Planning the supply of emergency medical products to cope with pandemics

The COVID-19 pandemic exposed inadequate planning in the supply of emergency medical products (EMP) worldwide. In what followed, an exponential growth in EMP demand during the first months of the pandemic proved extremely challenging for manufacturers to adapt to. This put healthcare workers, our first line of defense, in jeopardy and stretched healthcare systems beyond their capacities. Many governments realized the deficiency of their emergency stockpile policies, and as global demand outstripped supply, they struggled to meet their population's basic EMP needs using offshore suppliers. In this work, we present a game theoretical approach for the planning of EMP supplies using a game that models the interaction between governments and private manufacturers to secure such critical supplies in the case of pandemics, while reducing the overall cost to taxpayers, and taking into consideration manufacturers profit objectives. On one hand, a policymaker can decide the strategic stockpile size for EMPs and use subsidies to encourage manufacturers to onshore some or all of their EMP manufacturing capacity to improve their domestic crisis management capabilities in case of a pandemic. On the other hand, private manufactures can evaluate offshoring cost savings compared to subsidies offered by the government on the condition of onshoring production of subsidized products and offering such items to the public at contracted pricing in pandemics. We detail the two models, present a solution to balance the competing objectives, and discuss insights from the model's analysis. © 2021 IISE Annual Conference and Expo 2021. All rights reserved.

County-Level Planning for Efficient Distribution of Emergency Medical Countermeasures with RealOpt Software.

Emergency preparedness systems plan for antibiotic distribution and vaccine administration to respond to public health threats. The arrival of a COVID-19 vaccine underscores the importance of organized logistics for rapid administration to populations. The US Centers for Disease Control and Prevention Cities Readiness Initiative encourages frontline responders from 72 US cities and metropolitan statistical areas to use planning software, such as RealOpt-POD-v8.0.2, to design dispensing operations and predict staffing needs. However, planning can be difficult for local jurisdictions given uncertainty about how long it may take to complete various processes during a dispensing operation, including assessment of countermeasure needs for each person (eg, based on age or pregnancy status) and the careful dispensing of countermeasures and accompanying education. The Union County Health Department in Ohio gathered data on the timing of typical processes for an anthrax medical countermeasures distribution site through a small-scale drill and used these data to parameterize a RealOpt model capable of serving the rural county's population of just over 50,000 people within 24 hours. Results help fill a gap in parameterizing RealOpt-based planning models by highlighting the use of a small-scale drill to inform time estimates, which can be applied to RealOpt as part of county-level planning in advance of larger-scale drills to evaluate dispensing capabilities and effectiveness. The findings provide a methodological basis of future resource typing for adaptable and scalable dispensing, particularly for rural areas. Both the approach and resulting antibiotics dispensing schematic presented here could be tailored to support planning for population-based countermeasure administration to combat emerging pandemics.

COVID-19: through the eyes through the front line, an international perspective.

COVID-19 is continuing to ravage the globe. In many Western Countries, the populous has not embraced public health advice which has resulted in a resurgence of the COVID-19 virus. In the United States, there is an absence of a coordinated Federal response. Instead, frontline workers and average citizens are having to cope with extensive mixed messaging regarding mask usage and social distancing from the highest levels of government. This has resulted in the United States not being able to achieve a low level of infection since the pandemic began. In addition, many citizens hold a profound belief that individual freedoms must be preserved, even at the expense of public health; and view the wearing of masks as renouncing this right. These engrained political beliefs can be traced back to the late 1800s. The response of the United States has also been hampered by a highly cost-efficient healthcare system, which does not provide universal care and has a just-in-time supply chain, with far too few supplies in reserve. This efficiency prevented a rapid scaling up of the healthcare response, which resulted in severe deficiencies in available personal protective equipment (PPE) and healthcare staff. To compound issues many healthcare staff are not provided an economic or healthcare safety net. Other frontline workers, such as those who work in transportation and food services, are working under even greater adversities. Many of these workers are from diverse backgrounds, who, along with their families, are at even greater risk for COVID-19. This vulnerable population of frontline workers are faced with a choice of going to work with inadequate PPE or placing food on their families' table. In the United States, official recommendations seem to be ever changing, based more upon supply and test availability, than on science. We must rely on science and learn from the lessons of past pandemics or we will relive, even to a greater degree, the deaths and devastations experienced by our ancestors over 100 years ago.