Coordination of Processes as a Starting Point for Simulation-based

Management of Biological Incidents

Tereza Otčenášková

, Vladimír Bureš

, Pavel Čech

and Jana Prattingerová

Faculty of Informatics and Managmentu, University of Hradec Králové,

Rokitanského 62, Hradec Králové, Czech Republic

Regional Public Health Authority, Husova 64, Liberec, Czech Republic

Keywords: Biological Incident, Conceptual Perspective, Coordination, Management, Process, Simulation.

Abstract: Biological incidents nowadays represent more often as well as more serious threat endangering important

assets. Their management requires complex approach including high demands on technological support.

This paper neither contributes with another simulation model or results, nor offers the application of specific

technology. It utilises the literature analysis and interviews with experts to reveal the framework for

potential options and scenarios for simulation employment in the realm of management of biological

incidents. Conceptual issues related to the simulation of biological incidents together with process

perspective are provided and advantages as well as prospective utilisation in modelling and simulation are

discussed.

1 INTRODUCTION AND

PROBLEM FORMULATION

Biological incidents can be defined as events when a

biological agent harms or threatens humans,

livestock or other important assets (UNODA, 2009).

These problems represent a topical issue in several

areas of our society regardless if these are caused by

the biological weapons or if they occur

unintentionally like the leakage of a dangerous

substance from a factory or laboratory, or natural

incidence of a disease. Whereas the former can be

considered as more perilous, the latter is usually

more easily manageable. It is especially because

focal points can be typically identified quickly and

localised more precisely. Therefore, the critical

assets can be recognised faster and adequately

protected. On the other hand, during these incidents

it is hard to react promptly in the initial phase,

because the first phase of the agent identification can

last a significant time. Nevertheless, if appropriately

managed, their consequences can be minimized

(Bureš et al., 2012b). Coping with a biological

incident involving a highly persistent agent (e.g.

anthrax, Brucella, influenza or zoonosis) is a

complex process. It requires extensive information

and both considerable and appropriate resources.

Unfortunately, these are likely to be limited,

particularly if multiple facilities, areas or groups of

people are affected (Krauter et al., 2011). Therefore,

any available tool for decision support and for the

improvement of the effectiveness of the course of

action should be employed. This paper firstly

introduces the current state-of-the-art related to the

modelling and simulation utilisation during the

process of biological incidents. Afterwards, methods

followed by results are discussed. Finally, the

limitations, further research perspectives and

implications of the mentioned research are provided.

2 SIMULATION

AS A RESEARCH METHOD

As discussed above, the biological incident

management should be supported by appropriate and

efficient tools. Therefore, this paper addresses these

issues employing the simulations. The idea to use

modelling and simulations in epidemiology has been

mentioned earlier (Hurd and Kaneene, 1993).

Nevertheless, only particular aspects of the complex

problem predominantly attract researchers’ attention.

For instance, several models such as susceptible-

infected (SI) model (Naji and Mustafa, 2012),

446

cenášková T., Bureš V.,

Cech P. and Prattingerová J..

Coordination of Processes as a Starting Point for Simulation-based Management of Biological Incidents.

DOI: 10.5220/0004478704460452

In Proceedings of the 3rd International Conference on Simulation and Modeling Methodologies, Technologies and Applications (SIMULTECH-2013),

pages 446-452

ISBN: 978-989-8565-69-3

 2013 SCITEPRESS (Science and Technology Publications, Lda.)

susceptible-infected-recovered (SIR) model (Yusuf

and Benyah, 2012), or susceptible-exposed-infected-

recovered (SEIR) model (Forgoston et al., 2009)

have been already developed. Peculiar feature to

simulation in this realm is the examination of

characteristics and behaviour of a particular system

on the basis of the experiments realised on the

mathematical model of this system. Commonly used

approaches are based on a Liapunov function (Gao

et al., 2013), LaSalle's invariance principle (Xu,

2012), or Bayesian Markov-chain-Monte-Carlo

inference (Filipe et al., 2012). All the

aforementioned models and tools are proved to be

meaningful and applicable. However, their

utilisation is not mostly related to the general

context. Usually, every prospective user selects a

situation or aspect in which various systems, tools,

or methods are applied (e.g. prehospital care

(Junker, 2007) or industrial and agriculture incidents

(Bureš et al., 2012a)), but without broader

perspective, although a few of frameworks or

methodologies have been developed and published

(Nakano et al., 2009; Otčenášková et al., 2011).

Apparently, the successful application of

simulation requires a lot of precedent work prior to

building a computer simulation model. The

simulation itself consists of eight major phases,

which need to be followed for the proper application

of the simulation methodology (Ülgen et al., 1994).

