Raffaele Vardavas

Will the United States Declare Freedom from COVID-19 Too Soon?

RAND analyzed what could happen with COVID-19 deaths in the United States if restrictions all go away on July 4. Fully reopening the economy before Biden's vaccination target was met doubled the average number of COVID-19 deaths between Independence Day and the end of the year.

COVID-19 Could Become a Widespread Preexisting Condition in a Post-ACA World

The Affordable Care Act (ACA) is far from perfect, but its protections are particularly relevant to the COVID-19 pandemic. If the ACA is struck down, then protections for preexisting conditions will go with it. Policymakers should consider the potential implications for millions of COVID-19 survivors.

Modeling the Future of COVID-19: Q&A with RAND Experts

The phrase “flatten the curve” familiarized Americans with epidemiological models used to estimate virus transmission, cases, and potential deaths from COVID-19. But new models are needed as the country enters a different stage of the crisis.

Relaxing COVID-19 Restrictions Presents Stark Health and Economic Choices

RAND's new COVID-19 interventions impact tool uses epidemiological and economic models and continually refreshed data to estimate what could happen as restrictions are eased. The tool won't make the choices confronting state leaders less painful. But it can provide clear, evidence-based estimates of the health and economic trade-offs.

Estimates of COVID-19's Fatality Rate Might Change. And Then Change Again.

With infections of the new coronavirus confirmed in countries around the world, people are following the daily tally of COVID-19 cases, wondering exactly how lethal this new disease is. The truth is, it's hard to know.

Let's (Not) Play Games with Dodd-Frank

Dodd-Frank, the 2010 financial reform law, is now itself the target of reform. Those involved with the overhaul could draw inspiration from an unlikely source: video games. A simulation game could help predict the effects of changes to regulations—and avoid high-stakes missteps.

Draft

Co-Designing Capabilities for a Robust Pandemic Response: Stakeholder Engagement for Visioning, Backcasting, and Evaluating New Decision-Support Capabilities

The authors describe workshops convening public health policymakers to backcast a future in which pandemic response was improved, frame pandemic decision challenges, and demonstrate analytic capabilities to support robust decisions in such a future.

Report

Identifying Strategies for Strengthening the Health Care Workforce in the Commonwealth of Virginia

The authors of this report assess shortages in Virginia's health care workforce and identify potential interventions to address them.

Research Brief

Recommendations for Strengthening the Health Care Workforce in the Commonwealth of Virginia

This brief describes potential interventions to boost recruitment and retention in Virginia’s health care workforce and increase its structural efficiency. 

Draft

Using Artificial Intelligence to Generate Synthetic Health Data

Generating synthetic data enables making sensitive data sets available to the research community. The authors compare two methods for synthetic health data generation, analyze their performances, and evaluate their advantages and disadvantages.

Journal Article

Evaluation Via Simulation of Statistical Corrections for Network Nonindependence

Many statistical techniques assume independence of data points, but networked data violate this assumption. Our network simulations indicate that eight commonly used techniques intended to correct this problem in networked data fail to do so.

Journal Article

Optimal Non-Pharmaceutical Pandemic Response Strategies Depend Critically on Time Horizons and Costs

This paper performs a large-scale optimization exercise to find optimal non-pharmaceutical pandemic response strategies.

Journal Article

Association of COVID-19 Vaccination With Influenza Vaccine History and Changes in Influenza Vaccination

Using the RAND American Life Panel (ALP), we examine relationships among COVID and influenza vaccination amongst those who historically never, sometimes, or always vaccinate for influenza.

Research Brief

Increasing Subsidies and Expanding Health Insurance Options in Connecticut: Findings Without the Build Back Better Act

The authors estimated the impacts of policy options to increase the affordability of insurance in Connecticut with the assumption that subsidy enhancements enacted under the American Rescue Plan Act of 2021 would not continue past 2022.

Report

Increasing Subsidies and Expanding Health Insurance Options in Connecticut

The authors estimated the impacts of policy options to increase the affordability of insurance in Connecticut. They calculated enrollment, premiums, and state spending and considered whether the results differed by race, ethnicity, or income group.

Journal Article

Reciprocal Relationships Among Influenza Experiences, Perceptions, and Behavior: Results from a National, Longitudinal Survey of United States Adults

Likelihood of vaccination for influenza is associated with perceived risk and experience with influenza. Higher perceived risk of influenza may be more associated with interpreting ambiguous symptoms as influenza.

Journal Article

Modelling the Impact of Social Distancing and Targeted Vaccination on the Spread of COVID-19 Through a Real City-Scale Contact Network

We use mobile device data to construct empirical interpersonal physical contact networks in the city of Portland, Oregon, both before and after social distancing measures were enacted during the COVID-19 pandemic.

