arXiv subjects

Edilson F. Arruda

Publications and source records attributed to Edilson F. Arruda.

5 recordsLinked to original sources

arXiv2026

Integrated Framework for Long-term Elective Surgery Management under Uncertainty: From Strategic to Tactical Planning

In public healthcare systems, elective surgery waiting lists are a persistent management challenge, as hospitals must balance limited operating theatre capacity with uncertain and evolving demand. Long-term planning for these lists requires more than assigning operating theatre (OT) time to medical specialities, as isolated allocation decisions may fail to stabilise waiting lists over time. Such planning must account for uncertainty in patient arrivals in the queue and surgery durations, which are often neglected in OT scheduling models. In this context, we propose a novel integrated framework for elective surgery management under uncertainty, linking strategic queue-control decisions with tactical OT scheduling. The framework combines three components: (i) a closed-loop control policy that determines the number of patients to schedule in each planning cycle; (ii) a model to account for overtime-related cancellation risks; and (iii) a mixed-integer linear programming formulation, informed by the previous components, to solve an OT Scheduling Problem. The resulting tactical schedules are therefore guided by the long-term evolution of speciality-specific queues and by cancellation-risk considerations. We evaluate the proposed framework through a case study at University Hospital Unicamp, a large Brazilian public referral hospital. The results show that integrating strategic and tactical decisions stabilises waiting lists, controls cancellation risks, and supports more transparent theatre-allocation decisions, while remaining computationally efficient for practical implementation.

eess.SY↗

arXiv2022

Epidemic Control Modeling using Parsimonious Models and Markov Decision Processes

Many countries have experienced at least two waves of the COVID-19 pandemic. The second wave is far more dangerous as distinct strains appear more harmful to human health, but it stems from the complacency about the first wave. This paper introduces a parsimonious yet representative stochastic epidemic model that simulates the uncertain spread of the disease regardless of the latency and recovery time distributions. We also propose a Markov decision process to seek an optimal trade-off between the usage of the healthcare system and the economic costs of an epidemic. We apply the model to COVID-19 data from New Delhi, India and simulate the epidemic spread with different policy review times. The results show that the optimal policy acts swiftly to curb the epidemic in the first wave, thus avoiding the collapse of the healthcare system and the future costs of posterior outbreaks. An analysis of the recent collapse of the healthcare system of India during the second COVID-19 wave suggests that many lives could have been preserved if swift mitigation was promoted after the first wave.

q-bio.PE↗

arXiv2021

Reinfection and low cross-immunity as drivers of epidemic resurgence under high seroprevalence: a model-based approach with application to Amazonas, Brazil

This paper introduces a new multi-strain epidemic model with reinfection and cross-immunity to provide insights into the resurgence of the COVID-19 epidemic in an area with reportedly high seroprevalence due to a largely unmitigated outbreak: the state of Amazonas, Brazil. Although high seroprevalence could have been expected to trigger herd immunity and prevent further waves in the state, we have observed persistent levels of infection after the first wave and eventually the emergence of a second viral strain just before an augmented second wave. Our experiments suggest that the persistent levels of infection after the first wave may be due to reinfection, whereas the higher peak at the second wave can be explained by the emergence of the second variant and a low level of cross-immunity between the original and the second variant. Finally, the proposed model provides insights into the effect of reinfection and cross-immunity on the long-term spread of an unmitigated epidemic.

q-bio.PE↗

arXiv2021

A Novel Stochastic Epidemic Model with Application to COVID-19

In this paper we propose a novel SEIR stochastic epidemic model. A distinguishing feature of this new model is that it allows us to consider a set up under general latency and infectious period distributions. To some extent, queuing systems with infinitely many servers and a Markov chain with time-varying transition rate are the very technical underpinning of the paper. Although more general, the Markov chain is as tractable as previous models for exponentially distributed latency and infection periods. It is also significantly simpler and more tractable than semi-Markov models with a similar level of generality. Based on the notion of stochastic stability, we derive a sufficient condition for a shrinking epidemic in terms of the queuing system's occupation rate that drives the dynamics. Relying on this condition, we propose a class of ad-hoc stabilising mitigation strategies that seek to keep a balanced occupation rate after a prescribed mitigation-free period. We validate the approach in the light of recent data on the COVID-19 epidemic and assess the effect of different stabilising strategies. The results suggest that it is possible to curb the epidemic with various occupation rate levels, as long as the mitigation is not excessively procrastinated.

q-bio.QM↗

arXiv2021

Modelling and Optimal Control of Multi Strain Epidemics, with Application to COVID-19

This work introduces a novel epidemiological model that simultaneously considers multiple viral strains, reinfections due to waning immunity response over time and an optimal control formulation. This enables us to derive optimal mitigation strategies over a prescribed time horizon under a more realistic framework that does not imply perennial immunity and a single strain, although these can also be derived as particular cases of our formulation. The model also allows estimation of the number of infections over time in the absence of mitigation strategies under any number of viral strains. We validate our approach in the light of the COVID-19 epidemic and present a number of experiments to shed light on the overall behaviour under one or two strains in the absence of sufficient mitigation measures. We also derive optimal control strategies for distinct mitigation costs and evaluate the effect of these costs on the optimal mitigation measures over a two-year horizon. The results show that relaxations in the mitigation measures cause a rapid increase in the number of cases, which then demand more restrictive measures in the future.

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