Detection of Severe Respiratory Disease Epidemic Outbreaks by CUSUM-Based Overcrowd-Severe-Respiratory-Disease-Index Model

Table 1

OSRDI model variables.

No.	Concept	Description
1	Patients	Number of patients in the healthcare facility according to the following description.; Description: a patient already admitted into hospital requiring a bed, the equipment, and the attention of specialized personnel.
2	Available beds	Number of beds in the healthcare facility according to the following description.; Description: a bed in good condition and maintenance that provides comfort, supplied with necessary clothing. The headboard must be in contact with the wall, away from windows or doors that can obstruct hospital personnel free transit; beds must be articulated, their height must be adjustable and easy to handle and move, and they have to be provided with wheels; other fixtures and fittings would be a hypoallergenic waterproof mattress breathable to water steam, side rails, pillow with pillowcase, handle to adjust height and articulate the bed. Each bed must have a free space that has an air, oxygen, and suction outputs, as well as an easily available electricity supply outlet. Hospital bed dimensions: 0.80–0.90 m. (width) × 1.80–1.90 (length) × 0.70 m. (height without mattress). Minimal distance between beds: 1.20 m.
3	Available areas	Number of physical areas available in the healthcare facility, according to the following description.; Description: an available area to place a bed with infrastructure and the necessary equipment to give permanent assistance and clinic monitoring of vital signs to patients in critical condition. This area must have easy access to hospital, emergency department, intensive care unit, intermediate care facilities, and have air, oxygen, and suction outputs and an electricity supply outlet. The electrical installation must have 120 V to 240 V and easily identifiable ground connections.
4	Hemodynamic monitors	Number of usable hemodynamic monitors in the healthcare facility according to the following description.; Description: any monitor that measures patients’ hemodynamic parameters. Compulsory equipment: continuous electrocardiograph monitor (ECG) in one or two leads (DII and V5), continuous heart rate monitor, pulse oximeter (SpO2), noninvasive blood pressure monitors at 10 min intervals.; Optional equipment: Capnographs, exhaled CO2 monitor (EtCO2), ST analysis, and invasive blood pressure monitors.
5	Mechanical ventilators	Number of usable ventilators in a hospital facility according to this description.; Description: any mechanical ventilator with the following modes: assist control ventilation (ACV), synchronized intermittent mandatory ventilation (SIMV), and pressure support ventilation (PSV), with variable control (pressure, volume, flow, or time) and dual control, PEEP with battery to store energy, and a pneumatic compressor for adult and pediatric patients.
6	Doctors	Number of doctors in the hospital facility according to this description.; Description: doctors with postgraduate degree and/or training with patients in critical condition and/or anesthesiology, attested by a certified university program.
7	Respiratory technicians	Number of respiratory technicians in the hospital facility according to the following description.; Description: respiratory technicians or personnel trained to treat patients on mechanical ventilation.
8	Nurses	Number of nurses in the hospital facility according to the following description.; Description: nurses or technicians trained to treat patients in critical condition and surgical emergencies.

Variable description used for OSRDI model to determine saturation index (Section 2.1), [5].