Optimization of Influenza Antiviral Response in Texas.

摘要

Influenza pandemics pose a serious threat to the global population. According to the United States Department of Health and Human Services in 2014, the Spanish flu of 1918 killed almost 100 million people worldwide and Simonsen, Spreeuwenberg, and Lustig in 2013 estimated that the Swine flu more recently killed approximately 180,000 people. Government agencies, from the United States Centers for Disease Control and Prevention down to state and local regions, are prepared to respond to potential influenza pandemics with antiviral, vaccine, and social interventions. Mathematical models can guide policies to saves lives. In this thesis, we create an optimization model, implemented in the online tool Texas Antiviral Release Scheduling (TAVRS) that provides the optimal geo-temporal antiviral release schedule to advise decision makers at the Texas Department of State Health Services. We input the antiviral release schedule into an independent disease-spread simulation model to measure the effectiveness of the optimal release schedule. While the TAVRS optimal antiviral release schedule performs comparably to a simple population-proportionate release schedule during a simulated mild 2009-like influenza pandemic, the TAVRS release schedules saves an additional 10,000 lives three to four times greater than the population-proportionate release schedule when responding to a severe 1918-like influenza pandemic.