County-Level Planning for Efficient Distribution of Emergency Medical Countermeasures with RealOpt Software

Emergency preparedness systems plan for antibiotic distribution and vaccine administration to respond to public health threats. The arrival of a COVID-19 vaccine underscores the importance of organized logistics for rapid administration to populations. The US Centers for Disease Control and Prevention Cities Readiness Initiative encourages frontline responders from 72 US cities and metropolitan statistical areas to use planning software, such as RealOpt-POD-v8.0.2, to design dispensing operations and predict staffing needs. However, planning can be difficult for local jurisdictions given uncertainty about how long it may take to complete various processes during a dispensing operation, including assessment of countermeasure needs for each person (eg, based on age or pregnancy status) and the careful dispensing of countermeasures and accompanying education. The Union County Health Department in Ohio gathered data on the timing of typical processes for an anthrax medical countermeasures distribution site through a small-scale drill and used these data to parameterize a RealOpt model capable of serving the rural county's population of just over 50,000 people within 24 hours. Results help fill a gap in parameterizing RealOpt-based planning models by highlighting the use of a small-scale drill to inform time estimates, which can be applied to RealOpt as part of county-level planning in advance of larger-scale drills to evaluate dispensing capabilities and effectiveness. The findings provide a methodological basis of future resource typing for adaptable and scalable dispensing, particularly for rural areas. Both the approach and resulting antibiotics dispensing schematic presented here could be tailored to support planning for population-based countermeasure administration to combat emerging pandemics.