Operational response simulation tool for epidemics within refugee and IDP settlements: A scenario-based case study of the Cox’s Bazar settlement

The spread of infectious diseases such as COVID-19 presents many challenges to healthcare systems and infrastructures across the world, exacerbating inequalities and leaving the world’s most vulnerable populations most affected. Given their density and available infrastructure, refugee and internall...

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Autores principales:	Joseph Aylett-Bullock, Carolina Cuesta-Lazaro, Arnau Quera-Bofarull, Anjali Katta, Katherine Hoffmann Pham, Benjamin Hoover, Hendrik Strobelt, Rebeca Moreno Jimenez, Aidan Sedgewick, Egmond Samir Evers, David Kennedy, Sandra Harlass, Allen Gidraf Kahindo Maina, Ahmad Hussien, Miguel Luengo-Oroz
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Biology (General) QH301-705.5
Acceso en línea:	https://doaj.org/article/71146f995f374f89827b50859bf31ffe
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id	oai:doaj.org-article:71146f995f374f89827b50859bf31ffe
record_format	dspace
institution	DOAJ
collection	DOAJ
language	EN
topic	Biology (General) QH301-705.5
spellingShingle	Biology (General) QH301-705.5 Joseph Aylett-Bullock Carolina Cuesta-Lazaro Arnau Quera-Bofarull Anjali Katta Katherine Hoffmann Pham Benjamin Hoover Hendrik Strobelt Rebeca Moreno Jimenez Aidan Sedgewick Egmond Samir Evers David Kennedy Sandra Harlass Allen Gidraf Kahindo Maina Ahmad Hussien Miguel Luengo-Oroz Operational response simulation tool for epidemics within refugee and IDP settlements: A scenario-based case study of the Cox’s Bazar settlement
description	The spread of infectious diseases such as COVID-19 presents many challenges to healthcare systems and infrastructures across the world, exacerbating inequalities and leaving the world’s most vulnerable populations most affected. Given their density and available infrastructure, refugee and internally displaced person (IDP) settlements can be particularly susceptible to disease spread. In this paper we present an agent-based modeling approach to simulating the spread of disease in refugee and IDP settlements under various non-pharmaceutical intervention strategies. The model, based on the June open-source framework, is informed by data on geography, demographics, comorbidities, physical infrastructure and other parameters obtained from real-world observations and previous literature. The development and testing of this approach focuses on the Cox’s Bazar refugee settlement in Bangladesh, although our model is designed to be generalizable to other informal settings. Our findings suggest the encouraging self-isolation at home of mild to severe symptomatic patients, as opposed to the isolation of all positive cases in purpose-built isolation and treatment centers, does not increase the risk of secondary infection meaning the centers can be used to provide hospital support to the most intense cases of COVID-19. Secondly we find that mask wearing in all indoor communal areas can be effective at dampening viral spread, even with low mask efficacy and compliance rates. Finally, we model the effects of reopening learning centers in the settlement under various mitigation strategies. For example, a combination of mask wearing in the classroom, halving attendance regularity to enable physical distancing, and better ventilation can almost completely mitigate the increased risk of infection which keeping the learning centers open may cause. These modeling efforts are being incorporated into decision making processes to inform future planning, and further exercises should be carried out in similar geographies to help protect those most vulnerable. Author summary The spread of infectious diseases presents many challenges to healthcare systems and infrastructures across the world. Given their density and available infrastructure, refugee and internally displaced person (IDP) settlements can be particularly susceptible to the dangers of disease spread. This study seeks to understand how COVID-19 spreads in settlements, focusing on the Cox’s Bazar refugee settlement in Bangladesh. Our model simulates the movements and interactions of each individual in the settlement, incorporating information about family structures and demographic attributes, to understand how COVID-19 might spread under various intervention strategies. Our analysis suggests that mask wearing in indoor locations can have a significant effect on disease spread, even when wearing reusable cotton masks, which the people in the settlement can make themselves. We also look at different ways to treat individuals who only have milder symptoms and don’t yet require hospitalisation, as well as various scenarios which might allow for the safe reopening of schools in the settlement. With almost 80 million forcibly displaced people in the world, we hope that this work will inspire more modeling groups to focus on these vulnerable populations, which have been traditionally under-served by such efforts, to ensure no one is left behind.
format	article
author	Joseph Aylett-Bullock Carolina Cuesta-Lazaro Arnau Quera-Bofarull Anjali Katta Katherine Hoffmann Pham Benjamin Hoover Hendrik Strobelt Rebeca Moreno Jimenez Aidan Sedgewick Egmond Samir Evers David Kennedy Sandra Harlass Allen Gidraf Kahindo Maina Ahmad Hussien Miguel Luengo-Oroz
author_facet	Joseph Aylett-Bullock Carolina Cuesta-Lazaro Arnau Quera-Bofarull Anjali Katta Katherine Hoffmann Pham Benjamin Hoover Hendrik Strobelt Rebeca Moreno Jimenez Aidan Sedgewick Egmond Samir Evers David Kennedy Sandra Harlass Allen Gidraf Kahindo Maina Ahmad Hussien Miguel Luengo-Oroz
