Title: Algorithms for Emergency Shelter Location and Population Allocation during Extreme Heat Events

Extreme weather events have challenged our emergency response capabilities in recent years. Unfortunately, studies indicate that the number of such events is increasing over time. The humanitarian and economical consequences of these events can be catastrophic, especially if compounded by the lack of preparedness. In such cases, an effective emergency plan moves people to shelters with controlled environments and contains provisions for healthcare needs. In this research, we will design an evacuation plan for the case of a heat wave event in the Newark, New Jersey area.

We present stochastic optimization models that assign vulnerable populations to health care centers based on their health issues. We categorize people into three groups depending on their having; cardiovascular, respiratory, or dehydration problems. The demand for health care is random so is the mortality due to lack of treatment. Our objective is to minimize the mortality rate in case of extreme heat events. We utilize GIS-based data and the available demographic information of the Newark area into the model. The set of health centers that can provide the appropriate health care treatment is determined.

Title: Evacuating due to Extreme Weather Events

Extreme weather events such as hurricanes, tsunamis, and floods can directly threaten a region, while other extreme weather conditions can indirectly increase the likelihood of threats, for example drought, especially with the right wind conditions, can greatly increase the danger of wildfires. Often, to save lives, the best response is an evacuation of the threatened region. Examples of such evacuations include the well studied evacuation of New Orleans in response to Hurricane Katrina, the evacuation of the Houston area in response to Hurricane Rita, and the evacuation of portions of Santa Barbara in response to the 2009 Jesusita Fire. In response to a threat, we consider three evacuation processes that might be necessary, and that could benefit greatly from Operation Research-based modeling.

1. An automobile-centric regional evacuation.
2. A transit based evacuation for those without an automobile.
3. The evacuation of a regional hospital.

For each of these evacuation processes we provide a description, preliminary model, and a discussion of modeling issues.

Title: Planning for Mass Evacuation Events in Northern New Jersey

The United States Department of Homeland Security Urban Area Security Initiative (UASI) program provides funds to address the unique planning, equipment, training, and exercise needs of high threat, high density urban areas, and assist them in building an enhanced and sustainable capacity to prevent, protect against, respond to, and recover from acts of terrorism. New Jersey has defined its UASI funding region to include the core cities of Newark and Jersey City, the core counties of Essex and Hudson and those counties contiguous to Essex and Hudson, including Bergen, Morris, Passaic, Union and Middlesex counties. This planning region represents the center of the state's transportation infrastructure which includes the George Washington Bridge, the Holland and Lincoln tunnels, the ports of Elizabeth, Jersey City, and Newark, the New Jersey Turnpike and Garden State Parkway, Newark-Liberty Airport, the Northeast Corridor rail line, Newark Penn Station, Hoboken Terminal, as well as inter-coastal waterways. The region is also densely populated with chemical facilities.

A recent national review of emergency preparedness conducted by the US Department of Homeland Security found that nationwide "current catastrophic planning (in states and urban areas) is unsystematic and not linked within a national planning system." The review further found that "?outmoded planning processes, products, and tools were the primary contributor to the inadequacy of catastrophic planning." In addition, in the years since Hurricane Katrina, considerable attention has been given to the important role transportation plays in disaster planning, response and recovery. Highways, public transit, private buses, school transport and paratransit are all critical to successful evacuation operations during emergencies.

In 2008, the NJ Office of Homeland Security and Preparedness, on behalf of the northern NJ UASI Region engaged the Alan M. Voorhees Transportation Center at Rutgers to undertake a multi-year planning study to enhance the capability of the seven counties that comprise the UASI region to ensure that the region is prepared in the event of a catastrophe requiring mass evacuation. The planning study will result in a collaborative, cross-jurisdictional and multiagency all-hazards regional evacuation plan for the northern New Jersey UASI region. This presentation will review the work accomplished to date for this project and will showcase the results of behavioral and transportation modeling conducted for a Category 3 Hurricane scenario. It will also provide an overview of the integrated transportation response framework developed to address the evacuation needs of both general and special needs populations.

Title: Critical Care Demand Forecasting during Extreme Weather Events

Excessive heat events (EHE) have been associated with elevated morbidity and mortality: environmental stressors with high thermoregulatory demands require susceptible populations to undergo physiological adaptive processes that compromise immune function, exacerbate chronic health conditions, and increase susceptibility to infections. Vulnerable populations such as the elderly are at higher risk, particularly for the "older old" and the hospitalized, due to frailty and existing morbid conditions. Failure to consider delays between timing of exposure and medical care utilization may result in severe underestimation of health effects. It is likely that the surge in hospitalizations not only depends on susceptibility to exposure and heterogeneity of affected population, but also on time-distributed dose-response effects that can be modified by existing infrastructure. In order to minimize EHE-associated casualty in vulnerable subpopulation, data on the baseline morbidity profile are needed so that responses, including allocation of medical staff and equipment, can be optimized. From the Centers of Medicaid and Medicare Services (CMS) national hospitalization records, we abstracted and categorized the most commonly assigned diagnoses for the population aged 65+ in Newark, NJ from 1991 through 2006 based on their systemic and procedural properties. Seasonality assessments of the categorized outcomes were performed to evaluate the association between the prevalence of the outcomes and ambient minimal and maximal temperature. In this communication, suitability and challenges of using historical hospitalization records for forecasting medical care utilization during EHE will be outlined.

