12,26,42,53,55,68,81,91,133,144,159,167,169,170,202 • Central command structure to optimize distribution of patients to hospitals Use home health agencies as point of dispensing, use of disaster medical assistance teams to carry out evacuations, using local health work force • Increase inventory visibility and information sharing Optimize equipment and supplies (8 studies) 20,36,49,70,132,138,194,200 • Automated drug distribution cabinet • Strategies to optimally dispense antivirals • Installation of local extraction fans to achieve ventilator performance…”

Section: Specific Strategy and Evidence Basementioning

confidence: 99%

Resource Allocation and Pandemic Response: An Evidence Synthesis To Inform Decision Making

Hempel¹,

Burke²,

Hochman³

et al. 2020

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• When decision makers need to make difficult choices regarding the allocation of scarce resources and pandemic response, potential strategies include: o Reduction of demand for healthcare services through medical countermeasures (e.g., mass vaccination) or nonpharmaceutical interventions (e.g., social distancing); o Optimization of existing resources (e.g., central command structure); o Augmenting resources (e.g., adding temporary facilities or personnel); and o Implementation of crisis standards of care. • We identified 201 studies from January 2011 through May 2020 evaluating resource allocation and pandemic response strategies addressed in infectious disease threats, natural disasters, terrorism, and other mass casualty events for decision makers. Research designs were observational and critical appraisal results varied. • Most research exists to reduce care demand (n=149); higher quality studies reported benefits of contact tracing, school closures, travel restrictions, port of entry screening, and mass vaccination. We identified 28 evaluations of strategies to augment resources; higher quality studies reported the effectiveness of establishing temporary facilities, using volunteers, and using decision support software. Strategies to optimize existing resources have been assessed in 23 studies; higher quality studies reported successfully expanding scope of work and building on existing agreements between agencies. Few studies have evaluated crisis standards of care strategies. Coronavirus disease 2019 (COVID-19) research is emerging; four higher quality studies evaluated combinations of interventions; one reported the benefit of communitywide mask policies. • Most existing research is based on simulations, and future research is needed to test strategies in practice. Key Question What strategies are available to policymakers to optimize allocation of scarce resources during mass casualty events, especially pandemics? Methods We searched the databases PubMed, Web of Science, and Cochrane Database of Systematic Reviews on May 4, 2020. The search strategy is documented in Appendix A. We included empirical studies and simulations evaluating strategies for policymakers to allocate scarce resources. Studies had to address the allocation of scarce resources (broadly defined, as described above and in the appendix), and interventions had to be aimed at policymakers such as local public health officials rather than individual clinicians. The detailed eligibility criteria are documented in the appendix. For the update, literature reviewers screened citations and full-text articles in duplicate, one reviewer abstracted and appraised the data, and a systematic reviewer checked the work using online data abstraction software. The screening process is outlined in Appendix B. We documented the included studies in an evidence table (Appendix C). We used the same critical appraisal used in the previous report. For the synthesis, studies were stratified by strategy category and higher quality studies (critical appraisal scor...

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“…Let Q(t) be the fraction of individuals who have been preempted after receiving the drug. Then, (15) represents the evolution of Q(t).…”

Section: A2 Drug Onlymentioning

confidence: 99%

Countering the potential re-emergence of a deadly infectious disease - information warfare, identifying strategic threats, launching countermeasures

Ali

Rubin

Sarkar

2020

Preprint

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Eradicated infectious diseases like smallpox can re-emerge through accident or designs of bioterrorists, and perpetrate heavy casualties. Currently, only a small percentage of the populace is vaccinated, and their protection is likely to have waned. Most therefore are susceptible today. And when the disease re-emerges the susceptible individuals may be manipulated by disinformation on Social Media to refuse vaccines. Thus, a combination of countermeasures consisting of antiviral drugs and vaccines and a range of policies for their application need to be investigated. Opinions as to receptivity of vaccines evolve with time through social exchanges over networks that overlap with but are not identical to the disease propagation networks. These couple the spread of the biological and information contagion and necessitate a joint investigation of the two. Towards these, we develop a computationally tractable metapopulation epidemiological model that captures the joint spatio-temporal evolution of smallpox and opinion dynamics. The computations based on the model show that opinion dynamics has a substantial impact on the fatality count. Towards understanding how perpetrators are likely to seed the infection we identify a) the initial distribution of infected individuals that maximize the overall fatality count regardless of mobility patterns, and b) which habitation structures are more vulnerable to outbreaks. We assess the relative efficacy of different countermeasures and conclude that a combination of vaccines and drugs minimizes the fatalities, and by itself, for smallpox, drugs reduce fatalities more than the vaccine. Accordingly, we assess the efficacies of three separate policies for administering the drugs and identify the best among them for various parameter combinations. When the availability of the drug is finite, we show that increase in its supply substantially reduces the overall fatality. Our findings lead to policy recommendations for public health and urban design authorities towards thwarting smallpox and other infectious disease outbreaks.

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Modeling the Effect of Herd Immunity and Contagiousness in Mitigating a Smallpox Outbreak

Cited by 14 publications

References 35 publications

Stochastic Lattice gas Cellular Automata Model for Epidemics

Stochastic Lattice gas Cellular Automata Model for Epidemics

Resource Allocation and Pandemic Response: An Evidence Synthesis To Inform Decision Making

Countering the potential re-emergence of a deadly infectious disease - information warfare, identifying strategic threats, launching countermeasures

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