A Method for Reducing the Severity of Epidemics by Allocating Vaccines According to Centrality

One long-standing question in epidemiological research is how best to allocate limited amounts of vaccine or similar preventative measures in order to minimize the severity of an epidemic. Much of the literature on the problem of vaccine allocation has focused on influenza epidemics and used mathematical models of epidemic spread to determine the effectiveness of proposed methods. Our work applies computational models of epidemics to the problem of geographically allocating a limited number of vaccines within several Texas counties. We developed a graph-based, stochastic model for epidemics that is based on the SEIR model, and tested vaccine allocation methods based on multiple centrality measures. This approach provides an alternative method for addressing the vaccine allocation problem, which can be combined with more conventional approaches to yield more effective epidemic suppression strategies. We found that allocation methods based on in-degree and inverse betweenness centralities tended to be the most effective at containing epidemics.Comment: 10 pages, accepted to ACM BCB 201

Unethical Treatment Of Patients and Corpses by Paramedics During Covid-19: Evidence From Indonesia

This qualitative research aims to review how paramedics treat patients and corpses during the COVID-19 pandemic in Indonesia. It is still debatable that paramedics treat patients, not by medical ethics and nurse ethics, such as saying the patient has COVID-19 without a medical certificate. Likewise, with corpses, some patients who have died are categorized as COVID-19 victims without medical evidence. It happens because the cost of caring for victims of COVID-19 and the cost of burying a corpse infected with COVID-19 is more expensive than patients or cadavers who died from common diseases or outside COVID-19. Paramedics do not carry out work according to their paramedic ethics. This study uses a socio-legal approach, paramedical ethical theory, and COVID-19 related materials to answers why the paramedics disregard ethical behavior. This research proves that paramedics violated ethics during COVID-19 by betraying their profession with money and not carrying out work according to paramedic ethics. Paramedic ethics must be upheld and not commercialized profession on patients and corpses for cash as it is malpractice of paramedics' ethic and human rights violation. Keywords: Paramedics Ethic, Patient, Corpse, Commercialization, Malpractic

Risk Minimization for Spreading Processes over Networks via Surveillance Scheduling and Sparse Control

Spreading processes, such as epidemics and wildfires, have an initial localized outbreak that spreads rapidly throughout a network. The real-world risks associated with such events have stressed the importance and current limitations of methods to quickly map and monitor outbreaks and to reduce their impact by planning appropriate intervention strategies. This thesis is, therefore, concerned with risk minimization of spreading processes over networks via surveillance scheduling and sparse control. This is achieved by providing a flexible optimization framework that combines surveillance and intervention to minimize the risk. Here, risk is defined as the product of the probability of an outbreak occurring and the future impact of that outbreak. The aim is now to bound or minimize the risk by allocation of resources and use of persistent monitoring schedules. When setting up an optimization framework, four other aspects have been found to be of importance. First of all, being able to provide targeted risk estimation and minimization for more vulnerable or high cost areas. Second and third, scalability of algorithms and sparsity of resource allocation are essential due to the large network structures. Finally, for wildfires specifically, there is a gap between the information embedded in fire propagation models and utilizing it for path planning algorithms for efficient remote sensing. The presented framework utilizes the properties of positive systems and convex optimization, in particular exponential cone programming, to provide flexible and scalable algorithms for both surveillance and intervention purposes. We demonstrate with different spreading process examples and scenarios, focusing on epidemics and wildfires, that the presented framework gives convincing and scalable results. In particular, we demonstrate how our method can include persistent monitoring scenarios and provide more targeted and sparse resource allocation compared to previous approaches

