This post originally appeared in March of 2020 when the Coronavirus and just recently been declared a world-wide pandemic. Since that time, several new Coronavirus strains have appeared and while the global emergency as subsided, there is still significant concern in the healthcare community about future Coronavirus strains and other viruses such as Mpox and Bird Flu. As described in this post, simulation modeling and analysis is the perfect tool for pre-planning and the development of response and mitigation strategies.
March 13, 2020 – The last couple of weeks have witnessed the Coronavirus dominate every news cycle worldwide and not a day passes without new statistics of its spread and the decisions been made to combat it. This week new cases in Italy and across the globe convinced the World Health Organization (WHO) to officially announce the situation as an epidemic. What this means in terms of healthcare is an exponential increase in the number of patients seeking medical help which is expected to test the capacity planning abilities of healthcare facilities.
The process of developing excellent strategic plans for expansion while taking into consideration factors such as increased demand for services, available assets to work with, and scheduling is the forte of simulation. In regions where the Coronavirus situation is projected to escalate, simulation technology provides healthcare centers, manufacturers of testing kits, and epidemiologists with an excellent tool for capacity planning and data analysis.
Capacity Planning in Healthcare Centers with Simulation Software
Unexpected increases in patient inflow provide challenges for every healthcare facility but in this case, things are a bit different. We are currently in an epidemic and unaffected regions as of today have been advised to take precautionary steps and prepare public and private healthcare facilities for an influx of patients. This cautionary recommendation means now is the time to develop strategic plans and implement them before welcoming patients in the coming months.
Simulation software simplifies the planning and implementation process in many ways. These ways include optimizing bed utilization, determining the waiting time for diverse situations, and simulating demand with intent to respond to increased demand. Research from the National Center for Biotechnology Information (NCBI) puts how simulation optimizes capacity planning in healthcare centers in perspective.
The research used data from The Office of Health Policy under the Kentucky Cabinet for Health and Family Services, and data-sets of patient inflow from a couple of health centers in Kentucky to develop a discrete event simulation (DES) model. The data used spanned the duration of 5 years across healthcare centers in Kentucky and included patient gender and age to ensure high accuracy levels. With the DES model, patient flow within facilities, patient wait time, and bed utilization were mapped out. This made it possible to estimate and measure the level of services patients received within specific Kentucky healthcare facilities. It also measured the effect of increased capacity against increasing patient inflow. The DES model determined that a 5% increase in accommodation capacity ensures a high quality of service is given to patients if inflow increases by approximately 20 to 30%.
The study also made use of OptQuest, an optimization solver in Simio, to search for optimal solutions for enhancing service quality while taking into consideration capacity limitations. The model showed a 2% annual increase in a hospital’s capacity could maintain 80% of the service quality a facility offers as patient inflow increases.
Applying this to the Coronavirus situation means simulation can be used for designing community-based care frameworks for affected patients in record time. Simulation models can also take into consideration the pattern of care different patients will need and determine the optimal wait time that ensures every patient gets the care they deserve. The results from these simulations will then serve as the strategic plans needed to increase the capacity of healthcare centers in the worst-hit areas.
Logistics and Supply Chain Planning in Laboratories
During an epidemic, speaking about the positives helps everyone realize that solutions to the problem are being worked on. And here is one. The US, Israel, and China are currently working on vaccines to tackle the spread of the virus and its effects. It is expected that functional vaccines will be available within 12 to 18 months and clinical trials are already being done.
To mass-produce working vaccines, require a vibrant logistics and supply chain that ensures laboratories get the materials they need to work with. A functional global supply chain is also required to bring the final product to healthcare facilities where they will be sorely needed.
Simulation provides a solution for planning the re-routing of supply chains through affected regions to the laboratory. Test kit, safety equipment, and vaccine manufacturers can take advantage of simulation to schedule manufacturing activities within their facilities. In this case, scheduling manufacturing processes while taking the reduced capacity of a facility into consideration will help manufacturers retain a good percentage of their optimal working capacity. Thus, continuously manufacturing the items needed to successfully eradicate the novel virus.
Simulating the Coronavirus Epidemiology and Control in Affected Areas
Epidemiology models have provided realistic predictions on the spread or epidemiological outcomes of existing illnesses or viruses. Models of malaria epidemiology are examples of how simulation has been applied to determine spread and control strategies that can reduce it.
The OpenMalaria platform initiative is one example. In this scenario, individual-based stochastic simulation models of patients and a DES model were developed to study the spread of malaria within a population of 10,000. The study led to the discovery of a seasonal pattern for malaria. It also highlighted the fact that measures such as indoor residual spraying within certain timelines were effective in reducing the number of affected patients.
Although Coronavirus is still in its infancy, simulation of the coronavirus epidemiology in the future will help with preparing healthcare workers and facilities to tackle epidemics head-on. Today, the WHO and China have developed simulation models that help with contact tracing and isolated healthcare. This measure has helped with tracing suspected patients and creating isolation buffers to slow or stop the spread of the virus across China.
Conclusion
The effects of the novel coronavirus are being felt across all walks of life as work reduces and schools close. The best way to slow its spread and provide adequate healthcare for infected patients is through strategic planning. Simulation serves as one of the best tools, alongside educating the public, that government agencies and healthcare providers can employ in developing effective strategic planning and implementation policies.