1. Projecting demand for critical care beds during COVID-19 outbreaks in Canada.
- Author
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Shoukat, Affan, Wells, Chad R., Langley, Joanne M., Singer, Burton H., Galvani, Alison P., and Moghadas, Seyed M.
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COVID-19 ,CRITICAL care medicine ,BEDS ,INTENSIVE care units ,QUARANTINE ,CORONAVIRUS disease treatment ,HOSPITAL utilization statistics ,VIRAL pneumonia ,RESEARCH ,RESEARCH methodology ,EVALUATION research ,MEDICAL cooperation ,COMPARATIVE studies ,PSYCHOLOGICAL tests ,EPIDEMICS ,PATIENT-family relations ,RESEARCH funding ,STATISTICAL models ,MEDICAL needs assessment - Abstract
Background: Increasing numbers of coronavirus disease 2019 (COVID-19) cases in Canada may create substantial demand for hospital admission and critical care. We evaluated the extent to which self-isolation of mildly ill people delays the peak of outbreaks and reduces the need for this care in each Canadian province.Methods: We developed a computational model and simulated scenarios for COVID-19 outbreaks within each province. Using estimates of COVID-19 characteristics, we projected the hospital and intensive care unit (ICU) bed requirements without self-isolation, assuming an average number of 2.5 secondary cases, and compared scenarios in which different proportions of mildly ill people practised self-isolation 24 hours after symptom onset.Results: Without self-isolation, the peak of outbreaks would occur in the first half of June, and an average of 569 ICU bed days per 10 000 population would be needed. When 20% of cases practised self-isolation, the peak was delayed by 2-4 weeks, and ICU bed requirement was reduced by 23.5% compared with no self-isolation. Increasing self-isolation to 40% reduced ICU use by 53.6% and delayed the peak of infection by an additional 2-4 weeks. Assuming current ICU bed occupancy rates above 80% and self-isolation of 40%, demand would still exceed available (unoccupied) ICU bed capacity.Interpretation: At the peak of COVID-19 outbreaks, the need for ICU beds will exceed the total number of ICU beds even with self-isolation at 40%. Our results show the coming challenge for the health care system in Canada and the potential role of self-isolation in reducing demand for hospital-based and ICU care. [ABSTRACT FROM AUTHOR]- Published
- 2020
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