Health Care Logistics Network Design and Analysis on Pandemic Outbreaks: Insights From COVID-19.

Health care systems throughout the world are under pressure as a result of COVID-19. It is over two years since the first case was announced in China and health care providers are continuing to struggle with this fatal infectious disease in intensive care units and inpatient wards. Meanwhile, the burden of postponed routine medical procedures has become greater as the pandemic has progressed. We believe that establishing separate health care institutions for infected and non-infected patients would provide safer and better quality health care services. The aim of this study is to find the appropriate number and location of dedicated health care institutions which would only treat individuals infected by a pandemic during an outbreak. For this purpose, a decision-making framework including two multi-objective mixed-integer programming models is developed. At the strategic level, the locations of designated pandemic hospitals are optimized. At the tactical level, we determine the locations and operation durations of temporary isolation centers which treat mildly and moderately symptomatic patients. The developed framework provides assessments of the distance that infected patients travel, the routine medical services expected to be disrupted, two-way distances between new facilities (designated pandemic hospitals and isolation centers), and the infection risk in the population. To demonstrate the applicability of the suggested models, we perform a case study for the European side of Istanbul. In the base case, seven designated pandemic hospitals and four isolation centers are established. In sensitivity analyses, 23 cases are analyzed and compared to provide support to decision makers.

Simultaneous response to multiple disasters: Integrated planning for pandemics and large-scale earthquakes.

Since the beginning of COVID-19, individuals who have SARS-CoV-2 infectious have brought a heavy burden on the healthcare system. Unavoidably, along with pandemics, large-scale disasters, which are possibly emerging, may double the current health crisis. For a powerful disaster response plan, the health services should be prepared for the overwhelming number of disaster victims and infected individuals The proposed framework determines the appropriate number and location of temporary healthcare facilities for large-scale disasters while considering the burden of ongoing pandemic diseases. In this study, first, a multi-period, mix-integer mathematical model is developed to find the location and number of disaster emergency units and disaster medical facilities. Second, we develop an epidemic compartmental model to stimulate the negative effects of the disaster on disease spread and a mixed-integer mathematical model to find optimal number and the location of pandemic hospitals and isolation centers. To validate the mathematical models, a case study is conducted for a district of Istanbul, Turkey.

Risk assessment approach for analyzing risk factors to overcome pandemic using interval-valued q-rung orthopair fuzzy decision making method.

The process of developing and implementing sustainable strategies to prevent spread of COVID-19 for society typically requires integrating all social, technological, economic, governmental aspects in a systematic way. Since the clear understanding of risk factors contribute to the success of the strategies applied against COVID-19, a risk assessment procedure is applied in this study to properly evaluate risk factors cause to spread of pandemic as a multi-complex decision problem. Therefore, due to the evaluation of risk factors, which often involves uncertain information, the model is constructed based on interval-valued q-rung orthopair fuzzy-COmplex PRoportional ASsessment (IVq-ROF-COPRAS) method. While the developed framework is efficient to enhance the quality of decisions by implementing more realistic, precise, and effective application procedure under uncertain environment, it has capability to help governments for developing comprehensive strategies and responses. According to the results of the proposed risk analysis model, the top three risk factors are "The Approach that Prioritizes the Economy in Policies", "Insufficient Process Control in Normalization" and "Lack of Epidemic Management Culture in Individuals and Businesses". Lastly, to show applicability and efficiency of the model sensitivity and comparative analysis were conducted at the end of the study.

Analyses on ICU and non-ICU capacity of government hospitals during the COVID-19 outbreak via multi-objective linear programming: An evidence from Istanbul.

The current infectious disease outbreak, a novel acute respiratory syndrome [SARS]-CoV-2, is one of the greatest public health concerns that the humanity has been struggling since the end of 2019. Although, dedicating the majority of hospital-based resources is an effective method to deal with the upsurge in the number of infected individuals, its drastic impact on routine healthcare services cannot be underestimated. In this study, the proposed multi-objective, multi-period linear programming model optimizes the distribution decision of infected patients and the evacuation rate of non-infected patients simultaneously. Moreover, the presented model determines the number of new COVID-19 intensive care units, which are established by using existing hospital-based resources. Three objectives are considered: (1) minimization of total distance travelled by infected patients, (2) minimization of the maximum evacuation rate of non-infected patients and (3) minimization of the infectious risk of healthcare professionals. A case study is performed for the European side of Istanbul, Turkey. The effect of the uncertain length of the stay of infected patients is demonstrated via sensitivity analyses.