Title: What Previous Disasters Teach Us: The Hard Lessons of Katrina and Haiti's and the Need for at Reformulation Humanitarian Logistics

Extreme events pose serious logistical challenges to emergency and aid organizations active in preparation, response and recovery operations, as the disturbances they bring about have the potential to suddenly turn normal conditions into chaos. Under these conditions, delivering the critical supplies (e.g., food, water, medical supplies) urgently required becomes an extremely difficult task because of the severe damages to the physical and virtual infrastructures and the very limited, or non-existent, transportation capacity. In this context, the recovery process is made more difficult by the prevailing lack of knowledge about the nature and challenges of emergency supply chains. As a result, the design of reliable humanitarian logistic systems is hampered by the lack of: knowledge about the particulars of how formal and informal (emergent) supply chains operate and interact; methods to properly analyze and coordinate the flows of both priority and non-priority goods; and, in general, scientific methods to analyze logistic systems under extreme conditions.

This presentation is based on the quick response field work conducted by the author and his colleagues on New Orleans and Haiti. The presentation provides a succinct description of the key logistical issues that plagued the Katrina response, and then discusses preliminary observations concerning the response to the Port au Prince's and Chile's earthquakes. These cases provide an example of the need to significantly improve the efficiency of humanitarian logistics. The work is based, to a great extent, on public accounts of the event and the interviews conducted by the authors during a number of field visits to the impacted sites, as part of research projects funded by the National Science Foundation. Then, in the second part of the presentation, he will discuss policy implications of relevance to ensure an efficient flow of critical supplies to a site impacted by a natural or a man-made disaster.

The presentation discusses a number of not well understood differences between commercial and humanitarian logistics, and suggests a number of much needed improvements to humanitarian logistic modeling. This reflects the fact that, though seemingly similar, there are profound and fundamental differences between humanitarian and commercial logistics. The presentation stresses the need for a significant departure in humanitarian logistics modeling to ensure that the analytical formulations provide a meaningful depiction of the system being modeled. The presentation argues that humanitarian logistic formulations must strive to increasingly incorporate the unique features that make humanitarian logistics substantively different than commercial logistics. The lack of proper consideration of deprivation costs and the impacts of material convergence are identified as the most pressing areas in need of improvement.

This research was supported by the National Science Foundation's grants entitled "DRU: Contending with Materiel Convergence: Optimal Control, Coordination, and Delivery of Critical Supplies to the Site of Extreme Events" (National Science Foundation CMMI-0624083); and "Characterization of the Supply Chains in the Aftermath of an Extreme Event: The Gulf Coast Experience," (NSF-CMS-SGER 0554949). This support is both acknowledged and appreciated.

Title: Surge Capacity During a Mass Casualty Event

The current healthcare system may not be able to manage effectively the increased demand for medical care during a mass casualty event. As a result, an alternative healthcare system must be in place to identify those victims requiring emergency care and to ensure appropriate use of limited resources. The Southern Region, using regional funds, has established alternative care sites to meet the potential needs of those affected in an emergency.

Title: Heat Waves as a Public Health Emergency: a US Case Study

In 2006, a severe heat wave of unusually long duration and wide geographic extent affected the state of California, increasing emergency department visits and hospitalizations for heat-related and other causes. By understanding some of the geographic, age- and cause-specific groups who were most vulnerable to this morbidity, targeted heat wave preparedness planning and climate change adaptation efforts can be developed.

Title: Emergency Response, Disease Propagation Analysis, and Mitigation Strategies

A catastrophic health event, such as a naturally-occurring pandemic, or a calamitous meteorological or geological event, could cause tens or hundreds of thousands of casualties or more, weaken the economy, damage public morale and confidence, create panic and civil unrest, and threaten national security. It is therefore critical to establish a strategic vision that will enable a level of public health and medical preparedness sufficient to address a range of possible disasters. In this talk, we discuss strategies in setting up service shelters to house and service a large volume of individuals in need of care and assistance. Such a large influx of individuals to these shelters could raise the risk of a high level of intra-facility infections. Hence, proper design of service shelters, and understanding of operational factors that can mitigate infection are critical. We will discuss a large-scale simulation and rapid real-time optimization engine that allows us to design a disease propagation module to investigate disease propagation within shelters or clinical facilities. Local outbreak of infectious disease, intra-facility disease spread analysis, and effective mitigation strategies will be identified.

This work is joint with the Centers for Disease Control and Prevention.

Title: How does extreme weather affect the volume and nature of emergency medical 911 calls?

This talk discuss ways in which extreme weather events impacts human health risks through the lens of emergency medical service (EMS) systems. How to optimally utilize limited EMS resources depends on a number of factors, including the volume and nature of 911 calls. We analyze how the volume and nature of calls changes in response to the weather. We apply negative binomial and multinomial logistic regression to analyze the impact of real-time weather data on the calls (patients) that receive EMS service. The models are applied to two years of EMS data.

Title: The climatological dimensions of extreme weather events

Extreme weather events occur somewhere in the world on a daily basis, often endangering lives and property. This presentation will explore the distribution of events such as hurricanes/typhoons, tornadoes, blizzards, ice storms, windstorms and drought geographically and climatologically. Are they becoming more numerous or is there a "CNN factor" bringing heretofore local coverage of events to the attention of many around the world? What does the future have in store with respect to the frequency, magnitude and location of extreme weather events as the globe's climate changes?"

Title: Delta Air Lines Crew Reroute System

The Crew Reroute System is used to reroute flights in cases of disruptions (for example, due to storms or delayed arrivals causing missed connections). There are three basic components: (1) GUI used by the human operator, (2) Application Server to gather and serve data, and (3) Optimization Engine. The optimization engine employs a combination of heuristics and a branch-and-bound solver to find legal, optimal solutions consisting of disrupted as well as modified pairings. I will describe the workings of the optimization engine and give some illustrations from past operations.