| Severe Acute Respiratory Syndrome(SARS),Highly Pathogenic Avian Influenza(H5N1,H7N9),Influenza A(H1N1),Middle East Respiratory Syndrome(MERS),Ebola,and COVID-19 are just a few of the new and severe infectious diseases that have emerged in recent years.These diseases not only posed serious threats to people’s lives and property but also put the social security and public health systems of many different nations around the world under a tremendous amount of stress.Public health crises like the COVID-19 pandemic put a tremendous strain on the medical resources needed to prevent,manage,and cure infectious diseases.As a result,local and even National Health Service resources are severely constrained,and current health systems suffer significant losses.This paper is to capture the coupling interactions between prevention and control intervention measures and emergency medical resource allocation under the COVID-19 epidemic and its impact on the spread of the epidemic in Wuhan.This is of great theoretical value and practical significance for the response of emergency medical resource allocation and the improvement of epidemic prevention and control system under public health emergencies in China.A hybrid dynamic simulation model is established by integrating system dynamics model(SDM)with discrete event simulation(DES).Although the SDM can capture the dynamic transmission process of COVID-19,it cannot well capture the impact and important role of medical resources utilization before and after the outbreak of COVID-19.Discrete event simulation can model the hospital’s ability to treat patients and the allocation of medical resources,but it cannot capture the transmission dynamics of COVID-19.Therefore,we proposed a hybrid dynamic simulation model that can simultaneously capture the transmission dynamics of the COVID-19 epidemic in Wuhan,the planning and utilization of medical resources,and the situation of various prevention and control intervention measures taken by the government.At the same time,the model can also be used to forecast the shortterm and long-term scenarios.In this paper,Any Logic(Professional 8.7.3)simulation platform was used to conduct scenario analysis and counterfactual analysis for hybrid dynamic simulation model under various prevention and control intervention measures,medical resource allocation in Wuhan.The direct medical costs and indirect costs caused by COVID-19 were estimated.It provides a brand new approach for studying the transmission process of COVID-19 and the allocation of medical resources during public health emergencies.This research has following two major contributions.(1)Theoretical innovationMajority of research on COVID-19 focused on the employment of single model such as the system dynamics model and few studies can simultaneously consider the coupling relationship between the spread of COVID-19 and the allocation of medical resources.In this study,a general procedure of establishing hybrid dynamic simulation models is given by using the system dynamics at the macroscopic level while putting the discrete event simulation at the microcosmic level,which overcomes the limitations of the functionality of single model.(2)Practical innovationBased on the actual situations in China,scenarios including nonpharmaceutical interventions,such as community control,supply of medical resources from outside Wuhan,personal protection(wearing protective masks),pharmaceutical intervention(vaccination)and other intervention measures evaluated.Counterfactual analysis was conducted for the purpose of understanding the issues in the design of intervention,prevention and control policies,and medical resource allocation mechanisms.The hybrid dynamic simulation model can be generalized to explore the coupling relationship between disease transmission and medical resource allocation in different cities.The main conclusions of this study are as follows:As for the community control,stringent community control and medium community control work well for pandemic containment while less strigent community control does not produce satisfactory results.Considering the economic factors of medical resources,the simulations showed that stringent community control and 79% medical resource allocation can yield comparatively good results.In addition,imposing stringent community control 10 days early and 65% allocation of medical resources can yield comparatively good results.As far as the medical resources supply outside Wuhan is concerned,the earlier the external medical resources shipped into Wuhan,the stricter the community control,and the more adequate the external medical resources for Wuhan,the more patients can enter the hospital for treatment the less cumulative confirmed cases and accumulated deaths will occur,and the faster the pandemic can stabilize.The simulations showed that scenario with strigent community control,80% allocation of the external medical resources coming into Wuhan,and no delay of medical resources is a good option.Scenario with strigent community control,78% of the allocation of the external medical resources come into Wuhan,and 10 days early in obtaining the medical resources is another good option in this respect.As for the measures of personal protection(wearing face masks),the cumulative confirmed cases,deaths,actual non-hospital admissions were lower than that at the level of community control indicating that personal protective measures(wearing protective masks)were very effective in controlling the epidemic.Considering the impacts of economic factors on the degree of community control and medical resource allocation,the simulation showed that strigent community control and 76% medical resource allocation are the best local emergency prevention and control strategies at the level of personal protection.As for the pharmaceutical intervention(vaccination),the cumulative confirmed cases and deaths,the actual number of people not admitted to hospital,and the mean recovery time were all lower than that of measures obtained solely by community control.With more strigent community control,more vaccine supply and more effective vaccine,more patients will be admitted to the hospital for treatment,and fewer cumulative confirmed cases and deaths.This suggests that pharmaceutical interventions(vaccination)are very effective in controlling the outbreak.The simulation showed that scenario with strigent community control and 1.3 times vaccine supply is a good option for combined interventions.By comparing scenarios involving different level of community control and medical resources,it was found that the direct medical expenses of severe patients and the indirect economic losses of dead patients are the highest,and the indirect economic losses are much higher than the direct medical expenses in the same situation.Given the large intervention costs associated with community control and medical resources to assist Wuhan,wearing protective masks and increasing vaccination rate are two major measures that can significantly reduce the number of infections and reduce both direct medical costs and indirect economic losses.The results of this study provide a general reference process and a hybrid modeling framework for simulating the spread of COVID-19 in the real world and the allocation of medical resources,and provide quantitative analysis support for the simulation,and prediction of the spread of COVID-19,which is of great theoretical and practical significance for controlling public health emergencies.Therefore,our government has taken some preventive measures as soon as possible after the outbreak,such as city lockdown,community control,and personal protective measures. |
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