Rarely authors do present in their studies the context

and evidence their awareness of the overall

simulation process. Mostly, the simulation models

are described and results are interpreted. Therefore,

the aim of this paper is to introduce a model of the

epidemiological treatment of a biological incident

that comprise all stages of the process from incident

occurrence to its final termination. This process

view can be successfully applied as a framework for

simulations of biological incidents, which would be

more complex, respect the whole process, and

include more stakeholders.

3 METHODOLOGY

The main research question which determined the

research direction and methods was the following

“Is there a general process that can serve as a

framework for several existing and prospective

simulations in the area of biological incidents?”.

Thus, the discussed research activities were

grounded on the literature review and quantitative

research. The former was based on the analysis of

information resources such as military documents

(McClellan et al., 2010), public institution tools

(NASA, 2010), and approaches incorporated in

procedures of public health institutions. These

include for example State Veterinary Administration

of the Czech Republic, The National Institute of

Public Health in the Czech Republic, or The

National Reference Laboratory of the Czech

Republic. The latter consisted of several iterations of

in-depth un- and semi-structured interviews with

experts in epidemiology and public health realm.

The knowledge revelation, extraction and further

compilation were employed.

4 RESULTS

Three schematic process models of biological

incidents were developed. Based on the consultation

and recommendation of experts, the selected case

studies were anthrax, influenza and diarrhoea. The

complex process from its beginning representing by

the symptoms occurrence to its termination was

modelled. Whereas the full version of the process

description identifies several tasks, steps,

stakeholders or utilisable tools, the Appendix of this

paper comprises the simplified description (due to

space limitations) of the overall process of dealing

with the influenza epidemics. Particular model

elements can be consequently analysed and

appropriate technology can be deployed. Not only

decision support technologies or methods,

professional databases and communication tools can

be used, but also simulations of different biological

or epidemiological aspects can be applied.

4.1 Implications for Epidemiological

Simulations

Typically, simulation models are utilised during the

Scenario development phase (as stated in the

introduction section). Considering the context of the

scheme in the Appendix, it is obvious that various

parts of the incident can be simulated. The most

advantageous is to monitor the consequences of

diverse actions during relevant phase of the incident.

The process indicates that it can be also put in use in

Application of anti-epidemic measures or

Anamnesis trace stages. At the beginning, there are

three options how an incident might occur. The

simulation would provide for example the

comparison of time needed for the whole incident

termination based on differences among the

situations. For instance, there is a significant

difference between two cases. The first one is when

CoordinationofProcessesasaStartingPointforSimulation-basedManagementofBiologicalIncidents

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the infection is diagnosed at the general practitioner.

This might be compared to the problem on a

particular plane with an infected person. In this

situation, all other people who were on the board

and are suspected from the infection have to be

traced and their condition has to be monitored.

During this phase, the multi-agent based modelling

of the agent spread with integrated geographic

information system can be helpful (Wang et al.,

2010; Laskowski et al., 2011). The duration of the

initial phases of the incident depends also on the

methods employed in the laboratory to analyse the

samples. The three basic methods demonstrate

various demands on people, equipment, necessity of

safety precautions or time for further actions.

Methods potentially employed with their

characteristics follow:

 prompt methods: identification if it is influenza

virus or not,

 Polymerase Chain Reaction (PCR) method:

identification of influenza type,

 virus cultivation: clear specification of the

virus type and its analysis considering the

purposes of future vaccine preparation.

Demands within Application of anti-epidemic

measures in case of serious condition or suspicion of

new virus have the same impact on different

simulation scenarios. The quarantine simulations

might include the following parts:

 isolation (relating to infected people), possibly

their treatment,

 quarantine of health people suspected from the

infection,

 medical control (health condition monitoring).

Apart from these, closure of hospitals,

institutions of social care and places, where

susceptible and endangered population is present, is

necessary. Mostly, the searching for and contacting

of people who were in contact with the affected ones

(especially colleagues, co-passengers, family etc.) is

realised. There are cases when for example police

have to be involved as well to coerce people to stay

in the focus of the infection.

Before the virus is specifically described and

targeted measures are taken, a lot of information

should be gathered dependant on the seriousness of

the whole incident. These factors might also

influence the overall simulation and therefore should

be taken into account. Usually, the following

characteristics should be gathered:

 availability of treatment and vaccination,

 threat of the transmission,

 ways of the spread,

 period of infectiousness,

 susceptibility,

 infectiousness,

 or fatality rate.

All the mentioned factors can be considered as

variable inputs in the simulations which influence

the extent of stakeholders to be involved, time,

material, financial and other resources to be utilised

and also the overall effectiveness of required

processes within the incident management.

