Royal Flying Doctor Service COVID-19 activity and surge modelling in Australia.

Abstract

There is a COVID-19 pandemic. We aimed to describe the characteristics of patients transported by the Royal Flying Doctor Service (RFDS) for confirmed or suspected Coronavirus disease 2019 (COVID-19), and to investigate surge capacity of, and operational implications for, the RFDS in dealing with COVID-19. Prospective cohort study. To determine the characteristics of patients transported for confirmed or suspected COVID-19, we included patient data from 02 February 2020 to 06 May 2020. To investigate surge capacity and operational implications for RFDS in dealing with COVID-19, we built, and validated, an interactive operations area level discrete-event simulation decision support model, underpinned by RFDS aeromedical activity data from 2015 to 2019 (4-years). This model was subsequently used in a factorial in silico experiment to systematically investigate both the supply of RFDS aeromedical services and the increased rates of demand for these services, for diseases of the respiratory system. The RFDS conducted 291 patient episodes of care for confirmed or suspected COVID-19. This included 288 separate patients, including 136 males and 119 females (gender missing=33), with a median age of 62.0 years (IQR=43.5-74.9). The simulation decision support model we developed is capable of providing dynamic and real-time support for RFDS decision-makers in understanding the system's performance under uncertain COVID-19 demand. With increased COVID-19 related demand, the ability of the RFDS to cope will be driven by the number of aircraft available. The simulation model provided each aviation section with estimated numbers of aircraft required to meet a range of anticipated demands. Despite the lack of certainty in the actual level of COVID-19 related demand for RFDS services, modelling demonstrates that robustness of meeting such demand increases with the number of operational and medically staffed aircraft.