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; Victoria Valencia; Zhanwei Du; Michael Pignone; Mark E. Escott; Stephen I. Adler; S. Claiborne Johnston; Lauren Ancel Meyers

doi:10.1038/s41467-021-23989-x

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, Victoria Valencia, Zhanwei Du, Michael Pignone, Mark E. Escott, Stephen I. Adler, S. Claiborne Johnston, Lauren Ancel Meyers^*

^*Corresponding author for this work

Industrial Engineering and Management Sciences

Research output: Contribution to journal › Article › peer-review

33 Scopus citations

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.

Original language	English (US)
Article number	3767
Journal	Nature communications
Volume	12
Issue number	1
DOIs	https://doi.org/10.1038/s41467-021-23989-x
State	Published - Dec 1 2021

Funding

The authors thank Achyut Kasi and Cindy Sanchez for code to produce graphs and reports used in the manuscript. The Center for Nonlinear Studies at Los Alamos National Laboratory supported Haoxiang Yang’s work. Bismark Singh was co-financed by the Bavarian-Czech Academic Agency with funds from the Free State of Bavaria. This work was further supported by the National Institutes of Health under Grant NIH R01 AI151176 and by the U.S. Department of Homeland Security under Grant 2017-ST-061-QA0001. The views and conclusions contained in this document are those of the authors and should not be interpreted as necessarily representing the official policies, either expressed or implied, of the U.S. Department of Homeland Security.

ASJC Scopus subject areas

General Chemistry
General Biochemistry, Genetics and Molecular Biology
General Physics and Astronomy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1038/s41467-021-23989-x

Cite this

Yang, H., Sürer, Ö., Duque, D., Morton, D. P., Singh, B., Fox, S. J., Pasco, R., Pierce, K., Rathouz, P., Valencia, V., Du, Z., Pignone, M., Escott, M. E., Adler, S. I., Johnston, S. C., & Meyers, L. A. (2021). Design of COVID-19 staged alert systems to ensure healthcare capacity with minimal closures. Nature communications, 12(1), Article 3767. https://doi.org/10.1038/s41467-021-23989-x

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

Abstract

Funding

ASJC Scopus subject areas

UN SDGs

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