An optimization model for planning testing and control strategies to limit the spread of a pandemic - The case of COVID-19

A bed allocation model for pandemic situation considering general demand: A case study of Iran

Pandemics place a new type of demand from patients affected by the pandemic, imposing significant strain on hospital departments, particularly the intensive care unit. A crucial challenge during pandemics is the imbalance in addressing the needs of both pandemic patients and general patients. Often, the community's focus shifts toward the pandemic patients, causing an imbalance that can result in severe issues. Simultaneously considering both demands, pandemic-related and general healthcare needs, has been largely overlooked. In this article, we propose a bi-objective mathematical model for locating temporary hospitals and allocating patients to existing and temporary hospitals, considering both demand types during pandemics. Hospital departments, such as emergency beds, serve both demand types, but due to infection risks, accommodating a pandemic patient and a general patient in the same department is not feasible. The first objective function is to minimize the bed shortages considering both types of demands, whereas the second objective is cost minimization, which includes the fixed and variable costs of temporary facilities, the penalty cost of changing the allocation of existing facilities (between general and pandemic demand), the cost of adding expandable beds to existing facilities, and the service cost for different services and beds. To show the applicability of the model, a real case study has been conducted on the COVID-19 pandemic in the city of Qom, Iran. Comparing the model results with real data reveals that using the proposed model can increase demand coverage by 16%.

An optimization framework for large-scale screening under limited testing capacity with application to COVID-19

We consider the problem of targeted mass screening of heterogeneous populations under limited testing capacity. Mass screening is an essential tool that arises in various settings, e.g., ensuring a safe supply of blood, reducing prevalence of sexually transmitted diseases, and mitigating the spread of infectious disease outbreaks. The goal of mass screening is to classify whole population groups as positive or negative for an infectious disease as efficiently and accurately as possible. Under limited testing capacity, it is not possible to screen the entire population and hence administrators must reserve testing and target those among the population that are most in need or most susceptible. This paper addresses this decision problem by taking advantage of accessible population-level risk information to identify the optimal set of sub-populations to target for screening. We conduct a comprehensive analysis that considers the two most commonly adopted schemes: Individual testing and Dorfman group testing. For both schemes, we formulate an optimization model that aims to minimize the number of misclassifications under a testing capacity constraint. By analyzing the formulations, we establish key structural properties which we use to construct efficient and accurate solution techniques. We conduct a case study on COVID-19 in the United States using geographic-based data. Our results reveal that the considered proactive targeted schemes outperform commonly adopted practices by substantially reducing misclassifications. Our case study provides important managerial insights with regards to optimal allocation of tests, testing designs, and protocols that dictate the optimality of schemes. Such insights can inform policy-makers with tailored and implementable data-driven recommendations.

An interpretable system for predicting the impact of COVID-19 government interventions on stock market sectors

Evaluating and understanding the financial impacts of COVID-19 has emerged as an urgent research agenda. Nevertheless, the impacts of government interventions on stock markets remain poorly understood. This study explores, for the first time, the impact of COVID-19 related government intervention policies on different stock market sectors using explainable machine learning-based prediction models. The empirical findings suggest that the LightGBM model provides excellent prediction accuracy while preserving computationally efficient and easy explainability of the model. We also find that COVID-19 government interventions are better predictors of stock market volatility than stock market returns. We further show that the observed effects of government intervention on the volatility and returns of ten stock market sectors are heterogeneous and asymmetrical. Our findings have important implications for policymakers and investors in terms of promoting balance and sustaining prosperity across industry sectors through government interventions.

