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medrxiv; 2020.
Preprint Dans Anglais | medRxiv | ID: ppzbmed-10.1101.2020.07.16.20152033

Résumé

As communities reopen following shelter-in-place orders, they are facing two conflicting objectives. The first is to keep the COVID-19 fatality rate down. The second is to revive the U.S. economy and the livelihood of millions of Americans. In this paper, a team of researchers from the Center on Stochastic Modeling, Optimization, & Statistics (COSMOS) at the University of Texas at Arlington, in collaboration with researchers from University of Texas Southwestern Medical Center and Harvard Medical School, has formulated a computationally-efficient optimization framework, referred to as COSMOS COVID-19 Linear Programming (CC19LP), to study the delicate balance between the expected fatality rate and the level of normalcy in the community. Given the disproportionate fatality characteristics of COVID-19 among those in different age groups or with an underlying medical condition or those living with crowding, the key to the CC19LP framework is a focus on "key contacts" that separate individuals at higher risk from the rest of the population. The philosophy of CC19LP lies in maximizing protection of key contacts, so as to shield high-risk individuals from infection. Given the lack of pharmaceutical solutions, i.e., a vaccine or cure, the CC19LP framework minimizes expected fatalities by optimizing the use of non-pharmaceutical interventions, namely COVID-19 testing; personal protective equipment; and social precautions, such as distancing, hand-washing, and face coverings. Low-risk individuals that are not key contacts, including most children, are unrestricted and can choose to participate in pre-pandemic normal activities, which eliminates the need for compliance across the entire population. Consequently, the CC19LP framework demonstrates optimal strategies for protecting high-risk individuals while reopening communities.


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