4.2 Prospective Users

Furthermore, more stakeholders can be included and

simulation results can be more realistic. From the

perspective of involved institutions and individuals,

especially the awareness about the relations and

dependency is supported by the created model as

well as by the simulation process which shows who

interacts with whom and which processes

consequent from the course of action of particular

participant. This opens a new perspective for

simulation with the help of multi-agent models and

techniques, which have already been applied in case

of specific instances (Dion et al., 2011; Linard et al.,

2009). Each participant might moreover choose the

relevant part of simulation which is appropriate for

his or her purposes. Such advantageous approach is

both effective and clearer to the particular

stakeholder. For this reason, participants can try

various situations, get more expertise and experience

without any threats and costs even before an incident

occurs.

4.3 Integration Perspective

The acquired results enable not only putting the

existing simulations and models into context, but

also focusing future results and efforts on better and

meaningful integration of prospective outcomes with

other systems and applications. This is feasible due

to the practical and verified framework. Moreover,

the integration of simulations does not have to

remain at the conceptual level. Since the process

framework determines the context, issues related to

data integration, methodological or application

integration can be considered. The final integration

can contribute to the general scheme of

technological tools utilisable in management of

incidents, as described by Otčenášková et al. (2011).

In business practice every process has its own

owner who is responsible for its execution and

outputs. The process view on biological incidents

reveals that this approach ensures that the ownership

is distributed. This causes issues related to

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responsibilities, budgeting or willingness to

overcome existing barriers related to the

technological automation of particular process

segments. Unless this is solved, the simulations will

remain mostly isolated isles in the world of

technological support of decision-making in the area

of biological incidents management.

As apparent from Figure 1, the determination of

all parts of the simulation processes and all

stakeholders provides with clearer and easier

management of necessary actions. Moreover, the

end users vary significantly and therefore, the

outputs in form of recommendations, decision

support, or scenario creation can be prepared with

the help of plethora of technologies. At the

beginning of the incident management, necessary

data must be collected from several resources (see

bottom boxes in Figure 1). These are afterwards

processes thanks to the employment of techniques

and methods including data transformation,

database, analytical and end user tools. Simulation

belongs to the end users tools and therefore

influences significantly the technological support of

the incident management and consequently both the

chosen measures and actions. Hence, several

technologies can be mutually interrelated with

computer technologies and provide users with the

complex decision support.

Regardless the biological incident, the mentioned

concept ensures better resource planning, easier

identification of stakeholders, clearer and quicker

determination of responsibilities and involved

parties resulting in better crucial assets protection

followed by future prevention and preparedness

improvement.

Figure 1: Technological Context of Simulation in the Biological Incident Domain (Bureš, 2012b).

CoordinationofProcessesasaStartingPointforSimulation-basedManagementofBiologicalIncidents

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5 LIMITATIONS AND FURTHER

RESEARCH

The aforementioned research has particular

limitations. Even though, it was developed in the

Czech Republic, the applicability within different

countries is possible due to the general concepts

which are used. Nevertheless, some changes relating

to the specific institutions involved or the procedural

regulations might be relevant and should be

considered. As discussed above, only a few

scenarios have been simulated so far. Therefore, the

creation of scenarios for the purposes of other

diseases, infections and various threats and incidents

is possible.

There are various approaches and methods

relevant to be considered for the purposes of further

research of the discussed concept. These comprise

exploration of advanced utilisation and development

of gathered information and created models. As

examples, the following can be mentioned:

 Markov Chains to monitor the overall system

changes and to evaluate the probable transition

from one state to another,

 Net Analysis to represent the relations more

precisely and comprehensibly,

 Process Analysis to support the understanding of

chronological changes of the whole system

(model),

 Analysis and Forecasting of Time Series to reach

more appropriate system description and to

provide more precise predictions of the following

development,

 Causal Loop Diagram to visualise the influence

of one component on another or

 RASCI Matrix (responsible, accountable,

support, consulted and informed management of

the particular problem) to determine

responsibilities during the processes.

These methods can be either used separately or

they can be incorporated within already done outputs

to enhance their usability and precision of the

simulations and models.

6 CONCLUSIONS

Currently, the biological incidents require attention

especially because these occur relatively often, the

processes within them demand a lot of resources and

their consequences are more dangerous and

extensive. Nevertheless, simulation exemplifies a

method which can significantly support the

processes necessary for successful and prompt

incident termination. This paper introduces the

process view on incident management which can

consequently represent a framework for the

computer-based decision-making support. It further

highlights the possibilities and the advantages of

simulation method during the biological incident

management. The overall coordination and various

stakeholders are supported and the course of action

is managed more effectively to protect valuable

assets. The simulation is also contextualised and

areas for further research and development of the

mentioned concept are discussed.

ACKNOWLEDGEMENTS

This paper is supported by the project No.

CZ.1.07/2.2.00/28.0327 Innovation and support of

doctoral study program (INDOP), financed from EU

and Czech Republic funds. It is also written with the

support of the specific research project 2/2013

“Cooperation mechanisms of network organisations”

funded by the University of Hradec Králové, Czech

Republic.

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APPENDIX

Process View on the Influenza Incident (Authors’ Research)

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