Abstract
We study the feedback processes between individual behavior, disease prevalence, interventions and social networks during an influenza pandemic when a limited stockpile of antivirals is shared between the private and the public sectors. An economic model that uses prevalence-elastic demand for interventions is combined with a detailed social network and a disease propagation model to understand the feedback mechanism between epidemic dynamics, market behavior, individual perceptions, and the social network. An urban and a rural region are simulated to assess the robustness of results. Results show that an optimal split between the private and public sectors can be reached to contain the disease but the accessibility of antivirals from the private sector is skewed towards the richest income quartile. Also, larger allocations to the private sector result in wastage where individuals who do not need it are able to purchase it but who need it cannot afford it. Disease prevalence increases with household size and total contact time but not by degree in the social network, whereas wastage of antivirals decreases with degree and contact time. The best utilization of drugs is achieved when individuals with high contact time use them, who tend to be the school-aged children of large families.
Highlights
Successful pandemic preparedness for influenza demands full participation from the private and public sectors
This research considers the distribution of a limited antiviral stockpile between the markets and the hospitals with the aim of meeting the following goals: keep the disease spread under control by treating the infected at the hospitals for free; sell the market stockpile at a nominal cost so the worried-well at home can buy the antivirals for prevention; and help recover the cost of the stockpile
We find that in both regions, it is beneficial to split the antiviral stockpile between the private and public sectors because it helps to control the spread of the disease and recover the cost of antivirals
Summary
Successful pandemic preparedness for influenza demands full participation from the private and public sectors. This research considers the distribution of a limited antiviral stockpile between the markets (private sector) and the hospitals (public sector) with the aim of meeting the following goals: keep the disease spread under control by treating the infected at the hospitals for free; sell the market stockpile at a nominal cost so the worried-well at home can buy the antivirals for prevention; and help recover the cost of the stockpile. We identify optimum strategies that divide the antiviral stockpile between the market and the hospitals so that the epidemic stays under control and the entire cost of antivirals is recovered through the market. This is combined with a social distancing strategy that modifies the social network and changes opportunities for transmission, eventually affecting the evolution of the disease[11]
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