Study of contemporary medical politics

Thesis (Ph. D. in History, Anthropology, and Science, Technology and Society (HASTS))--Massachusetts Institute of Technology, Program in Science, Technology and Society, 2011.Cataloged from PDF version of thesis.Includes bibliographical references (p. 271-312).Over the past decade, the prevention and control of seasonal and pandemic influenza has grown to be one of the largest and most visible public health policies. This dissertation considers contemporary influenza policy as a case study in what I call medical politics, in which a disease that for most people is rather unremarkable has become the focus of intense (and costly) public health campaigns based on a shaky scientific basis. The dissertation seeks to explain how this could happen. The first two chapters show how influenza and its pandemics are marketed through an appeal to numerous scientific claims. Drawing on governmental marketing materials, statements by officials, and policy documents, I try to let officials speak for themselves and, as much as possible, refrain from analysis. Chapter 3 tells the story of the 2009 novel influenza H1N1 outbreak, showing how official understandings about influenza were called into question by an outbreak far milder than experts had predicted, and discusses investigations which highlighted the role of industry in shaping influenza policy. Chapter 4 analyzes official scientific claims regarding influenza, and argues that degree to which influenza is a serious public health problem is actually unclear. Furthermore, influenza vaccine effectiveness has been vastly overstated, predictive models of pandemic influenza are demonstrably flawed, and officials conflate true influenza with influenza-like illness (ILl), an often overlooked but critical distinction which allows officials to mislead the public into holding false assumptions about the potential benefits of influenza vaccine. Chapter 5 highlights the centrality of "virus-centric thinking" and the ethic of "saving lives" in public health practice as important factors that help explain how such a situation can exist and persist in light of the evidence. Chapter 6 addresses the policy implications of the dissertation's findings.by Peter N. Doshi.Ph.D.in History, Anthropology, and Science, Technology and Society (HAST

The impact of educational interventions on influenza and pneumococcal vaccination rates in primary care

Background. Influenza and pneumococcal vaccinations are important therapies supported by national and international guidelines for preventing morbidity and mortality from respiratory illnesses in high-risk groups. The responsibility for delivering these vaccinations in the United Kingdom lies with primary care. Little is known about how rates of influenza and pneumococcal vaccination can be increased in high-risk groups in primary care. Aim. To research methods of improving rates of influenza and pneumococcal vaccination in high-risk groups in primary care. Objectives. To investigate the impact of educational interventions for primary care teams on influenza and pneumococcal vaccination rates in high-risk groups. Method. The research had the following components: a. Literature search examining current practice and policy in relation to influenza and pneumococcal vaccination and studies undertaken to improve performance, both in general and specifically in relation to improving adult vaccination rates. b. Pilot study of targeting influenza and pneumococcal vaccination to high-risk groups in a single general practice. c. Effect of audit and feedback with an information pack to primary care teams on influenza and pneumococcal vaccination in primary care: before-and-after multipractice study. d. Effect of audit and feedback with an information pack to primary care teams, as part of a clinical governance programme, on influenza and pneumococcal vaccination in a primary care trust: before-and-after multipractice study. e. Randomised controlled study of an educational outreach intervention partly nested within primary care trust study with audit, feedback and information (passive dissemination of guidelines and recommendations) directed at primary health care teams compared with audit feedback and information alone using multifaceted interventions to increase influenza and pneumococcal vaccine uptake in high-risk groups in primary care. Results. The studies demonstrated significant improvements in influenza and pneumococcal vaccination rate in high-risk groups in primary care, showed the levels of improvement that could be expected from these types of intervention and described how primary care teams responded to direct and indirect educational interventions supported by measurement of performance. Conclusions. Education to multiprofessional teams is an important method for diffusion of innovations in the highly professionalised organisations of primary care and general practice. Educators need to understand the complex nature of primary care organisations and teams, when and how education for teams is likely to be successful, the barriers to implementation of new ideas and how to address these. Education when applied appropriately can have important effects in improving health care. This is more likely to occur when careful assessments are made around the nature of the evidence, clear outcomes are sought and measured and the healthcare intervention is understood from the perspective of the patient, the healthcare team and other stakeholders

Policy responses to disaster management: a comparative case study of the BRICS countries to the COVID-19 pandemic.

