Mathematical Modeling and
Public Policy: Responding to Health Crises1
John Glasser,*
Martin Meltzer,* and Bruce Levin†
*Centers for Disease Control and Prevention, Atlanta, Georgia, USA; and
†Emory University, Atlanta, Georgia, USA
Suggested
citation for this article
Mathematical models have long been used to study complex biologic processes,
such as the spread of infectious diseases through populations, but health
policymakers have only recently begun using models to design optimal strategies
for controlling outbreaks or to evaluate and possibly improve programs
for preventing them. In this session, three examples of such models were
examined.
Antibiotic
Resistance in Hospital Settings
Patient dependency characterizes the epidemiology of disease transmission
within multiple small wards with rapid patient turnover. Other variables
affecting the epidemiology of resistance are the use of antimicrobial
agents, introduction of colonized patients, and efficacy of infection-control
measures. A Markov chain model originally made for vector-borne diseases
was used to elucidate the relative importance of different routes within
intensive care units.
Managing
Foot-and-Mouth Disease Epidemics
State-of-the-art modeling approaches were used in Britain during the
outbreak of 2001 to address such questions as: Were planned control policies
sufficient to bring the epidemic under control? What was the optimal intensity
of preemptive culling? Would a logistically feasible vaccination program
be a more effective control option? This "real-time" use of
models, although of help in devising an effective control strategy, also
proved controversial.
Developing
Smallpox Models as Policy Tools
Although models of infectious diseases have influenced public policy,
that process and its results could be improved by regular, direct contact
and communication between modelers, policy advisors, and other infectious-disease
experts. At the U.S. Department of Health and Human Services, the Secretary's
Council on Public Health Preparedness is sponsoring initiatives using
various modeling approaches to assess biodefense strategies.
Common themes in this session were: 1) involving substantive experts,
thereby ensuring that conceptual frameworks underlying the mathematics
are faithful to current understanding of complex natural phenomena, 2)
including all possible interventions, which could then be evaluated alone
or in various combinations, and 3) identifying inadequacies in available
information, for augmentation through further research.
1Presented at the International Conference
on Emerging Infectious Diseases, Atlanta, Georgia, February 29 –
March 3, 2004, by Marc Bonten, Utrecht University Medical Center; Mark
Woolhouse, University of Edinburgh; and Ellis McKenzie, National Institutes
of Health.
Suggested citation
for this article:
Glasser J, Meltzer
M, Levin B. Mathematical modeling and public policy: responding to health
crises. Emerg Infect Dis [serial on the Internet]. 2004 Nov [date cited].
Available from http://www.cdc.gov/ncidod/EID/vol10no11/04-0797_08.htm
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