Report

Temporary Safety-Net Policies and Pandemic-Related Insurance Loss in New York State

Researchers assess the importance of temporary provisions relative to long-standing policies in stabilizing health insurance enrollment in New York state despite heavy job loss during the coronavirus disease 2019 pandemic.

Journal Article

Reopening California: Seeking Robust, Non-Dominated COVID-19 Exit Strategies

This paper uses simulation models and the Robust Decision Making (RDM) approach to stress-test California's reopening strategy and other alternatives over a wide range of futures.

Journal Article

Could Periodic Nonpharmaceutical Intervention Strategies Produce Better COVID-19 Health and Economic Outcomes?

We developed a COVID-19 transmission model to compare the effects of nonpharmaceutical public health interventions (NPIs). We find that the periodic switch between low and high NPI levels could have produced similar health outcomes as static strategies but better social welfare outcomes.

Journal Article

Modeling Infectious Behaviors: The Need to Account for Behavioral Adaptation in COVID-19 Models

In this essay we discuss the need for new types of simulation models of COVID-19 that couple transmission dynamics with adaptive behaviors.

Commentary

Reopening Under Uncertainty: Stress-Testing California's COVID-19 Exit Strategy

Researchers used the Robust Decision Making approach to stress-test California's response to the COVID-19 pandemic. This Perspective presents lessons learned from these experiments and outlines four characteristics of the best reopening strategies.

Draft

Modeling COVID-19 Nonpharmaceutical Interventions: Exploring periodic NPI Strategies

Develops a COVID-19 transmission model used as part of RAND's web-based COVID-19 decision support tool that compares the effects of nonpharmaceutical public health interventions on health and economic outcomes.

Journal Article

Modeling Agent Behaviors for Policy Analysis Via Reinforcement Learning

This paper examines the value of reinforcement learning models as adaptive, high-performing, and behaviorally-valid models of agent decision-making in Agent-based Models.

Research Brief

10Plan, How Would It Affect Health Care Spending by Consumers and the Federal Government

The 10Plan is a self-pay plan for individuals currently uninsured or covered by a private nongroup health insurance plan. The authors built a microsimulation model to estimate health care spending under both the status quo and the 10Plan.

Commentary

Protecting the Most Vulnerable by Vaccinating the Most Active

In this Perspective, the authors used a network model to illustrate five different vaccination strategies for coronavirus disease 2019, showing that vaccinating the most-active people might be the best way to protect the vulnerable in the pandemic.

Report

Analysis of the 10Plan: A Self-Pay System Designed to Minimize the Burden of Health Care Costs

The 10Plan is a self-pay plan for individuals currently uninsured or covered by a private nongroup health insurance plan. The authors built a microsimulation model to estimate health care spending under both the status quo and the 10Plan.

Report

Logistics Analysis of Puerto Rico: Will the Seaborne Supply Chain of Puerto Rico Support Hurricane Recovery Projects?

Puerto Rico's seaborne logistics capacity is assessed in the context of recovery efforts following the Hurricane Maria. Key constraints are identified along with actions to mitigate potential bottlenecks.

Draft

Deep Generative Modeling in Network Science with Applications to Public Policy Research

Explores deep generative modeling in network science towards informing key public policy questions.

Tool

The Health and Economic Impacts of Nonpharmaceutical Interventions to Address COVID-19: A Decision Support Tool for State and Local Policymakers

There is an urgent need for an assessment of public health interventions to address coronavirus disease 2019 (COVID-19) and determine when to relax them. This document describes the COVID-19 Decision Support Tool, which is designed to fill that need.

Journal Article

The Stability of Influenza Vaccination Behavior Over Time: A Longitudinal Analysis of Individuals Across 8 Years

U.S. adults completed multiple surveys about influenza vaccinations over an 8 year period. Findings indicate that individuals with only a weak tendency to vaccinate or not to vaccinate are mostly likely to be impacted by interventions.

Report

Medicare for 50-to-64-Year-Olds: Assessing the Effects of Allowing Older Adults to Buy Into the Medicare Program

In this report, the authors analyze how allowing adults ages 50 and older to buy into the Medicare program could affect health insurance coverage, individual market premiums, and federal health care spending.

Draft

RAND's Interdisciplinary Behavioral and Social Science Agent-Based Model of Income Tax Evasion: Technical Report

Explores an agent-based computational simulation model of individual income tax evasion tools to understand how taxpayers change their compliance behavior and what government policies could help mitigate the problem of tax evasion.

Journal Article

Panel Discussion: Moving Social-Behavioral Modeling Forward

This chapter describes panel discussion and debate relating to various multi-scale phenomena in social science, including emergence.

