A Model for the Rapid Distribution of Critical Medical Countermeasures to Large U.S. Populations During a Public Health Emergency via the SNS-RSS-POD System

In the event of a large scale public health emergency in the United States, the need for emergency medical supplies may quickly exceed existing local and regional resources. In these circumstances, specific life-saving countermeasures may be released from the CDC (The United States Centers for Disease Control and Prevention) Strategic National Stockpile (SNS) and delivered to local Points of Dispensing (PODs) via a rapid emergency distribution system that involves multiple governmental agencies and private sector organizations. Included in this distribution system are temporary Receiving, Staging, Storage (RSS) warehousing operations. One of the primary objectives of this SNS-RSS-POD system is to treat the last person in need in the last active POD within 48 hours of the decision to activate this system. There is a concern that under certain conditions, some PODs may not have sufficient service (treatment) time to meet this 48 hour objective. This study explores this concern and focuses on increasing the amount of available service time for the last active POD (and the other PODs) by reducing process times elsewhere in the system. A model is presented for designers and operators of these systems to assess their system; predict which POD is expected to be the last active POD; and estimate the amount of available service time for that last active POD. Further, utilizing Critical Path Methods (CPM), opportunities for process improvements are examined and recommendations are offered. A supporting mathematical model is developed that represents the SNS-RSS-POD system in terms of overall system time as well as time spent in individual subsections of this system. Recommended improvements are introduced into this mathematical model to assess the potential impact of implementing these changes. Finally, another supporting mathematical model is developed that expresses the potential impact of these recommended improvements in terms of human lives saved during a public health emergency under certain conditions in which the overall capability of the SNS-RSS-POD system is challenged.