Two resource distribution strategies for dynamic mitigation of influenza pandemics

Figures & data

Figure 1 Schematic of single-region simulation model.

Figure 2 Schematic of disease natural history model.

Table 1 Inter-regional travel probabilities

Origin/destination	Inter-regional travel probability
	Hillsborough	Miami D	Duval	Leon
Hillsborough	0.00	0.60	0.27	0.13
Miami D	0.74	0.00	0.16	0.10
Duval	0.61	0.29	0.00	0.10
Leon	0.52	0.31	0.17	0.00

Table 2 Instantaneous infection probabilities

Age group	0–5	6–19	20–29	31–65	66–99
αi	0.156	0.106	0.205	0.195	0.344

Table 3 Mortality probabilities for different age groups

Age group	% High-risk cases	% Mortality in high-risk cases	μi
0–19	6.4	9.0	0.007
20–64	14.4	40.9	0.069
65+	40.0	34.4	0.162

Table 4 Regional resource and budget requirements

Region (population)	Resource requirements by region					Cost of resource	Required budget
	Hillsb (1,007,916)	Miami D (2,209,702)	Duval (852,168)	Leon (248,761)	Total (4,318,547)
Resource
Vaccine stock	305,036	679,181	241,522	76,007	1,301,745	$8.48/dose	$11.038 M
Antiviral stock	415,294	749,058	460,393	105,307	1,730,052	$60/dose	$103.803 M
No. antiv. nurses	650	1,104	786	166	2,706	$27/hr 8 hr/day, 50 days	$29.226 M
No. vacc. nurses	1,059	2,358	839	264	4,520	$27/hr 8 hr/day, 14 days	$13.668 M
					Total budget requirement		$157.737 M

Table 5 Values of pandemic impact measures (societal and economic costs)

Pandemic impact measure (age group, years)	Value US$
Average cost of lost lifetime productivity of a deceased case (0–19)	$1,336,347.86
Average cost of lost lifetime productivity of a deceased case (20–64)	$1,370,987.28
Average cost of lost lifetime productivity of a deceased case (65–99)	$98,959.24
Average cost of lost productivity and medical expenses of a recovered/deceased case (0–19)	$5,078.48
Average cost of lost productivity and medical expenses of a recovered/deceased case (20–64)	$10,466.68
Average cost of lost productivity and medical expenses of a recovered/deceased case (65–99)	$11,566.09
Average daily cost of lost productivity of a non-infected quarantined case (20–99)	$432.54

Figure 3 Sensitivity analysis on total resource availability (measured in terms of the average number of infected (a) and the average number of deaths (b)).

Figure 4 Sensitivity analysis on total resource availability (measured in terms of the total cost).

Table 6 Average number of regional outbreaks for both models

Model	Total resource availability
	20%	50%	80%
Quantity-based	1.89	1.44	1.38
Budget-based	1.63	1.33	1.20