Health Care Logistics Network Design and Analysis on Pandemic Outbreaks: Insights From COVID-19.

Health care systems throughout the world are under pressure as a result of COVID-19. It is over two years since the first case was announced in China and health care providers are continuing to struggle with this fatal infectious disease in intensive care units and inpatient wards. Meanwhile, the burden of postponed routine medical procedures has become greater as the pandemic has progressed. We believe that establishing separate health care institutions for infected and non-infected patients would provide safer and better quality health care services. The aim of this study is to find the appropriate number and location of dedicated health care institutions which would only treat individuals infected by a pandemic during an outbreak. For this purpose, a decision-making framework including two multi-objective mixed-integer programming models is developed. At the strategic level, the locations of designated pandemic hospitals are optimized. At the tactical level, we determine the locations and operation durations of temporary isolation centers which treat mildly and moderately symptomatic patients. The developed framework provides assessments of the distance that infected patients travel, the routine medical services expected to be disrupted, two-way distances between new facilities (designated pandemic hospitals and isolation centers), and the infection risk in the population. To demonstrate the applicability of the suggested models, we perform a case study for the European side of Istanbul. In the base case, seven designated pandemic hospitals and four isolation centers are established. In sensitivity analyses, 23 cases are analyzed and compared to provide support to decision makers.