Selectively caring for the most severe COVID-19 patients delays ICU bed shortages more than increasing hospital capacity

Abstract

1AbstractSARS-CoV-2, the virus responsible for COVID-19, has killed hundreds of thousands of Americans. Although physical distancing measures played a key role in slowing COVID-19 spread in early 2020, infection rates are now peaking at record levels across the country. Hospitals in several states are threatened with overwhelming numbers of patients, compounding the death toll of COVID-19. Implementing strategies to minimize COVID-19 hospitalizations will be key to controlling the toll of the disease, but non-physical distancing strategies receive relatively little attention. We present a novel system of differential equations designed to predict the relative effects of hospitalizing fewer COVID-19 patients vs increasing ICU bed availability on delaying ICU bed shortages. This model, which we call SEAHIRD, was calibrated to mortality data on two US states with different peak infection times from mid-March – mid-May 2020. It found that hospitalizing fewer COVID-19 patients generally delays ICU bed shortage more than a comparable increase in ICU bed availability. This trend was consistent across both states and across wide ranges of initial conditions and parameter values. We argue that being able to predict which patients will develop severe COVID-19 symptoms, and thus require hospitalization, should be a key objective of future COVID-19 research, as it will allow limited hospital resources to be allocated to individuals that need them most and prevent hospitals from being overwhelmed by COVID-19 cases.

COVID-19: Data-Driven optimal allocation of ventilator supply under uncertainty and risk

“…(2020) Estimate the transmission rate of COVID-19 infections COVID-19 Kretzschmar et al. (2020) Estimate due to delays in testing and isolation COVID-19 Roberts et al. (2020) Analyze the impacts of ICU bed capacity COVID-19 Tuan et al.…”

“…(2020) ). For example, Roberts, Seymour, & Dimitrov (2020) come up with a series of differential equations that are designed to compare the two scenarios based on delaying of ICU bed shortage - effects of hospitalizing fewer COVID-19 patients versus increasing the ICU bed capacity.…”

COVID-19: Optimal Allocation of Ventilator Supply under Uncertainty and Risk

“…Differential equations have been mainly used to solve compartmental disease models (see, e.g., Ambikapathy and Krishnamurthy (2020), Wei et al (2020), Zeb et al (2020), Tuan et al (2020), and Wang et al (2020)). For example, Roberts et al (2020) come up with a series of differential equations that are designed to compare the two scenarios based on delaying of ICU bed shortageeffects of hospitalizing fewer COVID-19 patients versus increasing the ICU bed capacity.…”