A multi-echelon dynamic cold chain for managing vaccine distribution.

While cold chain management has been part of healthcare systems, enabling the efficient administration of vaccines in both urban and rural areas, the COVID-19 virus has created entirely new challenges for vaccine distributions. With virtually every individual worldwide being impacted, strategies are needed to devise best vaccine distribution scenarios, ensuring proper storage, transportation and cost considerations. Current models do not consider the magnitude of distribution efforts needed in our current pandemic, in particular the objective that entire populations need to be vaccinated. We expand on existing models and devise an approach that considers the needed extensive distribution capabilities and special storage requirements of vaccines, while at the same time being cognizant of costs. As such, we provide decision support on how to distribute the vaccine to an entire population based on priority. We do so by conducting predictive analysis for three different scenarios and dividing the distribution chain into three phases. As the available vaccine doses are limited in quantity at first, we apply decision tree analysis to find the best vaccination scenario, followed by a synthetic control analysis to predict the impact of the vaccination programme to forecast future vaccine production. We then formulate a mixed-integer linear programming (MILP) model for locating and allocating cold storage facilities for bulk vaccine production, followed by the proposition of a heuristic algorithm to solve the associated objective functions. The application of the proposed model is evaluated by implementing it in a real-world case study. The optimized numerical results provide valuable decision support for healthcare authorities.

Convalescent plasma bank facility location-allocation problem for COVID-19.

With convalescent plasma being recognized as an eminent treatment option for COVID-19, this paper addresses the location-allocation problem for convalescent plasma bank facilities. This is a critical topic, since limited supply and overtly increasing cases demand a well-established supply chain. We present a novel plasma supply chain model considering stochastic parameters affecting plasma demand and the unique features of the plasma supply chain. The primary objective is to first determine the optimal location of the plasma banks and to then allocate the plasma collection facilities so as to maintain proper plasma flow within the network. In addition, recognizing the perishable nature of plasma, we integrate a deteriorating rate with the objective that as little plasma as possible is lost. We formulate a robust mixed-integer linear programming (MILP) model by considering two conflicting objective functions, namely the minimization of overall plasma transportation time and total plasma supply chain network cost, with the latter also capturing inventory costs to reduce wastage. We then propose a CPLEX-based optimization approach for solving the MILP functions. The feasibility of our results is validated by a comparison study using the Non-Dominated Sorting Genetic Algorithm-II (NSGA-II) and a proposed modified NSGA-III. The application of the proposed model is evaluated by implementing it in a real-world case study within the context of India. The optimized numerical results, together with their sensitivity analysis, provide valuable decision support for policymakers.

Selection of the best healthcare waste disposal techniques during and post COVID-19 pandemic era.

In recent years, municipal authorities especially in the developing nations are battling to select the best health care waste (HCW) disposal technique for the effective treatment of the medical wastes during and post COVID-19 era. As evaluation of various disposal alternatives of HCW and selection of the best technique requires considering various tangible and intangible criteria, this can be framed as multi-criteria decision-making (MCDM) problem. In this paper, we propose an assessment framework for the selection of the best HCW disposal technique based on socio-technical and triple bottom line perspectives. We have identified 10 criteria on which the best HCW disposal techniques to be selected based on extant literature review. Next, we use Fuzzy VIKOR method to evaluate 9 HCW disposal alternatives. The effectiveness of the proposed framework has been demonstrated with a real-life case study in Indian context. To check the robustness of the proposed methodology, we have compared the results obtained with Fuzzy TOPSIS (Technique of Order Preference Similarity to the Ideal Solution). The results help the municipal authorities to establish a methodical approach to choose the best HCW disposal techniques. Our findings indicate that incineration is the best waste disposal technique among the available alternatives. Even if the dataset indicates 'incineration' is the best method, we must not forget about the environmental concerns arising from this method. In COVID time, incineration may be the best method as indicated by the data analysis, but "COVID" should not be an excuse for causing "Environmental Pollution".