Masters Degree. University of KwaZulu-Natal, Durban.Disaster management is a component that is responsible for ensuring the protection and safety of countries and their communities. The role of disaster management incudes, to organise the appropriate control mechanisms, allocate the necessary resources and follow the required practice policies. This is all done to prevent, prepare for, respond to as well as recover from a range of emergencies. Disaster management is utilised to respond to a range of disastrous events ranging from natural disasters, man-made disasters, biological disasters and technological disasters The COVID-19 pandemic presented a new set of challenges for countries to combat, which ultimately led to many revisiting their disaster management policy responses. Previous work has failed to address the disaster management policy responses that governments sought to implement particularly when dealing with pandemics. The main aim for governments was to implement effective disaster management policy responses which would result in reducing the spread and impact of the virus. For this, governments relied on restructuring existing disaster management policies to evoke greater powers to make decisions faster. This study sought to investigate the disaster management policy responses in BRICS countries through comparative case approach and SWOT analysis towards the COVID-19 pandemic. The study implemented a qualitative approach, secondary sources of information were used. Secondary sources of information such as articles, journals, books and government publications. These sources were fundamental towards this study because it provided the overall research that was examined in this study. Content thematic analysis was used to comprehend the information collected from texts to present arguments and grasp a coherent conclusion. Comparative case study approach was used for effective comparison among the chosen case studies. The formulation of themes was guided by the Disaster Management Model being mitigation, preparedness, prevention, recovery and response. The results of this study showed that the case studies possessed individual strengths and weaknesses. Due to the impact of the pandemic the policy responses varied based on population size, resources, leadership, accountability and preparedness. This concluded in varied disaster management policy responses that were effective during different stages of the pandemic

International Externalities in Pandemic Influenza Mitigation

A serious influenza pandemic could be devastating for the world. Ideally, such a pandemic could be contained, but this may be infeasible. One promising method for pandemic mitigation is to treat infectious individuals with antiviral pharmaceuticals. While most of the benefits from treatment accrue to the country in which treatment occurs, there are some positive spillovers: when one country treats more of its population this both reduces the attack rate in the other country and increases the marginal benefit from additional treatment in the other country. These externalities and complementarities may mean that self-interested rich countries should optimally pay for some AV treatment in poor countries. This dissertation demonstrates the presence of antiviral treatment externalities in simple epidemiological SIR models, and then in a descriptively realistic Global Epidemiological Model (GEM). This GEM simulates pandemic spread between cities through the international airline network, and between cities and rural areas through ground transport. Under the base case assumptions of moderate transmissibility of the flu, the distribution of antiviral stockpiles from rich countries to poor and lower middle income countries may indeed pay for itself: providing a stockpile equal to 1% of the population of poor countries will reduce cases in rich countries after 1 year by about 6.13 million cases at a cost of 4.62 doses per rich-country case avoided. Concentrating doses on the outbreak country is, however, even more cost-effective: in the base case it reduces the number of influenza cases by 4.76 million cases, at the cost of roughly 1.92 doses per case avoided. These results depend on the transmissibility of the flu strain, the efficacy of antivirals in reducing infection and on the proportion of infectious who can realistically be identified and treated

Networks of inter-organisational coordination during disease outbreaks

Multi-organisational environment is demonstrating more complexities due the ever-increasing tasks’ complications in modern environments. Disease outbreak coordination is one of these complex tasks that require multi-skilled and multi-jurisdictional agencies to coordinate in dynamic environment. This research discusses theoretical foundations and practical approaches to suggest frameworks to study complex inter-organisational networks in dynamic environments, specifically during disease outbreak. We study coo¬¬rdination as being an interdisciplinary domain, and then uses social network theory to model it. I have surveyed 70 health professionals whom have participated in the swine influenza H1N1 2009 outbreak. I collected both qualitative and quantitative data in order to build a comprehensive understanding of the dynamics of the inter-organisational network that evolved during that outbreak. Then I constructed a performance model by use three main components of the network theory: degree centrality, connectedness and tie strength as the independent variables, and disease outbreak inter-organisational performance as the dependent one. In addition, we study both the formal networks and the informal ones. Formal networks are based on the standard operating structures, and the informal ones emerge based on trust, mutual benefits and relationships. Results suggest that the proposed social network measures have positive effect on coordination performance during the outbreak in both formal and informal networks, except centrality in the formal one. In addition, none of those measures influence performance before the outbreak. Practically, the results suggest that increasing the communication frequency and diversifying the tiers of the inter-organisational links enhance the overall network’s performance in formal coordination. In the informal one, links are created with the intention to improve performance; hence, all suggested network measures improve performance