RT Journal Article
SR Electronic
T1 Projecting demand for critical care beds during COVID-19 outbreaks in Canada
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP E489
OP E496
DO 10.1503/cmaj.200457
VO 192
IS 19
A1 Shoukat, Affan
A1 Wells, Chad R.
A1 Langley, Joanne M.
A1 Singer, Burton H.
A1 Galvani, Alison P.
A1 Moghadas, Seyed M.
YR 2020
UL http://www.cmaj.ca/content/192/19/E489.abstract
AB 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.See related editorial at www.cmaj.ca/lookup/doi/10.1503/cmaj.200606