Government releases Weill computer model for bioterror response

By Timothy Paul

NEW YORK, N.Y. -- The U.S. Department of Health and Human Services has announced the release of a new computer model, developed by researchers in the Department of Public Health at Weill Cornell Medical College, that will help health officials better plan large-scale antibiotic dispensing and vaccination responses to bioterrorism and large-scale epidemics. Funded by the Agency for Healthcare Research and Quality (AHRQ), this is the first such computer model that hospitals and public health agencies can easily download and customize to meet their local needs. The computer model will be made available to all 50 states and major U.S. cities in order to help them comply with federal guidelines on preparedness for large-scale disasters.

The computer model allows public health and emergency planners to estimate the number and type of staff required to operate mass prophylaxis clinics that provide an entire locality with critical antibiotics or vaccinations in a timely fashion. The model is available for use and for download from the Department of Health and Human Services Web site in HTML and Excel spreadsheet form at http://www.ahrq.gov/research/biomodel.htm.

"This is science-based research at its best," said Secretary of Health and Human Services Tommy G. Thompson. "Weill Cornell Medical College and the many other research institutions funded by HHS are providing health care systems with the critical information and tools they'll need in responding to the unthinkable."

"This model aids not only the design of clinics, but the design and operation of an entire communitywide mass prophylaxis campaign," said Dr. Nathaniel Hupert, the model's author and assistant professor of public health and medicine at Weill Cornell Medical College and assistant attending physician at NewYork-Presbyterian Hospital.

"This work represents the culmination of a multiyear, AHRQ-funded initiative by the Department of Public Health at Weill Cornell to provide real-world tools necessary to plan large-scale public health response strategies to bioterrorism or natural epidemics," said Dr. Alvin Mushlin and Dr. Mark Callahan, in a prepared statement. Mushlin is chair of the Department of Public Health at Weill Cornell Medical College and attending physician at NewYork-Presbyterian Hospital, and Callahan is associate professor of public health and medicine at Weill Cornell and associate attending physician at NewYork-Presbyterian.

Hupert and his colleagues developed the model after testing a variety of patient triage and drug-dispensing plans from New York City, the District of Columbia, Florida, California and other states and after evaluating live mass prophylaxis exercises in Arizona and New York City, in which thousands of volunteers were given simulated medications in response to a hypothetical anthrax release. Taking elements from these plans and from prior collaborative work with government agencies, the Weill Cornell researchers developed two "best practice" dispensing clinic designs for bioterrorism response, including attacks involving anthrax and smallpox.

The researchers then developed mathematical representations of clinic activity, using discrete event simulation modeling, and adapted these for use in common spreadsheet and Web-based programs. They represent the activities of clinic staff and patients and provide customizable information -- including number of clinic sites, number of staff required and the time required to complete a mass prophylaxis campaign, as well as a number of customizable variables, such as the number of law enforcement personnel required for efficient operation of the clinics.

In the instance of a smallpox attack on Chicago (population of 2.8 million), for example, the seven-day, 24-hour medical response would require 8,895 staff members (including medical personnel, counselors and support staff). With an anthrax attack on the same population, a total staffing of 6,461 would be needed. For a smallpox attack on Washington, D.C. (population 570,000), 1,811 staff would be needed to vaccinate the entire population in one week; for an anthrax attack, 1,315 staff would be needed.