An Agent-Based Simulation Model of Epidemic Spread in a Residential School for Children with Disabilities

TIME BLOCK	ACTIVITY SUMMARY
Early Morning	Staff wake at 6. Students wake, housekeeper and housemother supervise younger student bedrooms at 7. Breakfast at 8.
Morning	External student arrives. Students and academic teachers move once per hour within assigned classrooms. Principal and vocational teachers remain in bedrooms. Housemother and housekeeper may work together or in own rooms. Caretaker in external space.
Afternoon	Lunch at 1300. Student free time at 1400: small chance of going outside, otherwise common room. All students to common room at 1500. Vocational classes 1600–1800: subject chosen with some probability based on sex and space availability. Vocational teachers move within assigned classrooms 1500-1800. Principal supervises common room at 1500. Housemother and housekeeper supervise common room 1400–1600. Caretaker in external space. At 1800, boys and girls have gym or communication class on alternating days. These classes are held in restricted portions of the dining room and common room. When not teaching or supervising, staff move to bedrooms.
Evening	At 1900, external student leaves; all other agents eat dinner. All agents to bedrooms at 2000; housemother and housekeeper supervise younger student bedrooms. All staff to common room at 2100, then bedrooms at 2200.

Average epidemic outcomes (±1 standard deviation) for modeled scenarios.

SCENARIO	NUMBER OF EPIDEMICS (%)	FINAL SIZE – TOTAL (%)	FINAL SIZE – STAFF (%)	FINAL SIZE – STUDENTS (%)	MORTALITY (%)	PEAK SIZE (%)	DAYS TO EPIDEMIC THRESHOLD	PEAK DAY	LAST DAY
Baseline	234 (47)	79.7 ± 13.0	62.6 ± 15.9	86.2 ± 14.2	3.1 ± 2.2	29.0 ± 7.4	6.4 ± 2.1	14.0 ± 3.7	24.3 ± 4.1
Student First Case	400 (80)	78.7 ± 12.8	58.0 ± 18.9**	86.5 ± 13.4	3.0 ± 2.2	29.2 ± 7.4	5.2 ± 1.7**	12.2 ± 3.4**	23.0 ± 4.2**
More Bedrooms	227 (45)	74.7 ± 15.6**	63.1 ± 17.5	79.1 ± 17.2**	2.8 ± 1.8**	25.1 ± 7.3**	6.2 ± 2.2	14.3 ± 3.9	25.0 ± 4.3*
Hospital (~15%)	243 (49)	72.9 ± 16.9**	57.6 ± 18.5**	78.7 ± 18.9**	2.6 ± 2.1**	25.7 ± 7.9**	6.0 ± 1.9**	13.8 ± 3.8	24.2 ± 4.5

[i] t-test vs. baseline: * p < .1, ** p < .05.

Average epidemic outcomes (±1 standard deviation) varying the probability of hospitalization.

HOSPITALIZATION PROBABILITY (TARGET %)	NUMBER OF EPIDEMICS (%)	FINAL SIZE – TOTAL (%)	FINAL SIZE – STAFF (%)	FINAL SIZE – STUDENTS (%)	MORTALITY (%)	CHILDREN HOSPITALIZED (%)	PEAK SIZE (%)	DAYS TO EPIDEMIC THRESHOLD	PEAK DAY	LAST DAY
0.001 (5)	243 (49)	78.6 ± 11.7	61.3 ± 17.6	85.2 ± 12.7	3.1 ± 2.2	6.1 ± 3.7	28.2 ± 7.0	6.3 ± 2.0	14.2 ± 3.7	24.6 ± 4.2
0.002 (10)	233 (47)	74.9 ± 16.7	58.7 ± 18.1	81.1 ± 18.7	2.5 ± 1.9	10.8 ± 4.7	27.1 ± 8.0	6.4 ± 2.2	13.5 ± 3.7	24.1 ± 4.5
0.003 (15)	243 (49)	72.9 ± 16.9	57.6 ± 18.5	78.7 ± 18.9	2.6 ± 2.1	14.8 ± 5.6	25.7 ± 7.9	6.0 ± 1.9	13.8 ± 3.8	24.2 ± 4.5
0.004 (20)	231 (46)	71.6 ± 18.4	56.3 ± 20.5	77.4 ± 20.1	2.8 ± 2.2	18.9 ± 6.7	24.8 ± 7.5	6.4 ± 2.2	14.1 ± 4.0	24.2 ± 4.9
0.005 (25)	242 (48)	70.5 ± 19.3	56.5 ± 19.1	75.7 ± 21.8	2.7 ± 2.1	22.7 ± 7.9	24.7 ± 8.4	6.0 ± 2.1	13.3 ± 4.1	23.6 ± 4.8
ANOVA (F_{4, 1187})		8.9**	2.8**	9.4**	2.9**	293.3**	9.2**	2.1*	2.2*	1.3