BACKGROUND PROBLEM: A deadly outbreak of the Swine Flu was reported in SW Asia in June.

Our clinic in Kuwait on a post of approximately 1000 personnel, may be at risk of an outbreak. The post commander is considering four options: 1. Do nothing 2. Invest in personal protective equipment (PPE) at a cost of $300K 3. Vaccinate the entire post at a cost of $500K 4. Vaccinate and invest in PPE at a cost of $800K OBJECTIVE: The post would like to minimize the number of infections due to the flu (available manpower).

Option 1. Do nothing

Option 2. Invest in personal protective equipment (PPE) TRIANGULAR DISTRIBUTION ASSUMPTIONS a. Based on CDC data, the worst case scenario is approximately 60% of the post will be infected if the post invests in PPE. b. In the best case scenario, the outbreak does not reach our outpost (possible due to its remote location in the desert). c. The most likely outcome is 350 people will become infected if the post invests in PPE.

TRIANGULAR DISTRIBUTION ASSUMPTIONS a. Based on CDC data, the worst case scenario is approximately 80% of the post will be infected if no action is taken. b. In the best case scenario, the outbreak does not reach our outpost (possible due to its remote location in the desert). c. The most likely outcome is 40%, or 400 people, will become infected if no preventative actions are taken.

Option 1. Do nothing

Option 2. Invest in personal protective equipment (PPE) FRACTILE DISTRIBUTION ASSUMPTIONS

FRACTILE DISTRIBUTION ASSUMPTIONS

FRACTILE DISTRIBUTION ASSUMPTIONS a. Used the Triangular distribution data as the best, median and worst cases. b. With no action, we assumed that the 25th percentile outcome would be close to the median, and the 75th percentile result would be close to the worst case.Therefore, the 25th and 75th percentiles were assumed to be 300 and 700, respectively.

FRACTILE DISTRIBUTION ASSUMPTIONS a. Used the Triangular distribution data as the best, median and worst cases. b. We assumed that the vaccination effectiveness would be approximately linear centered around 350 infections with the worst case as a "long tail." Therefore, the 25th and 75th percentiles were assumed to be 250 and 450, respectively

Asia in June. Our clinic, located

25th median (50) 75th GUIDANCE: best (0) ForNo each option, clearly 0 define the random variable construct action 300 400 and 700 fractile respectively based on450 available PPE and triangular distribution 0 100 350 data or reasonable assumptions. Plot cumulative distribution Vaccination 0 200 300 450 function (cdf) and probability density (pdf) for both PPE and Vaccination 0 25 function 100 130 distributions. For each option, calculate the expected value and the conditional expected value of the random variable.

u (available manpower).

- Plot your results in the functional space, identify Pareto-optimal solutions and discuss your results. I placed these assumptions here but we put them with their repsective tabs. The bit out of place here

al protective

Option 3. Vaccinate the entire post

Option 4. Vaccinate and invest in PPE

TRIANGULAR DISTRIBUTION ASSUMPTIONS worst case 60% of the post invests in a. Based on CDC data, the worst case scenario is approximately 50% of the post will be infected if the entire post is vaccinated. b. In the best case scenario, the outbreak does not reach our outpost (possible due to its remote location in the desert). c. The most likely outcome is 200 people will become infected if the entire post is vaccinated. This is based on the CDC planning approximation of an 80% effective vaccine.

TRIANGULAR DISTRIBUTION ASSUMPTIONS a. Based on CDC data, the worst case scenario is approximately 35% of the post will be infected if the entire post is vaccinated and invests in PPE. b. In the best case scenario, the outbreak does not reach our outpost (possible due to its remote location in the desert). c. The most likely outcome is 100 people will become infected if the entire post is vaccinated and invests in PPE.

our outpost e location in

e is 350 people e post invests

protective

Option 3. Vaccinate the entire post

NOT Sure if the assumptions make any sens (areas highlight in RED). Please check and re as needed. Option 4. Vaccinate and invest in PPE

UMPTIONS

FRACTILE DISTRIBUTION ASSUMPTIONS

FRACTILE DISTRIBUTION ASSUMPTIONS

UMPTIONS

FRACTILE DISTRIBUTION ASSUMPTIONS a. Used the Triangular distribution data as the best, median and worst cases. b. Based on the CDC report, vaccines are generally 80% effective. We assumed that the vaccination effectiveness would be approximately parabolic centered around 200 infections - with the worst case as a "long tail." Therefore, the 25th and 75th percentiles were assumed to be 100 and 300, respectively.

FRACTILE DISTRIBUTION ASSUMPTIONS a. Used the Triangular distribution data as the best, median and worst cases. b.We assumed that the vaccination effectiveness would be a skewed parabolic centered around 100 infections - with the worst case as a "long tail." Therefore, the 25th and 75th percentiles were assumed to be 50 and 125, respectively.

bution data

h percentiles

worst (100) ble and construct 800 ased on available 600 distribution 500 df) for both 350

e and the

optimal

ed these assumptions here but we could em with their repsective tabs. They seem a t of place here - then again the whole

ntire post is

s 100 people ntire post is

if the assumptions make any sense hlight in RED). Please check and revise

never less than Most Likely never more than alpha expected value slope x conditional E(X)

a c b 0.1 400 -0.00000625 621.1145618 680.7430412

0 400 800

0 0.0025 0 Do Nothing

0.003 0.0025 0.002

Do nothing 0 0 25 0.001953 50 0.007813 75 0.017578 100 0.03125 125 0.048828 150 0.070313 175 0.095703 200 0.125 225 0.158203 250 0.195313 275 0.236328 300 0.28125 325 0.330078 350 0.382813 375 0.439453 400 0.5 425 0.560547 450 0.617188 475 0.669922 500 0.71875 525 0.763672 550 0.804688 575 0.841797 600 0.875 625 0.904297 650 0.929688 675 0.951172 700 0.96875 725 0.982422 750 0.992188 775 0.998047 800 1

0.0015 0.001 0.0005 0 0 200

never less than 1.2 Most Likely 1 never more than

0.8 0.6 0.4 0.2 0 0 200

Expected Value

Do Nothing

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best (0) 0 1 0

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y 0 0 300 300 400 400 700 700 800 800 0 0.000833 0.000833 0.0025 0.0025 0.000833 0.000833 0.0025 0.0025 0

From alpha calculate beta (assume alpha = 0.1 1-alpha = 0.9 beta = 760

Interpretation of beta Beta is the level of adverse con that can be exceeded with wit

EXCEEDENCE 25th median (50) 75th worst (100) 0.25 0.5 0.75 1 cumulative 0.75 0.5 0.25 0 exceedance 300 400 700 800
1.2 1 0.8

Density Plot 300 400 700 0.0025 0.000833333 0.0025 0.000833 0.0025 0.000833

800 0 0.0025

0.6 0.4 0.2 0 0 200

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0.003 0.0025 0.002

m alpha calculate beta (assume alpha is greater than .75)

0.002 0.0015

# infected

0.001 0.0005

Beta is the level of adverse consequence (# infected) that can be exceeded with with (1-alpha) probability.

0 0 200

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