Abstract
Dedicated clinics can be established in an influenza pandemic to isolate people and potentially reduce opportunities for influenza transmission. However, their operation requires resources and their existence may attract the worried-well. In this study, we quantify the impact of opening dedicated influenza clinics during a pandemic based on an agent-based simulation model across a time-varying social network of households, workplaces, schools, community locations, and health facilities in the state of Georgia. We calculate performance measures, including peak prevalence and total attack rate, while accounting for clinic operations, including timing and location. We find that opening clinics can reduce disease spread and hospitalizations even when visited by the worried-well, open for limited weeks, or open in limited locations, and especially when the clinics are in operation during times of highest prevalence. Specifically, peak prevalence, total attack rate, and hospitalization reduced 0.07-0.32%, 0.40-1.51%, 0.02-0.09%, respectively, by operating clinics for the pandemic duration.
Highlights
During the H1N1 influenza pandemic in 2009–2020, many people visited health facilities to seek diagnoses and treatment [1]
We evaluated the changes in the prevalence of infection, the total attack rate in population at risk, hospitalizations, and transmission of infections in hospitals along with the resources needed to operate the clinics for different periods of time
We modeled disease spread in households, workplaces and schools, and the community among census tracts and counties in the state of Georgia [15] and quantified the impact of dedicated influenza clinics on transmission
Summary
During the H1N1 influenza pandemic in 2009–2020, many people visited health facilities to seek diagnoses and treatment [1]. Visits to emergency departments (EDs) surge, which might result in opportunities for transmission to others. Some facilities chose to dedicate space and resources to the establishment of clinics, which could diagnose and manage people with known or suspected influenza infections to divert them from EDs [2,3,4]. Dedicated influenza clinics could help to separate people with influenza-like illness (“ILI patients”) from other people seeking care for a non-ILI diagnosis (“non-ILI patients”), and reduce transmission to uninfected people who had the potential for a severe ILI manifestation if exposed. Dedicated influenza clinics required human and material resources at a time when a system.
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