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Predictive analytics are getting better at profiling the clinical impact of air- and heat-related emergencies, as well as the stress they place on response infrastructure.
A curtain of dense, yellow smog killed 20 residents and shortened the lives of countless others in the industrial town of Donora, Pennsylvania, in 1948, when a temperature inversion trapped pollution in the breathable air in and around the borough southeast of Pittsburgh. Had the inversion lasted an extra day, an estimated 1,000 people would have perished.
Fast forward to the present century, when air pollution and heat waves increasingly pose challenges to cities domestically and abroad—including 15,000 excess deaths in France in August 2003.
Pittsburgh, as part of its ONEPGH resilience strategy, has begun testing emergency response technology coupled with predictive analytics to assess how current response infrastructure might hold up in such a crisis.
“How bad does ‘bad’ have to be to break the system?” asked Chris Callsen, Intermedix vice president of operations analytics, in an interview with Route Fifty.
The Nashville, Tennessee-based tech company’s Optima Predict response planning simulation was paired with the University of Pittsburgh Graduate School of Public Health’s Framework for Reconstructing Epidemiological Dynamics (FRED) modeling system to build a profile of increased demand for emergency management services.
First FRED estimates smog and heat’s clinical impact on different communities, such as the number of acute respiratory disease-related 9-1-1 calls, and then Optima generates an EMS response plan for personnel, vehicles and other resources.
“Using technology and professional experience together is a great way for us to model how systems interact, and we can also use different scenarios and circumstances to replicate the process in the future,” Rebecca Kiernan, the city of Pittsburgh’s senior resilience coordinator, said in a statement.
Increase demand on the system in the FRED model, and the city can see how EMS would respond to the heavier workload and develop mitigation strategies.
This all took place during a day-long event in April facilitated by the Rockefeller Foundation’s 100 Resilient Cities program for 50-plus public health, emergency management and air quality professionals from across Western Pennsylvania.
As resources were spun up to 300 percent normal volume in the simulator, the system became less stable. At 400 percent, EMS response times were much longer—some almost an hour. And by 500 percent, the breaking point, the system in theory collapses, Callsen said.
Pittsburgh’s EMS system is designed so incidents are handled within 45 minutes to an hour, but at the response system’s collapse, resources are stuck waiting for hospital beds to open. Most incidents take up to an hour to respond to, let alone be treated and cleared.
The workshop posed a hypothetical, rather than addressing what Pittsburgh should do in the situation. And the possibility of calling for outside aid, thereby adding resources like 20 units of Federal Emergency Management Agency task force to the system, wasn’t factored into the simulation.
Still, crisis response professionals liked the concept of being able to create scenarios with realistic simulation outputs, Callsen said.
Like many cities, Pittsburgh faces problems related to aging infrastructure an existing modeling tool other than FRED could help simulate, like a utility being unable to deliver potable water continuously leading to system failure.
Serious air pollution creates a number of medically complex patients, who require health care infrastructure. Moving forward, Pittsburgh could test how to accommodate them with increased accuracy.
The simulation findings are in the process of being put into a report, Callsen said, with the potential to be presented at 100 RC’s annual conference as a best practice for other communities.
“The door is open to work with Pittsburgh going forward, where once we get additional documentation then next steps can be identified,” Callsen said. “Everybody left the room thinking there was more value to be had.”
Dave Nyczepir is a News Editor at Government Executive’s Route Fifty and is based in Washington, D.C.