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India: Simulation to Strengthen Pandemic  Response 

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A team of researchers from the Indian Institute of Technology Delhi (IIT-Delhi), the All-India Institute of Medical Sciences (AIIMS), and the University of Exeter Business School, have developed a probabilistic discrete-event simulation of the operations of a public healthcare network in a north Indian district. The team demonstrated its use for planning the capacity of the network for a single wave of the COVID-19 pandemic.

A statement from IIT-Delhi said that the pandemic caused significant strain on healthcare systems across the world, revealing insufficiencies in existing infrastructure, which struggled to handle the overwhelming caseload. To address this demand-capacity gap, makeshift COVID-19 facilities were established globally, such as the Nightingale hospitals in the United Kingdom and COVID-19 Care Centres (CCCs) in India.

The team recognised the need for analytical tools that offer quantitative evaluations of the capability of existing healthcare infrastructure in a particular region, which often consists of multiple tiers, to effectively handle pandemic caseloads. This information is crucial for appropriately planning the capacity of makeshift COVID-19 care facilities. The tools must possess the capability to effectively manage the considerable uncertainty inherent in these situations, for instance, around care provision processes, caseload fluctuations, patient progression, and patient flow across the network.

The public healthcare network they modelled was established using data from the COVID-19 caseload experienced during the first wave in a district located in North India. The network consisted of 10 primary health centres (PHCs), 3 community health centres (CHCs), and a district hospital. To create an accurate representation, simulation models of the operations of each of these facilities were created and then linked together to build the public health network simulation. The researchers devised a pandemic response strategy, which was integrated into the simulation model.

The simulation results revealed that the existing capacity of the public health network, specifically in terms of general ward beds, ICU beds with supplemental oxygen, and ICUs with ventilator beds, needs to be strengthened to cope with the wave of COVID-19 cases. Furthermore, a care centre would be required. However, it was found that the capacity of medical personnel, including doctors and nurses, was sufficient for providing medical care (excluding administration and paperwork) during the simulated wave. Using the simulation tool, the researchers then estimated the required capacity for the makeshift COVID-19 care centre to minimise patient wait times and ensure timely access to appropriate care.

Although the simulation tool was demonstrated through a COVID-19 case study, it can facilitate planning the operational response of the public health network in any region facing various health crises, including outbreaks like dengue or cholera. Additionally, the tool proves valuable in assessing the impact of operational policy changes during routine care situations, such as when a new referral policy from lower-tier to higher-tier facilities is introduced.

IIT-Delhi, one of the 23 IITs in India, was established with the primary purpose of serving as a Centre of Excellence for education, research, and technological development in the fields of science and engineering. Originally founded as the College of Engineering in 1961, it gained recognition as an Institution of National Importance through the “Institutes of Technology (Amendment) Act, 1963,” and was renamed as the “Indian Institute of Technology Delhi”.


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