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Design of control strategies to help prevent the spread of COVID-19 pandemic.

ABSTRACT: This paper proposes control strategies to allocate COVID-19 patients to screening facilities, health facilities, and quarantine facilities for minimizing the spread of the virus by these patients. To calculate the transmission rate, we propose a function that accounts for contact rate, duration of the contact, age structure of the population, susceptibility to infection, and the number of transmission events per contact. Moreover, the COVID-19 cases are divided into different groups according to the severity of their disease and are allocated to appropriate health facilities that provide care tailored to their needs. The multi-stage fuzzy stochastic programming approach is applied to cope with uncertainty, in which the probability associated with nodes of the scenario tree is treated as fuzzy variables. To handle the probabilistic model, we use a more flexible measure, Me measure, which allows decision-makers to adopt varying attitudes by assigning the optimistic-pessimistic parameter. This measure does not force decision-makers to hold extreme views and obtain the interval solution that provides further information in the fuzzy environment. We apply the proposed model to the case of Tehran, Iran. The results of this study indicate that assigning patients to appropriate medical centers improves the performance of the healthcare system. The result analysis highlights the impact of the demographic differences on virus transmission, and the older population has a greater influence on virus transmission than other age groups. Besides, the results indicate that behavioral changes in the population and their vaccination play a key role in curbing COVID-19 transmission.

SUBMITTER: Hosseini-Motlagh SM

PROVIDER: S-EPMC8592648 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundDuring the spread of the novel coronavirus disease (COVID-19), internet hospitals in China were engaged with epidemic prevention and control, offering epidemic-related online services and medical support to the public.ObjectiveThe aim of this study is to explore the role of internet hospitals during the prevention and control of the COVID-19 outbreak in China.MethodsOnline epidemic-related consultations from multicenter internet hospitals in China during the COVID-19 epidemic were collected. The counselees were described and classified into seven type groups. Symptoms were recorded and compared with reported patients with COVID-19. Hypochondriacal suspicion and offline visit motivation were detected within each counselees' group to evaluate the social panic of the epidemic along with the consequent medical-seeking behaviors. The counselees' motivation and the doctors' recommendation for an offline visit were compared. Risk factors affecting the counselees' tendency of hypochondriacal suspicion and offline visit motivation were explored by logistic regression models. The epidemic prevention and control measures based on internet hospitals were listed, and the corresponding effects were discussed.ResultsA total of 4913 consultations were enrolled for analysis with the median age of the counselees at 28 years (IQR 22-33 years). There were 104 (2.12%) healthy counselees, 147 (2.99%) hypochondriacal counselees, 34 (0.69%) exposed counselees, 853 (17.36%) mildly suspicious counselees, 42 (0.85%) moderately suspicious counselees, 3550 (72.26%) highly suspicious counselees, and 183 (3.72%) severely suspicious counselees. A total of 94.20% (n=4628) of counselees had epidemic-related symptoms with a distribution similar to those of COVID-19. The hypochondriacal suspicion (n=2167, 44.11%) was common. The counselees' motivation and the doctors' recommendation for offline visits were inconsistent (P<.001) with a Cohen kappa score of 0.039, indicating improper medical-seeking behaviors. Adult counselees (odds ratio [OR]=1.816, P<.001) with epidemiological exposure (OR 7.568, P<.001), shortness of breath (OR 1.440, P=.001), diarrhea (OR 1.272, P=.04), and unrelated symptoms (OR 1.509, P<.001) were more likely to have hypochondriacal suspicion. Counselees with severe illnesses (OR 2.303, P<.001), fever (OR 1.660, P<.001), epidemiological exposure history (OR 1.440, P=.01), and hypochondriacal suspicion (OR 4.826, P<.001) were more likely to attempt an offline visit. Reattending counselees (OR 0.545, P=.002) were less motivated to go to the offline clinic.ConclusionsInternet hospitals can serve different types of epidemic counselees, offer essential medical supports to the public during the COVID-19 outbreak, reduce the social panic, promote social distancing, enhance the public's ability of self-protection, correct improper medical-seeking behaviors, reduce the chance of nosocomial cross-infection, and facilitate epidemiological screening, thus, playing an important role on preventing and controlling COVID-19.

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Design of control strategies to help prevent the spread of COVID-19 pandemic.

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