Risk-averse multi-stage stochastic programming to optimizing vaccine allocation and treatment logistics for effective epidemic response

Abstract

Abstract Existing compartmental-logistics models in epidemics control are limited in terms of optimizing the allocation of vaccines and treatment resources under a risk-averse objective. In this paper, we present a data-driven, mean-risk, multi-stage, stochastic epidemics-vaccination-logistics model that evaluates various disease growth scenarios under the Conditional Value-at-Risk (CVaR) risk measure to optimize the distribution of treatment centers, resources, and vaccines, while minimizing the total expected number of infections, deaths, and close contacts of infected people under a limited budget. We integrate a new ring vaccination compartment into a Susceptible-Infected-Treated-Recovered-Funeral-Burial epidemics-logistics model. Our formulation involves uncertainty both in the vaccine supply and the disease transmission rate. Here, we also consider the risk of experiencing scenarios that lead to adverse outcomes in terms of the number of infected and dead people due to the epidemic. Combining the risk-neutral objective with a risk measure allows for a tradeoff between the weighted expected impact of the outbreak and the expected risks associated with experiencing extremely disastrous scenarios. We incorporate human mobility into the model and develop a new method to estimate the migration rate between each region when data on migration rates is not available. We apply our multi-stage stochastic mixed-integer programming model to the case of controlling the 2018–2020 Ebola Virus Disease (EVD) in the Democratic Republic of the Congo (DRC) using real data. Our results show that increasing the risk-aversion by emphasizing potentially disastrous outbreak scenarios reduces the expected risk related to adverse scenarios at the price of the increased expected number of infections and deaths over all possible scenarios. We also find that isolating and treating infected individuals are the most efficient ways to slow the transmission of the disease, while vaccination is supplementary to primary interventions on reducing the number of infections. Furthermore, our analysis indicates that vaccine acceptance rates affect the optimal vaccine allocation only at the initial stages of the vaccine rollout under a tight vaccine supply.