A Novel Approach to Multihazard Modeling and Simulation

Authored by Silas W. Smith, Ian Portelli, Giuseppe Narzisi, Lewis S. Nelson, Fabian Menges, E. Dianne Rekow, Joshua S. Mincer, Bhubaneswar Mishra, Lewis R. Goldfrank

Date Published: 2009-06

DOI: 10.1097/dmp.0b013e3181a88899

Sponsors: United States Department of Defense United States Department of Homeland Security

Platforms: Repast

Model Documentation: Other Narrative Mathematical description

Model Code URLs: Model code not found

Abstract

Objective: To develop and apply a novel modeling approach to support medical and public health disaster planning and response using a sarin release scenario in a metropolitan environment. Methods: An agent-based disaster simulation model was developed incorporating the principles of dose response, surge response, and psychosocial characteristics superimposed on topographically accurate geographic information system architecture. The modeling scenarios involved passive and active releases of sarin in multiple transportation hubs in a metropolitan city. Parameters evaluated included emergency medical services, hospital surge capacity (including implementation of disaster plan), and behavioral and psychosocial characteristics of the victims. Results: In passive sarin release scenarios of 5 to 15 L, mortality increased nonlinearly from 0.13% to 8.69%, reaching 55.4% with active dispersion, reflecting higher initial doses. Cumulative mortality rates from releases in 1 to 3 major transportation hubs similarly increased nonlinearly as a function of dose and systemic stress. The increase in mortality rate was most pronounced in the 80% to 100% emergency department occupancy range, analogous to the previously observed queuing phenomenon. Effective implementation of hospital disaster plans decreased mortality and injury severity. Decreasing ambulance response time and increasing available responding units reduced mortality among potentially salvageable patients. Adverse psychosocial characteristics (excess worry and low compliance) increased demands on health care resources. Transfer to alternative urban sites was possible. Conclusions: An agent-based modeling approach provides a mechanism to assess complex individual and systemwide effects in rare events. (Disaster Med Public Health Preparedness. 2009; 3: 75-87)

Tags

Agent-based model Mortality crowding resource utilization sarin