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http://conacyt.repositorioinstitucional.mx/jspui/handle/1000/2928| A flexible load sharing system optimising ICU demand in the context of COVID-19 pandemic | |
| Lacasa Lucas. Challen Robert. Brooks-Pollock Ellen. Danon Leon. | |
| Acceso Abierto | |
| Atribución-NoComercial-SinDerivadas | |
| 10.1101/2020.03.31.20049239 | |
| As the number of cases of COVID-19 continues to grow exponentially, local health services are likely to be overwhelmed with patients requiring intensive care. We develop and implement an algorithm to provide optimal re-routing strategies to either transfer patients requiring Intensive Care Units (ICU) or ventilators, constrained by feasibility of transfer. We validate our approach with realistic data extracted from UK and Spain. For the UK case, we coarse-grain the NHS system at the level of NHS trusts and, subsequently cover the whole set of geopositioned trusts to extract a 4-regular geometric graph which indicates, for a given trust, its four nearest neighbors. The Spanish case is analysed at the autonomous community level, and we extract a contact network where nodes correspond to autonomous communities and links indicate adjacent communities. Estimates of weekly ICU demand could be extrapolated from an age structured epidemiological model by considering contagion-to-ICU likelihood estimates or alternatively from available data. Through random search optimisation we identify the best load sharing strategy, where the cost function to minimise is based on the total number of ICU units above capacity and we implement and test two optimisation strategies. Our framework is flexible allowing for additional criteria, different cost functions, and this methodology is general enough that it can easily be extended to optimise other resources beyond ICU units or ventilators. Assuming a uniform ICU demand across trusts, we show that using our method it is possible to enable access to ICU treatment to up to 1000 cases in the UK in a single step of the algorithm, and with more realistic demand the algorithm is able to balance about 600 beds per step in the Spanish system, leading to potentially saving a large percentage of these lives that would otherwise not have access to ICU if no load sharing was implemented. | |
| www.medrxiv.org | |
| 2020 | |
| Artículo | |
| https://www.medrxiv.org/content/medrxiv/early/2020/04/03/2020.03.31.20049239.full.pdf | |
| Inglés | |
| VIRUS RESPIRATORIOS | |
| Aparece en las colecciones: | Artículos científicos |
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| 1102995.pdf | 798.75 kB | Adobe PDF | Visualizar/Abrir |