author_sort	Joseph Aylett-Bullock
title	Operational response simulation tool for epidemics within refugee and IDP settlements: A scenario-based case study of the Cox’s Bazar settlement
title_short	Operational response simulation tool for epidemics within refugee and IDP settlements: A scenario-based case study of the Cox’s Bazar settlement
title_full	Operational response simulation tool for epidemics within refugee and IDP settlements: A scenario-based case study of the Cox’s Bazar settlement
title_fullStr	Operational response simulation tool for epidemics within refugee and IDP settlements: A scenario-based case study of the Cox’s Bazar settlement
title_full_unstemmed	Operational response simulation tool for epidemics within refugee and IDP settlements: A scenario-based case study of the Cox’s Bazar settlement
title_sort	operational response simulation tool for epidemics within refugee and idp settlements: a scenario-based case study of the cox’s bazar settlement
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/71146f995f374f89827b50859bf31ffe
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spelling	oai:doaj.org-article:71146f995f374f89827b50859bf31ffe2021-11-04T05:44:46ZOperational response simulation tool for epidemics within refugee and IDP settlements: A scenario-based case study of the Cox’s Bazar settlement1553-734X1553-7358https://doaj.org/article/71146f995f374f89827b50859bf31ffe2021-10-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8553081/?tool=EBIhttps://doaj.org/toc/1553-734Xhttps://doaj.org/toc/1553-7358The spread of infectious diseases such as COVID-19 presents many challenges to healthcare systems and infrastructures across the world, exacerbating inequalities and leaving the world’s most vulnerable populations most affected. Given their density and available infrastructure, refugee and internally displaced person (IDP) settlements can be particularly susceptible to disease spread. In this paper we present an agent-based modeling approach to simulating the spread of disease in refugee and IDP settlements under various non-pharmaceutical intervention strategies. The model, based on the June open-source framework, is informed by data on geography, demographics, comorbidities, physical infrastructure and other parameters obtained from real-world observations and previous literature. The development and testing of this approach focuses on the Cox’s Bazar refugee settlement in Bangladesh, although our model is designed to be generalizable to other informal settings. Our findings suggest the encouraging self-isolation at home of mild to severe symptomatic patients, as opposed to the isolation of all positive cases in purpose-built isolation and treatment centers, does not increase the risk of secondary infection meaning the centers can be used to provide hospital support to the most intense cases of COVID-19. Secondly we find that mask wearing in all indoor communal areas can be effective at dampening viral spread, even with low mask efficacy and compliance rates. Finally, we model the effects of reopening learning centers in the settlement under various mitigation strategies. For example, a combination of mask wearing in the classroom, halving attendance regularity to enable physical distancing, and better ventilation can almost completely mitigate the increased risk of infection which keeping the learning centers open may cause. These modeling efforts are being incorporated into decision making processes to inform future planning, and further exercises should be carried out in similar geographies to help protect those most vulnerable. Author summary The spread of infectious diseases presents many challenges to healthcare systems and infrastructures across the world. Given their density and available infrastructure, refugee and internally displaced person (IDP) settlements can be particularly susceptible to the dangers of disease spread. This study seeks to understand how COVID-19 spreads in settlements, focusing on the Cox’s Bazar refugee settlement in Bangladesh. Our model simulates the movements and interactions of each individual in the settlement, incorporating information about family structures and demographic attributes, to understand how COVID-19 might spread under various intervention strategies. Our analysis suggests that mask wearing in indoor locations can have a significant effect on disease spread, even when wearing reusable cotton masks, which the people in the settlement can make themselves. We also look at different ways to treat individuals who only have milder symptoms and don’t yet require hospitalisation, as well as various scenarios which might allow for the safe reopening of schools in the settlement. With almost 80 million forcibly displaced people in the world, we hope that this work will inspire more modeling groups to focus on these vulnerable populations, which have been traditionally under-served by such efforts, to ensure no one is left behind.Joseph Aylett-BullockCarolina Cuesta-LazaroArnau Quera-BofarullAnjali KattaKatherine Hoffmann PhamBenjamin HooverHendrik StrobeltRebeca Moreno JimenezAidan SedgewickEgmond Samir EversDavid KennedySandra HarlassAllen Gidraf Kahindo MainaAhmad HussienMiguel Luengo-OrozPublic Library of Science (PLoS)articleBiology (General)QH301-705.5ENPLoS Computational Biology, Vol 17, Iss 10 (2021)

Operational response simulation tool for epidemics within refugee and IDP settlements: A scenario-based case study of the Cox’s Bazar settlement

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