Design of COVID-19 staged alert systems to ensure healthcare capacity with minimal closures

Haoxiang Yang, Özge Sürer, Daniel Duque, David P. Morton, Bismark Singh, Spencer J. Fox, Remy Pasco, Kelly Pierce, Paul Rathouz, Victoria Valencia, Zhanwei Du, Michael Pignone, Mark E. Escott, Stephen I. Adler, S. Claiborne Johnston and Lauren Ancel Meyers ()
Additional contact information
Haoxiang Yang: Los Alamos National Laboratory
Özge Sürer: Northwestern University
Daniel Duque: Northwestern University
David P. Morton: Northwestern University
Bismark Singh: Friedrich-Alexander-Universität Erlangen-Nürnberg
Spencer J. Fox: The University of Texas at Austin
Remy Pasco: The University of Texas at Austin
Kelly Pierce: The University of Texas at Austin
Paul Rathouz: The University of Texas at Austin
Victoria Valencia: The University of Texas at Austin
Zhanwei Du: The University of Texas at Austin
Michael Pignone: The University of Texas at Austin
Mark E. Escott: The City of Austin
Stephen I. Adler: The City of Austin
S. Claiborne Johnston: The University of Texas at Austin
Lauren Ancel Meyers: The University of Texas at Austin

Nature Communications, 2021, vol. 12, issue 1, 1-7

Abstract: Abstract Community mitigation strategies to combat COVID-19, ranging from healthy hygiene to shelter-in-place orders, exact substantial socioeconomic costs. Judicious implementation and relaxation of restrictions amplify their public health benefits while reducing costs. We derive optimal strategies for toggling between mitigation stages using daily COVID-19 hospital admissions. With public compliance, the policy triggers ensure adequate intensive care unit capacity with high probability while minimizing the duration of strict mitigation measures. In comparison, we show that other sensible COVID-19 staging policies, including France’s ICU-based thresholds and a widely adopted indicator for reopening schools and businesses, require overly restrictive measures or trigger strict stages too late to avert catastrophic surges. As proof-of-concept, we describe the optimization and maintenance of the staged alert system that has guided COVID-19 policy in a large US city (Austin, Texas) since May 2020. As cities worldwide face future pandemic waves, our findings provide a robust strategy for tracking COVID-19 hospital admissions as an early indicator of hospital surges and enacting staged measures to ensure integrity of the health system, safety of the health workforce, and public confidence.

Date: 2021
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DOI: 10.1038/s41467-021-23989-x

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