Report

Increasing Cost-Effective Readiness for the U.S. Air Force by Reducing Supply Chain Variance: Technical Analysis of Flying Hour Program Variance

Seeking to reduce the $4 billion that it spends annually on spare parts, the Air Force asked RAND researchers to identify the causes and gauge the effects of flying hour variance (the difference between predicted and actual numbers of flying hours).

Report

Preventing, Identifying, and Treating Prescription Drug Misuse Among Active-Duty Service Members

This report presents the framework of an analytic tool that can help the military predict future trends in PDM based on current demographics of active-duty service members and rates of injury and prescribing of prescription drugs.

Journal Article

A Cost-Effectiveness Analysis of Preexposure Prophylaxis for the Prevention of HIV Among Los Angeles County Men Who Have Sex with Men

Some strategies for treating high-risk individuals before HIV infection can be cost effective while helping to reduce incidence of the disease.

Report

Improving Decision Support for Infectious Disease Prevention and Control: Aligning Models and Other Tools with Policymakers' Needs

This report provides an overview of decision-support tools, including models and nonmodeling approaches, for policymakers and modelers and provides recommendations for using the tools to inform real-world infectious disease-related policy questions.

Research Brief

Assessing the Department of Defense's Approach to Reducing Mental Health Stigma

This brief assesses the military's approach to reducing stigma for mental health disorders.

Journal Article

The Effect of Near-Term Policy Choices on Long-Term Greenhouse Gas Transformation Pathways

This paper introduces a new agent-based, game theoretic model designed to compare how near-term choices regarding alternative policy architectures influence long-term emission reduction trajectories.

Journal Article

Benefits of PrEP as an Adjunctive Method of HIV Prevention During Attempted Conception Between HIV-uninfected Women and HIV-infected Male Partners

Data on effectiveness of preexposure prophylaxis (PrEP) for human immunodeficiency virus (HIV)–uninfected women attempting conception with HIV-infected male partners are limited to observational studies.

Report

Estimating the economic costs of antimicrobial resistance: Model and Results

The independent Review on AMR led by the economist Jim O'Neill commissioned RAND Europe to conduct a study estimating the global costs of antimicrobial resistance until 2050 in the absence of any progress in tackling the challenge.

Report

Mental Health Stigma in the Military

This report assesses the U.S. military's approach to reducing stigma for mental health disorders and their treatment, how well it is working, and how it might be improved. It presents priorities for getting service members the treatment they need.

Report

An Evolutionary Model of Industry Transformation and the Political Sustainability of Emission Control Policies

To compare the long-term sustainability of alternative carbon emission reduction policies, an agent-based simulation explores the co-evolution of an industry sector, its technology base, and political coalitions that influence government policy.

Journal Article

Conscious Consideration of Herd Immunity in Influenza Vaccination Decisions

Influenza vaccination decisions may be influenced by perceived risk reduction related to herd immunity.

Journal Article

Test-and-treat in Los Angeles: A Mathematical Model of the Effects of Test-And-Treat for the Population of Men Who Have Sex with Men in Los Angeles County

There is evidence to suggest that antiretroviral therapy (ART) and testing for human immunodeficiency virus (HIV) reduce the probability of transmission of HIV.

Journal Article

Modeling Employer Self-Insurance Decisions After the Affordable Care Act

Self-insurance rates will increase among small firms only under the hypothetical situation that generous stop-loss policies are available to them after implementation of the ACA. Even if many small firms choose to self insure under this situation, it will not increase the premiums charged in the insurance exchanges by more than a few tenths of a percent.

Journal Article

Modeling Influenza Vaccination Behavior Via Inductive Reasoning Games

The authors show that individual immunization choices can cause severe influenza epidemics and illustrate the actions that might be undertaken to prevent them.

Journal Article

Small Firms' Actions in Two Areas, and Exchange Premium and Enrollment Impact

An analysis of two rules that allow small businesses to avoid participating in health reform concludes they will have only a minor impact because relatively few businesses are likely to take advantage of the options.

Report

Employer Self-Insurance Decisions and the Implications of the Patient Protection and Affordable Care Act as Modified by the Health Care and Education Reconciliation Act of 2010 (ACA)

Implications of the Patient Protection and Affordable Care Act of 2010 (as Modified by the Health Care and Education Reconciliation Act) for small firms' decisions to offer self-insured health plans and consequences of self-insurance for enrollees.

Journal Article

A Universal Long-Term Flu Vaccine May Not Prevent Severe Epidemics

Universal vaccines that provide short-term protection are likely to result in small frequent epidemics, whereas universal vaccines that provide long-term protection are likely to result in severe infrequent epidemics.

Draft

Overview of the COMPARE Microsimulation Model

To enhance the assessment of proposals to reform U.S. health policy, RAND researchers created the COMPARE microsimulation model, which develops a synthetic U.S. population and projects how it would respond to a variety of coverage-oriented options.