Create An ICU

So now we can tell people they’re sick, and when they hear they’re sick they go home. But we also want to account for another function of a hospital - providing treatment for severe cases.

Let’s breakdown what we’ll need to modify in our existing model:

1. At risk. Right now a person is infected or not infected, but we want to delineate between the mild and severe cases.
2. ICU Capacity. A hospital, so long as it has room in its intensive care unit, should treat severe cases. Instead of going home, the person will move to the hospital and stay there until they’re recovered.

On your Hospital initialization (in init.json), add a value for icu_beds. This will represent the number of Intensive Care Unit beds that a hospital has.

init.json

 "icu_beds": 10,

In init.json , expand the hospital agent by adding a value for icu_capacity.

{
  "agent_name": "Hospital",
  "position": [20,20],
  "height": 4,
  "color": "blue",
  "icu_beds": 10,
  "behaviors": ["test_for_virus.js"]
  "type": "hospital"
}

Note: Your init.json might look different if you used create_stacks or create_scatters - the same basic approach should apply.

If you reset the simulation and click on the hospital agent the inspect modal will now display the value for icu_beds. Click the inverted pyramid to select/deselect displayed attributes.

Open the check_infected file. A person agent is sending a request to the hospital to test them; now they should also send personal information to the hospital. In particular we want to know how likely it is they're at_risk of complications from the disease. It’s a little bit of a hand-wave that they are directly sending their at_risk level - you can imagine they’re sending a blood/spit sample and don’t know what it contains, or providing demographic info like their age or pre-existing conditions. In a more complicated model we'd likely determine their at_risk degree from a variety of different measures.

In this case, let's include a key-value pair in the message data packet for at_risk in the "check_infected" behavior:

function check_hospital() {
  state.addMessage("Hospital", "test", {
    test_sick: true,
    at_risk: state.at_risk,
  });
}

Open the test_for_virus behavior and, in our message parsing loop, add control-flow logic to differentiate the risky cases from the non-risky cases. When a person is seriously ill, they get a bed in the hospital, so long as there’s a bed to give:

// test_for_virus.js

test_messages.forEach((m) => {
  let icu_or_home = false;

  if (state.icu_beds && m.data.at_risk) {
    state.icu_beds -= 1;
    icu_or_home = true;
  }
  //existing code
});

Let’s add a flag that the person has a case severe enough that they will stay in the hospital; this is how we’ll let the person know they either need to stay at the hospital or they can rest up at home. Modify the message sent to include that variable:

// test_for_virus.js

test_messages.forEach((m) => {
  // ...
  let icu_or_home = false;

  if (state.icu_beds && m.data.at_risk) {
    state.icu_beds -= 1;
    icu_or_home = true;
  }

  state.addMessage(m.from, "test_result", {
    sick: true,
    icu_or_home: icu_or_home,
  });
});

Let’s return to our person agent. They’ve just received a message from the hospital telling them if they're sick and if they should go home or come to the hospital. We already have the mild case handled - they go home. We need to modify the logic for the severe case:

// check_infected.js
//A person checks for messages from the hospital telling them their test results
let msgs = context.messages().filter((msg) => msg.type === "test_result");

msgs.forEach((msg) => {
  if (msg.data.sick && msg.data.icu_or_home) {
    state.icu = true;
    state.destination = state.hospital;
  } else if (msg.data.sick) {
    state.destination = state.home;
  }
});

With this change if a person finds out they have a severe case, their destination is set as the hospital.

We'll need to make a change to the daily_movement file as well, to prevent the agent from moving away once they've arrived at the icu until they're better.

// daily_movement.js
// Line 53
if (state.social_distancing || state.icu) {
  return;
}

When they recover, we want agents to signal to the hospital that they’re leaving and that there’s a free ICU bed available. And then, of course, we want agents to actually leave!

We need to add:

• A message sender that, when a person is recovered, sends a message to the hospital that they’re better.
• A message handler that increments the hospital's icu_capacity by 1 when it receives the “recovered” message.

The infection behavior handles the logic for infection state:

// infection.js
// Line 87
if (state.infection_duration === 0) {
    state.health_status = Math.random() < immunity_proportion ? "immune" : "healthy");
    state.color = "green";
    //TODO: notify the hospital the person has recovered
}

This is another opportunity to use message passing. We'll create a message to send to the Hospital telling them that the person has recovered.

// Line 87
if (state.infection_duration === 0) {
    state.health_status = Math.random() < immunity_proportion ? "immune" : "healthy");
    state.color = "green";

    if (state.icu) {
        state.addMessage("Hospital", "recovered", {
            "msg": "All Better!"
        })
        state.icu = false;
        state.destination = state.home;
        state.out = true;
    }
}

Finally, let's handle the message logic on the Hospitals side in the "test_for_virus" behavior at the top of the behavior:

// test_for_virus.js

const recovered_messages = context
  .messages()
  .filter((m) => m.type === "recovered");
//Frees up a bed for each (recovered,severe) case
recovered_messages.forEach((m) => (state.icu_beds += 1));

Congratulations! You've added a hospital and some basic behaviors to your simulation. You should now be starting to see how adding agents and behaviors can quickly create models that mirror the real world.