Projecting hospital utilization during the COVID-19 outbreaks in the United States
JournalProceedings of the National Academy of Sciences of the United States of America
PublisherNational Academy of Sciences
MetadataShow full item record
AbstractIn the wake of community coronavirus disease 2019 (COVID-19) transmission in the United States, there is a growing public health concern regarding the adequacy of resources to treat infected cases. Hospital beds, intensive care units (ICUs), and ventilators are vital for the treatment of patients with severe illness. To project the timing of the outbreak peak and the number of ICU beds required at peak, we simulated a COVID-19 outbreak parameterized with the US population demographics. In scenario analyses, we varied the delay from symptom onset to self-isolation, the proportion of symptomatic individuals practicing self-isolation, and the basic reproduction number R0. Without self-isolation, when R0 = 2.5, treatment of critically ill individuals at the outbreak peak would require 3.8 times more ICU beds than exist in the United States. Self-isolation by 20% of cases 24 h after symptom onset would delay and flatten the outbreak trajectory, reducing the number of ICU beds needed at the peak by 48.4% (interquartile range 46.4-50.3%), although still exceeding existing capacity. When R0 = 2, twice as many ICU beds would be required at the peak of outbreak in the absence of self-isolation. In this scenario, the proportional impact of self-isolation within 24 h on reducing the peak number of ICU beds is substantially higher at 73.5% (interquartile range 71.4-75.3%). Our estimates underscore the inadequacy of critical care capacity to handle the burgeoning outbreak. Policies that encourage self-isolation, such as paid sick leave, may delay the epidemic peak, giving a window of time that could facilitate emergency mobilization to expand hospital capacity.
SponsorsSupport from the Canadian Institutes of Health Research (grant OV4-170643; Canadian 2019 Novel Coronavirus Rapid Research), and the Natural Sciences and Engineering Research Council of Canada. Funding from the NIH (grant UO1-GM087719), the Burnett and Stender families' endowment, the Notsew Orm Sands Foundation, NIH grant 1R01AI151176-01, and National Science Foundation grant RAPID-2027755. Also supported by the NIH grant K01 AI141576.
KeywordCritical care need
Coronavirus Disease 2019 (COVID-19)
Identifier to cite or link to this itemhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85083489819&doi=10.1073%2fpnas.2004064117&partnerID=40&md5=b867985f28e9c0aab9755db5fc85e278; http://hdl.handle.net/10713/12665