Forecasting local hospital bed demand for COVID-19 using on-request simulations

Abstract

For hospitals, realistic forecasting of bed demand during impending epidemics of infectious diseases is essential to avoid being overwhelmed by a potential sudden increase in the number of admitted patients. Short-term forecasting can aid hospitals in adjusting their planning and freeing up beds in time.We created an easy-to-use online on-request tool based on local data to forecast COVID-19 bed demand for individual hospitals. The tool is flexible and adaptable to different settings, and it is based on a stochastic compartmental model for estimating the epidemic dynamics and coupled with an exponential smoothing model for forecasting.The models are written in R and Julia and implemented as an R-shiny dashboard. The model is parameterized using COVID-19 incidence, vaccination, and bed occupancy data at customizable geographical resolutions, loaded from official online sources or uploaded manually. Users can select their hospital's catchment area and adjust the number of COVID-19 occupied beds at the start of the simulation. The tool provides short-term forecasts of disease incidence and past and forecasted estimation of the epidemic reproductive number at the chosen geographical level. These quantities are then used to estimate the bed occupancy in both general wards and intensive care unit beds. The platform has proven efficient, providing results within seconds while coping with many concurrent users.By providing ad-hoc, local data informed forecasts, this platform allows decisionmakers to evaluate realistic scenarios for allocating scarce resources, such as ICU beds, at various geographic levels.