An allocation model for emergency medical services based on integrated healthcare during an epidemic

Enhanced virus control and patient treatment outcomes during an epidemic requires flexible and efficient medical services. This research explores an epidemic medical service allocation model from an integrated healthcare perspective, aiming to enhance the overall regional emergency medical service capability based on collaborative medical treatment. The study is based on COVID-19 medical services and its main treatment stages, and resource allocation models are constructed for the allocation of multiple medical services. The model addresses the dispersed medical service resources and demands in a certain region, and realizes the division of labor and resource sharing among medical institutions from the perspectives of distance, cost, and fairness with the advantage of integrated healthcare. We design examples in the context of COVID-19 epidemic and verify the validity and applicability of the model under different phases. This paper provides reference to the research and practice of achieving collaborative medical treatment between multiple medical institutions.

Quantifying the risk of indoor drainage system in multi-unit apartment building as a transmission route of SARS-CoV-2.

The COVID-19 pandemic has had a profound impact on human society. The isolation of SARS-CoV-2 from patients' feces on human cell line raised concerns of possible transmission through human feces including exposure to aerosols generated by toilet flushing and through the indoor drainage system. Currently, routes of transmission, other than the close contact droplet transmission, are still not well understood. A quantitative microbial risk assessment was conducted to estimate the health risks associated with two aerosol exposure scenarios: 1) toilet flushing, and 2) faulty connection of a floor drain with the building's main sewer pipe. SARS-CoV-2 data were collected from the emerging literature. The infectivity of the virus in feces was estimated based on a range of assumption between viral genome equivalence and infectious unit. The human exposure dose was calculated using Monte Carlo simulation of viral concentrations in aerosols under each scenario and human breathing rates. The probability of COVID-19 illness was generated using the dose-response model for SARS-CoV-1, a close relative of SARS-CoV-2, that was responsible for the SARS outbreak in 2003. The results indicate the median risks of developing COVID-19 for a single day exposure is 1.11 × 10-10 and 3.52 × 10-11 for toilet flushing and faulty drain scenario, respectively. The worst case scenario predicted the high end of COVID-19 risk for the toilet flushing scenario was 5.78 × 10-4 (at 95th percentile). The infectious viral loads in human feces are the most sensitive input parameter and contribute significantly to model uncertainty.