Comprehensive Policymaking Framework for Sustainable Epidemic Response and Resilience

Description

On 19 July 2021, the UK lifted most COVID-19 related restrictions[1]. The next day, Victoria, Australia extended its fifth lockdown by one week[2]. The wildly differing responses and attitudes by world governments to the COVID-19 pandemic reflect the numerous considerations that must be made, including vaccination rates, healthcare capacity, and economic impact. In particular, medical centres and hospitals must balance both COVID-19 and non-COVID-19 services, attempting to clear backlogs of elective services while also dealing with staff burnout and resignations as the pandemic drags on. For better decision-making, models are required for predicting healthcare utilization and patient flow in hospitals during this pandemic (or a possible future epidemic), accounting for the effect of vaccination, the appearance of new disease variants, and changes in public health policy. In this project, we will develop a framework for decision-making in ICUs during the current pandemic and future epidemics, particularly in the later stages and the transition to "sustainable endemicity"[3]. Our framework will be generic, allowing for the modelling of diverse scenarios and what-if analyses, and will consider the effects of vaccination, disease mutations, and migration (in order to model countries reopening to international travel). Additionally, we will consider network-based epidemiological models in our analysis, which thus captures the effect of superspreading events and the emergence of new variants. Next, we will develop methods for evaluating performance metrics, which we will use to solve optimization problems such as resource allocation/staffing, patient routing, admission control/triage and early discharges, and elective scheduling. Finally, to demonstrate the feasibility and usefulness of the proposed framework, we will apply it to an example ICU network based on real ICU and COVID- 19 epidemiological data collected from Hong Kong and other metropolitan regions. The results of this project will thus become highly valuable for future epidemics of novel infectious diseases, particularly for determining how quickly nations and states can lift restrictions without overloading public health systems. The Hong Kong Hospital Authority's Coordinating Committee of Intensive Care fully supports this project and will collaborate with our research team at CityU (see the attached support letter). This work is motivated by the PI's practical experience and recent research achievements in traffic and epidemiological modelling and the clinical needs and medical know-how of the Coordinating Committee, members of which will also serve as Co-Is. Additionally, one Co-I has extensive epidemiological modelling experience, including COVID-19 modelling for multiple interconnected geographical regions[4,5].