A new computer model incorporating a wider range of variables can foster better outcomes in large-scale emergency situations. PLAN C is an agent-based modeling approach that allows researchers to assess both individual and system-wide effects in public health disasters. Its purpose is to help evaluate both explicit tracing of individual behavior and macroscopic analysis of population trends in catastrophic events, the researchers said. The model integrates dose response, surge response, and psychosocial characteristics — an appropriate amount of complexity, factual data, timeliness, and functionality.
To test the PLAN C model in a hypothetical scenario, the nerve agent sarin was released in three locations in New York City: the Port Authority Bus Terminal, Grand Central Terminal, and Penn Station. The evaluation looked at emergency medical services, hospital surge capacity, and behavioral and psychosocial characteristics of the victims — particularly patient “worry” using GIS technology. The researchers found that in a passive release of sarin ranging from 5 to 15 L, mortality increased from 0.13% to 8.69%, reaching 55.4% with active dispersion.
The increase in mortality rate was most pronounced in the 80% to 100% emergency department occupancy range and adverse psychosocial characteristics — such as excess worry and low compliance — increased demands on healthcare resources. Further work is needed to address theoretical and computational limitations, refinement, and the integration of additional parameters of interests, other participants in disaster response, alternative hazard scenarios, and consequences of model overfitting.
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Melissa Lawrence, Social Marketing Administrator, VERTICES, LLC