Design of COVID-19 staged alert systems to ensure healthcare capacity with minimal closures.
Haoxiang YangÖzge SürerDaniel DuqueDavid P MortonBismark SinghSpencer J FoxRemy PascoKelly PiercePaul RathouzVictoria ValenciaZhanwei DuMichael PignoneMark E EscottStephen I AdlerS Claiborne JohnstonLauren Ancel MeyersPublished in: Nature communications (2021)
Community mitigation strategies to combat COVID-19, ranging from healthy hygiene to shelter-in-place orders, exact substantial socioeconomic costs. Judicious implementation and relaxation of restrictions amplify their public health benefits while reducing costs. We derive optimal strategies for toggling between mitigation stages using daily COVID-19 hospital admissions. With public compliance, the policy triggers ensure adequate intensive care unit capacity with high probability while minimizing the duration of strict mitigation measures. In comparison, we show that other sensible COVID-19 staging policies, including France's ICU-based thresholds and a widely adopted indicator for reopening schools and businesses, require overly restrictive measures or trigger strict stages too late to avert catastrophic surges. As proof-of-concept, we describe the optimization and maintenance of the staged alert system that has guided COVID-19 policy in a large US city (Austin, Texas) since May 2020. As cities worldwide face future pandemic waves, our findings provide a robust strategy for tracking COVID-19 hospital admissions as an early indicator of hospital surges and enacting staged measures to ensure integrity of the health system, safety of the health workforce, and public confidence.
Keyphrases
- coronavirus disease
- healthcare
- sars cov
- public health
- intensive care unit
- mental health
- respiratory syndrome coronavirus
- climate change
- physical activity
- lymph node
- emergency department
- clinical decision support
- single molecule
- mechanical ventilation
- extracorporeal membrane oxygenation
- density functional theory
- social media
- molecular dynamics
- global health
- clinical evaluation
- pet ct
- acute respiratory distress syndrome
- current status