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Design of COVID-19 staged alert systems to ensure healthcare capacity with minimal closures

Design of COVID-19 staged alert systems to ensure healthcare capacity with minimal closures
Design of COVID-19 staged alert systems to ensure healthcare capacity with minimal closures

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.

2041-1723
Yang, Haoxiang
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Sürer, Özge
d084f375-0dbc-4e68-b977-4acad08eec0e
Duque, Daniel
752fe32d-e07b-43ea-b855-98f073c9333b
Morton, David P.
3e053a27-b1bb-4764-b807-c6ab0a133bbe
Singh, Bismark
9d3fc6cb-f55e-4562-9d5f-42f9a3ddd9a1
Fox, Spencer J.
a114bd86-7986-4fac-99e5-d2b7c12448e7
Pasco, Remy
3dba1a7c-e14c-4fef-8c38-79673438fb32
Pierce, Kelly
68c63f86-9020-4f66-af2a-58ab3e0c70bc
Rathouz, Paul
f36cd3f4-0db9-4ecf-8208-de4ea02b222d
Valencia, Victoria
81d20803-8033-4925-aff2-e717f40d2533
Du, Zhanwei
8b0b560e-1079-480e-8192-0a7bae92bf7d
Pignone, Michael
e598585c-a874-4582-b7d4-ab263f02a9a5
Escott, Mark E.
816b3b77-bbf6-475d-8aff-f87e598ddc54
Adler, Stephen I.
f3a711cd-e644-482c-be72-06d970df366a
Johnston, S. Claiborne
93cc0979-a19d-42a9-9d9f-488abedb4da9
Meyers, Lauren Ancel
4f9ada54-8b4c-4607-ad88-dafb19fa06b3
Yang, Haoxiang
38323049-f94b-416d-a654-12b31778b51c
Sürer, Özge
d084f375-0dbc-4e68-b977-4acad08eec0e
Duque, Daniel
752fe32d-e07b-43ea-b855-98f073c9333b
Morton, David P.
3e053a27-b1bb-4764-b807-c6ab0a133bbe
Singh, Bismark
9d3fc6cb-f55e-4562-9d5f-42f9a3ddd9a1
Fox, Spencer J.
a114bd86-7986-4fac-99e5-d2b7c12448e7
Pasco, Remy
3dba1a7c-e14c-4fef-8c38-79673438fb32
Pierce, Kelly
68c63f86-9020-4f66-af2a-58ab3e0c70bc
Rathouz, Paul
f36cd3f4-0db9-4ecf-8208-de4ea02b222d
Valencia, Victoria
81d20803-8033-4925-aff2-e717f40d2533
Du, Zhanwei
8b0b560e-1079-480e-8192-0a7bae92bf7d
Pignone, Michael
e598585c-a874-4582-b7d4-ab263f02a9a5
Escott, Mark E.
816b3b77-bbf6-475d-8aff-f87e598ddc54
Adler, Stephen I.
f3a711cd-e644-482c-be72-06d970df366a
Johnston, S. Claiborne
93cc0979-a19d-42a9-9d9f-488abedb4da9
Meyers, Lauren Ancel
4f9ada54-8b4c-4607-ad88-dafb19fa06b3

Yang, Haoxiang, Sürer, Özge, Duque, Daniel, Morton, David P., Singh, Bismark, Fox, Spencer J., Pasco, Remy, Pierce, Kelly, Rathouz, Paul, Valencia, Victoria, Du, Zhanwei, Pignone, Michael, Escott, Mark E., Adler, Stephen I., Johnston, S. Claiborne and Meyers, Lauren Ancel (2021) Design of COVID-19 staged alert systems to ensure healthcare capacity with minimal closures. Nature Communications, 12 (1), [3767]. (doi:10.1038/s41467-021-23989-x).

Record type: Article

Abstract

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.

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More information

Accepted/In Press date: 21 May 2021
e-pub ahead of print date: 18 June 2021
Published date: 1 December 2021

Identifiers

Local EPrints ID: 472283
URI: http://eprints.soton.ac.uk/id/eprint/472283
ISSN: 2041-1723
PURE UUID: 527ef876-dd1c-4dc6-a65e-5ac66f18bf15
ORCID for Bismark Singh: ORCID iD orcid.org/0000-0002-6943-657X

Catalogue record

Date deposited: 30 Nov 2022 17:45
Last modified: 28 Feb 2024 03:16

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Contributors

Author: Haoxiang Yang
Author: Özge Sürer
Author: Daniel Duque
Author: David P. Morton
Author: Bismark Singh ORCID iD
Author: Spencer J. Fox
Author: Remy Pasco
Author: Kelly Pierce
Author: Paul Rathouz
Author: Victoria Valencia
Author: Zhanwei Du
Author: Michael Pignone
Author: Mark E. Escott
Author: Stephen I. Adler
Author: S. Claiborne Johnston
Author: Lauren Ancel Meyers

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