%0 Journal Article
%T Predictive and Reactive Distribution of Vaccines and Antivirals during Cross-Regional Pandemic Outbreaks
%A Andr¨¦s Uribe-S¨˘nchez
%A Alex Savachkin
%J Influenza Research and Treatment
%D 2011
%I Hindawi Publishing Corporation
%R 10.1155/2011/579597
%X As recently pointed out by the Institute of Medicine, the existing pandemic mitigation models lack the dynamic decision support capability. We develop a large-scale simulation-driven optimization model for generating dynamic predictive distribution of vaccines and antivirals over a network of regional pandemic outbreaks. The model incorporates measures of morbidity, mortality, and social distancing, translated into the cost of lost productivity and medical expenses. The performance of the strategy is compared to that of the reactive myopic policy, using a sample outbreak in Fla, USA, with an affected population of over four millions. The comparison is implemented at different levels of vaccine and antiviral availability and administration capacity. Sensitivity analysis is performed to assess the impact of variability of some critical factors on policy performance. The model is intended to support public health policy making for effective distribution of limited mitigation resources. 1. Introduction As of July 2010, WHO has reported 501 confirmed human cases of avian influenza A/(H5N1) which resulted in 287 deaths worldwide [1]. At the same time, the statistics for the H1N1 2009 outbreak has so far included 214 countries with a total reported number of infections and deaths of 419,289 and 18,239, respectively [2]. Today, an ominous expectation exists that the next pandemic will be triggered by a highly pathogenic virus, to which there is little or no pre-existing immunity in humans [3]. The nation's ability to mitigate a pandemic influenza depends on the available emergency response resources and infrastructure, and, at present, challenges abound. Predicting the exact virus subtype remains a difficult task, and even when identified, reaching an adequate vaccine supply can currently take up to nine months [4, 5]. Even if the existing vaccines prove to be potent, their availability will be limited by high production and inventory costs [6, 7] and also will be constrained by the supply of antiviral drugs, healthcare providers, hospital beds, medical supplies, and logistics. Hence, pandemic mitigation will have to be done amidst limited availability of resources and supporting infrastructure. This challenge has been acknowledged by WHO [7] and echoed by the HHS and CDC [8, 9]. The existing models on pandemic influenza (PI) containment and mitigation aims to address various complex aspects of the pandemic evolution process including: (i) the mechanism of disease progression, from the initial contact and infection transmission to the asymptomatic phase,
%U http://www.hindawi.com/journals/irt/2011/579597/