Determining the location of isolation hospitals for COVID-19 via Delphi-based MCDM method.

The existing contagious epidemic disease, [SARS]-CoV-2, has been one of the biggest public health problems that humankind combatting against since December 2019. Answering the increase in the number of infected patients during the pandemic is one of the biggest challenges for healthcare systems, where resources have already been employed by a significant number of patients. While assigning most of the resources to infected people is an effective way in a short-term planning, its bitter effects on regular healthcare cannot be undervalued. Moreover, within this plan the risk of spreading the disease to other patients and healthcare providers is another risk that should not be underestimated. Therefore, in this study, we proposed the Delphi-based multicriteria decision-making (MCDM) framework for selecting the most appropriate location for an isolation hospital serving only epidemic-based patients with mild to moderate symptoms. The integrated framework consists of Delphi, Best-Worst Method, and interval type-2 fuzzy Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) methodologies. Nine most effecting criteria are considered in the evaluation of five alternative locations in a real case study conducted at the European side of Istanbul. Ataturk Airport is determined as the best location to set up an isolation hospital based on determined nine evaluation criteria. The effectiveness and robustness of the framework are analyzed through comparative and sensitivity analyses.

Assessing countries' performances against COVID-19 via WSIDEA and machine learning algorithms.

The COVID-19 pandemic, which first spread to the People of Republic of China and then to other countries in a short time, affected the whole world by infecting millions of people and have been increasing its impact day by day. Hundreds of researchers in many countries are in search of a solution to end up this pandemic. This study aims to contribute to the literature by performing detailed analyses via a new three-staged framework constructed based on data envelopment analysis and machine learning algorithms to assess the performances of 142 countries against the COVID-19 outbreak. Particularly, clustering analyses were made using k-means and hierarchic clustering methods. Subsequently, efficiency analysis of countries were performed by a novel model, the weighted stochastic imprecise data envelopment analysis. Finally, parameters were analyzed with decision tree and random forest algorithms. Results have been analyzed in detail, and the classification of countries are determined by providing the most influential parameters. The analysis showed that the optimum number of clusters for 142 countries is three. In addition, while 20 countries out of 142 countries were fully effective, 36% of them were found to be effective at a rate of 90%. Finally, it has been observed that the data such as GDP, smoking rates, and the rate of diabetes patients do not affect the effectiveness level of the countries.

A novel intuitionistic fuzzy MCDM-based CODAS approach for locating an authorized dismantling center: a case study of Istanbul.

As the number of end-of-life vehicles (ELVs) increases rapidly, their management has become one of the most important environmental topics worldwide. This study is conducted to evaluate various alternatives for location selection of an authorized dismantling center (ADC) for ELVs using a multi-criteria decision-making (MCDM) approach. An intuitionistic fuzzy MCDM-based combinative distance-based assessment (CODAS) approach is proposed to aid waste managers and solve their problem. The intuitionistic fuzzy weighted averaging operator is utilized to aggregate individual opinions of decision-makers into a group opinion. The intuitionistic fuzzy Euclidean and Hamming distances are used to calculate the assessment score of alternatives. A real-life case study of Istanbul is provided to illustrate how this novel intuitionistic fuzzy MCDM-based CODAS approach can be used for alternative selection in real-world applications. The comparison with the available state-of-the-art intuitionistic fuzzy set-based MCDM approaches approves the validity and consistency of the proposed intuitionistic fuzzy CODAS approach. The intuitionistic fuzzy CODAS, WASPAS, and TOPSIS approaches generate exactly the same ordering of alternatives for the new ADC in Istanbul. The results show that the intuitionistic fuzzy CODAS approach indicates valid results and is an effective decision-making technique for vagueness and uncertainty nature of linguistic assessments.