A foot and mouth disease ranking of risk using cattle transportation

Foot-and-mouth disease (FMD) is a highly infectious condition that affects domestic and wild cloven-hoofed animals. This disease has substantial economic consequences. Livestock movement is one of the primary causes of disease dissemination. The centrality properties of the livestock mobilization transportation network provide valuable information for surveillance and control of FMD. However, the same transportation network can be described by different centrality descriptions, making it challenging to prioritize the most vulnerable nodes in the transportation network. This work considers the construction of a single network risk ranking, which helps prioritize disease control measurements. Results show that the proposed ranking constructed on 2016 livestock mobilization data may predict an actual outbreak reported in the Cesar (Colombia) region in 2018, with a performance measured by the area under the receiver operating characteristic curve of 0.91. This result constitutes the first quantitative evidence of the predictive capacity of livestock transportation to target FMD outbreaks. This approach may help decision-makers devise strategies to control and prevent FMD.

Optimal timing of non-pharmaceutical interventions during an epidemic

In response to the recent outbreak of the SARS-CoV-2 virus governments have aimed to reduce the virus's spread through, inter alia, non-pharmaceutical intervention. We address the question when such measures should be implemented and, once implemented, when to remove them. These issues are viewed through a real-options lens and we develop an SIRD-like continuous-time Markov chain model to analyze a sequence of options: the option to intervene and introduce measures and, after intervention has started, the option to remove these. Measures can be imposed multiple times. We implement our model using estimates from empirical studies and, under fairly general assumptions, our main conclusions are that: (1) measures should be put in place not long after the first infections occur; (2) if the epidemic is discovered when there are many infected individuals already, then it is optimal never to introduce measures; (3) once the decision to introduce measures has been taken, these should stay in place until the number of susceptible or infected members of the population is close to zero; (4) it is never optimal to introduce a tier system to phase-in measures but it is optimal to use a tier system to phase-out measures; (5) a more infectious variant may reduce the duration of measures being in place; (6) the risk of infections being brought in by travelers should be curbed even when no other measures are in place. These results are robust to several variations of our base-case model.

Introduction to the special issue on the role of operational research in future epidemics/ pandemics

In this special issue, 23 research papers are published focusing on COVID-19 and operational research solution techniques. First, we detail the process from advertising the call for papers to the point where the best papers are accepted. Then, we provide a summary of each paper focusing on applications, solution techniques and insights for practitioners and policy makers. To provide a holistic view for readers, we have clustered the papers into different groups: transmission, propagation and forecasting, non-pharmaceutical intervention, healthcare network configuration, healthcare resource allocation, hospital operations, vaccine and testing kits, and production and manufacturing. Then, we introduce other possible subjects that can be considered for future research.

Optimizing two-dose vaccine resource allocation to combat a pandemic in the context of limited supply: The case of COVID-19

The adequate vaccination is a promising solution to mitigate the enormous socio-economic costs of the ongoing COVID-19 pandemic and allow us to return to normal pre-pandemic activity patterns. However, the vaccine supply shortage will be inevitable during the early stage of the vaccine rollout. Public health authorities face a crucial challenge in allocating scarce vaccines to maximize the benefits of vaccination. In this paper, we study a multi-period two-dose vaccine allocation problem when the vaccine supply is highly limited. To address this problem, we constructed a novel age-structured compartmental model to capture COVID-19 transmission and formulated as a nonlinear programming (NLP) model to minimize the total number of deaths in the population. In the NLP model, we explicitly take into account the two-dose vaccination procedure and several important epidemiologic features of COVID-19, such as pre-symptomatic and asymptomatic transmission, as well as group heterogeneity in susceptibility, symptom rates, severity, etc. We validated the applicability of the proposed model using a real case of the 2021 COVID-19 vaccination campaign in the Midlands of England. We conducted comparative studies to demonstrate the superiority of our method. Our numerical results show that prioritizing the allocation of vaccine resources to older age groups is a robust strategy to prevent more subsequent deaths. In addition, we show that releasing more vaccine doses for first-dose recipients could lead to a greater vaccination benefit than holding back second doses. We also find that it is necessary to maintain appropriate non-pharmaceutical interventions (NPIs) during the vaccination rollout, especially in low-resource settings. Furthermore, our analysis indicates that starting vaccination as soon as possible is able to markedly alleviate the epidemic impact when the vaccine resources are limited but are currently available. Our model provides an effective tool to assist policymakers in developing adaptive COVID-19 likewise vaccination strategies for better preparedness against future pandemic threats.

