Scenario comparison

Fixed illustrative runs under three transmission scenarios: citywide epidemic scale, ward-bed pressure, then which hospital systems and ZIPs are most stressed.

These tables use the fixed scenario parameter sets below. To test other parameter sets and see how citywide stress changes, open the Shiny app.

Model assumptions (fixed scenario parameters)

Mid values from the project parameter registry. Shared occupancy and hospital-routing rules apply to all three scenarios.

Parameter	Seasonal flu (best)	Pandemic flu (moderate)	COVID-like (worst)
R₀	1.25	1.5	3
P(symptomatic \| infection)	25%	50%	70%
Hospitalization \| case	1.4%	10%	50%
ICU \| hospitalization	17%	20%	30%
LOS ward (days)	6	7.5	9.5
LOS ICU (days)	7	8.5	11
CFR (symptomatic)	0.1%	0.1%	3%

Baseline occupancy: ward 79.8%, ICU 79.4% → city free beds ≈ 3,226 ward / 346 ICU (from NYC hospital bed counts).
Modeled cases are split across ZIP codes using population × composite risk (illustrative, not a fitted spatial model).
Each ZIP is assigned to its nearest hospital. When that hospital’s free beds are full, extra patients go to the next-closest hospital.

Citywide incidence and ward demand

Citywide daily incidence and ward census for three scenarios vs free ward beds

Hospital systems (by assigned ZIP cases)

Hospital systems with the most cases among ZIP codes assigned to their hospitals.

Top hospital system	Seasonal flu (best)		Pandemic flu (moderate)		COVID-like (worst)
Top hospital system	System	Cases	System	Cases	System	Cases
#1	NYC H+H	5,589	NYC H+H	219,252	NYC H+H	1,274,374
#2	INDEPENDENT	2,904	INDEPENDENT	113,907	INDEPENDENT	662,069
#3	NEW YORK - PRESBYTERIAN	2,657	NEW YORK - PRESBYTERIAN	104,230	NEW YORK - PRESBYTERIAN	605,823

Hospital systems (by ward admissions, including overflow)

Hospital systems with the most ward admissions after redirecting overflow from full hospitals.

Top hospital system	Seasonal flu (best)		Pandemic flu (moderate)		COVID-like (worst)
Top hospital system	System	Ward admits	System	Ward admits	System	Ward admits
#1	NYC H+H	78	NYC H+H	22,358	NYC H+H	10,812
#2	INDEPENDENT	40	NEW YORK - PRESBYTERIAN	14,616	NEW YORK - PRESBYTERIAN	7,963
#3	NEW YORK - PRESBYTERIAN	37	MOUNT SINAI HEALTH SYSTEM	9,451	MOUNT SINAI HEALTH SYSTEM	5,087

Most vulnerable (high cases / low free acute beds) ZIPs

Rank order, ZIP, free beds, and assigned hospital are the same across scenarios. Cases and ratios scale with each scenario.

Map of the most vulnerable ZIP codes and their assigned hospitals

#	ZIP	Free acute beds	Assigned hospital	Seasonal flu (best)		Pandemic flu (moderate)		COVID-like (worst)
#	ZIP	Free acute beds	Assigned hospital	Cases	Ratio	Cases	Ratio	Cases	Ratio
#1	10456	29	BRONXCARE CENTER FULTON MANDY (1164)	316	10.9	12,379	428.3	71,953	2,489.7
#2	11229	24	MAIMONIDES MIDWOOD COMMUNITY (1293)	223	9.2	8,755	361.8	50,886	2,102.7
#3	11230	24	MAIMONIDES MIDWOOD COMMUNITY (1293)	209	8.6	8,210	339.2	47,718	1,971.8
#4	10002	30	NYP: LOWER MANHATTAN (1437)	251	8.5	9,864	332.1	57,334	1,930.4
#5	11385	34	WYCKOFF HEIGHTS MC (1318)	260	7.7	10,181	300.3	59,179	1,745.7

Vulnerability ratio = cumulative ZIP cases ÷ free acute beds at the assigned hospital. Free acute beds = staffed beds × (1 − ward occupancy). Illustrative analyses — not clinical guidance.