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Responding to Simulated Pandemic Influenza in San Antonio, Texas

Published online by Cambridge University Press:  02 January 2015

George Miller ,
Stephen Randolph  and
Jan E. Patterson
George Miller*
Affiliation:
Altarum Institute, Ann Arbor, Michigan
Stephen Randolph
Affiliation:
Altarum Institute, San Antonio, Texas
Jan E. Patterson
Affiliation:
Departments of Medicine and Pathology, University of Texas Health Science Centerand South Texas Veterans Health Care System, San Antonio, Texas
*
Altarum Institute, P.O. Box 134001, Ann Arbor, MI 48113-4001 (george.miller@altarum.org)
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Abstract

Objective.

To describe the results of a simulation study of the spread of pandemic influenza, the effects of public health measures on the simulated pandemic, and the resultant adequacy of the surge capacity of the hospital infrastructure and to investigate the adequacy of key elements of the national pandemic influenza plan to reduce the overall attack rate so that surge capacity would not be overwhelmed.

Design.

We used 2 discrete-event simulation models: the first model simulates the contact and disease transmission process, as affected by public health interventions, to produce a stream of arriving patients, and the second model simulates the diagnosis and treatment process and determines patient outcomes.

Setting.

Hypothetical scenarios were based on the response plans, infrastructure, and demographic data of the population of San Antonio, Texas.

Results.

Use of a mix of strategies, including social distancing, antiviral medications, and targeted vaccination, may limit the overall attack rate so that demand for care would not exceed the capacity of the infrastructure. Additional simulations to assess social distancing as a sole mitigation strategy suggest that a reduction of infectious community contacts to half of normal levels would have to occur within approximately 7 days.

Conclusions.

Under ideal conditions, the mix of strategies may limit demand, which can then be met by community surge capacity. Given inadequate supplies of vaccines and antiviral medications, aggressive social distancing alone might allow for the control of a local epidemic without reliance on outside support.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 29 , Issue 4 , April 2008 , pp. 320 - 326
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2008

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