Design of COVID-19 Staged Alert Systems to Ensure Healthcare Capacity with Minimal Closures

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

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


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 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.

Original languageEnglish (US)
JournalUnknown Journal
StatePublished - Dec 24 2020

ASJC Scopus subject areas

  • Medicine(all)

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