Logistics of temporary testing centers for coronavirus disease

The ongoing COVID-19 pandemic has caused the death of millions of people, and PCR testing is widely used as the gold standard method to detect the infections to restrict the outbreak. Through the interviews conducted with people from the field in South Korea, the UK, and Turkey, we have found that there are numerous testing strategies worldwide. Those testing strategies include drive-through and home delivery testing capabilities, local test sites, and mobile test centers. Our primary motivation is to propose a generic model based on the best practices in the UK and South Korea. Also, we aim to present a case study on Turkey for the implementation of vital procedures and increase their availability. This paper represents a study on how to construct a temporary testing logistics system during the initial phases of pandemics to increase the availability of PCR testing with the primary objective of maximizing total sample collection. The design also considers minimizing the maximum walking distance to increase the convenience of sample collection for the people living in the neighborhoods. The proposed system consists of temporary testing centers and a central laboratory. Temporary testing centers perform direct tours to the potential areas to collect samples and bring the collected sample to the designated central laboratories located at central hospitals. Moreover, to represent the non-linear inheritance of the pandemic progress within a population, we consider diminishing sample potentials over time and coverage. This new problem is defined as an extension of the Selective Vehicle Routing Problem and Covering Tour Problem. We propose a mathematical model and four two-stage math-heuristic algorithms to determine the location and routing of the temporary testing centers and their lengths of stay at each visited location. The performances of the proposed solution methodologies are tested on two data sets. The first set is constructed by the confirmed cases of the districts of Seoul, Korea, and by the interview of health personnel of H+ Yangji Hospital COVID-19 semi-mobile booth application, and the second set is constructed by 99 hospital/health centers from distinct neighborhoods of 22 districts of Istanbul, Turkey. The Pareto set of optimum solutions is generated based on total sample collection and maximum walking distance. Finally, sensitivity analyses on some design parameters are conducted.

Long-term spatial and population-structured planning of non-pharmaceutical interventions to epidemic outbreaks

In this paper, we consider the problem of planning non-pharmaceutical interventions to control the spread of infectious diseases. We propose a new model derived from classical compartmental models; however, we model spatial and population-structure heterogeneity of population mixing. The resulting model is a large-scale non-linear and non-convex optimisation problem. In order to solve it, we apply a special variant of covariance matrix adaptation evolution strategy. We show that results obtained for three different objectives are better than natural heuristics and, moreover, that the introduction of an individual's mobility to the model is significant for the quality of the decisions. We apply our approach to a six-compartmental model with detailed Poland and COVID-19 disease data. The obtained results are non-trivialand sometimes unexpected; therefore, we believe that our model could be applied to support policy-makers in fighting diseases at the long-term decision-making level.

The significance of advanced COVID-19 diagnostic testing in pandemic control measures

During the 2 years since the start of the novel coronavirus disease 2019 (COVID-19) pandemic, the scientific world made an enormous effort to fight against this disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has high transmissibility. Advancements in vaccine and treatment strategies have reduced both the hospitalization and mortality rates. However, the virus has shown its ability to evolve and evade from our COVID-19 combating armamentaria by the most common evolution mechanism—mutation. Diagnostic testing has been the first line of defense following the identification of the causative agent. Ever since, the scientific community has developed nuclei acid-based, antigen-based, and antibody-based diagnostic tests, and these testing methodologies are still playing a central role in slowing down viral transmission. These testing methods have different sensitivity and specificity and could be optimally used in areas facing different challenges owing to different level and conditions of COVID-19 outbreak. In this review, we discuss these testing methodologies as well as the considerations on how to apply these diagnostic tests optimally in the community to cope with the ever-changing pandemic conditions.