Management of hospital beds and ventilators in the Gauteng province, South Africa, during the COVID-19 pandemic.

We conducted an observational retrospective study on patients hospitalized with COVID-19, during March 05, 2020, to October 28, 2021, and developed an agent-based model to evaluate effectiveness of recommended healthcare resources (hospital beds and ventilators) management strategies during the COVI...

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Main Authors: Mahnaz Alavinejad, Bruce Mellado, Ali Asgary, Mduduzi Mbada, Thuso Mathaha, Benjamin Lieberman, Finn Stevenson, Nidhi Tripathi, Abhaya Kumar Swain, James Orbinski, Jianhong Wu, Jude Dzevela Kong
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLOS Global Public Health
Online Access:https://doi.org/10.1371/journal.pgph.0001113
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author Mahnaz Alavinejad
Bruce Mellado
Ali Asgary
Mduduzi Mbada
Thuso Mathaha
Benjamin Lieberman
Finn Stevenson
Nidhi Tripathi
Abhaya Kumar Swain
James Orbinski
Jianhong Wu
Jude Dzevela Kong
author_facet Mahnaz Alavinejad
Bruce Mellado
Ali Asgary
Mduduzi Mbada
Thuso Mathaha
Benjamin Lieberman
Finn Stevenson
Nidhi Tripathi
Abhaya Kumar Swain
James Orbinski
Jianhong Wu
Jude Dzevela Kong
author_sort Mahnaz Alavinejad
collection DOAJ
description We conducted an observational retrospective study on patients hospitalized with COVID-19, during March 05, 2020, to October 28, 2021, and developed an agent-based model to evaluate effectiveness of recommended healthcare resources (hospital beds and ventilators) management strategies during the COVID-19 pandemic in Gauteng, South Africa. We measured the effectiveness of these strategies by calculating the number of deaths prevented by implementing them. We observed differ ences between the epidemic waves. The length of hospital stay (LOS) during the third wave was lower than the first two waves. The median of the LOS was 6.73 days, 6.63 days and 6.78 days for the first, second and third wave, respectively. A combination of public and private sector provided hospital care to COVID-19 patients requiring ward and Intensive Care Units (ICU) beds. The private sector provided 88.4% of High care (HC)/ICU beds and 49.4% of ward beds, 73.9% and 51.4%, 71.8% and 58.3% during the first, second and third wave, respectively. Our simulation results showed that with a high maximum capacity, i.e., 10,000 general and isolation ward beds, 4,000 high care and ICU beds and 1,200 ventilators, increasing the resource capacity allocated to COVID- 19 patients by 25% was enough to maintain bed availability throughout the epidemic waves. With a medium resource capacity (8,500 general and isolation ward beds, 3,000 high care and ICU beds and 1,000 ventilators) a combination of resource management strategies and their timing and criteria were very effective in maintaining bed availability and therefore preventing excess deaths. With a low number of maximum available resources (7,000 general and isolation ward beds, 2,000 high care and ICU beds and 800 ventilators) and a severe epidemic wave, these strategies were effective in maintaining the bed availability and minimizing the number of excess deaths throughout the epidemic wave.
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spelling doaj.art-b3c59a7cc16744509ccfe57fe9479d142023-09-03T08:52:31ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-01211e000111310.1371/journal.pgph.0001113Management of hospital beds and ventilators in the Gauteng province, South Africa, during the COVID-19 pandemic.Mahnaz AlavinejadBruce MelladoAli AsgaryMduduzi MbadaThuso MathahaBenjamin LiebermanFinn StevensonNidhi TripathiAbhaya Kumar SwainJames OrbinskiJianhong WuJude Dzevela KongWe conducted an observational retrospective study on patients hospitalized with COVID-19, during March 05, 2020, to October 28, 2021, and developed an agent-based model to evaluate effectiveness of recommended healthcare resources (hospital beds and ventilators) management strategies during the COVID-19 pandemic in Gauteng, South Africa. We measured the effectiveness of these strategies by calculating the number of deaths prevented by implementing them. We observed differ ences between the epidemic waves. The length of hospital stay (LOS) during the third wave was lower than the first two waves. The median of the LOS was 6.73 days, 6.63 days and 6.78 days for the first, second and third wave, respectively. A combination of public and private sector provided hospital care to COVID-19 patients requiring ward and Intensive Care Units (ICU) beds. The private sector provided 88.4% of High care (HC)/ICU beds and 49.4% of ward beds, 73.9% and 51.4%, 71.8% and 58.3% during the first, second and third wave, respectively. Our simulation results showed that with a high maximum capacity, i.e., 10,000 general and isolation ward beds, 4,000 high care and ICU beds and 1,200 ventilators, increasing the resource capacity allocated to COVID- 19 patients by 25% was enough to maintain bed availability throughout the epidemic waves. With a medium resource capacity (8,500 general and isolation ward beds, 3,000 high care and ICU beds and 1,000 ventilators) a combination of resource management strategies and their timing and criteria were very effective in maintaining bed availability and therefore preventing excess deaths. With a low number of maximum available resources (7,000 general and isolation ward beds, 2,000 high care and ICU beds and 800 ventilators) and a severe epidemic wave, these strategies were effective in maintaining the bed availability and minimizing the number of excess deaths throughout the epidemic wave.https://doi.org/10.1371/journal.pgph.0001113
spellingShingle Mahnaz Alavinejad
Bruce Mellado
Ali Asgary
Mduduzi Mbada
Thuso Mathaha
Benjamin Lieberman
Finn Stevenson
Nidhi Tripathi
Abhaya Kumar Swain
James Orbinski
Jianhong Wu
Jude Dzevela Kong
Management of hospital beds and ventilators in the Gauteng province, South Africa, during the COVID-19 pandemic.
PLOS Global Public Health
title Management of hospital beds and ventilators in the Gauteng province, South Africa, during the COVID-19 pandemic.
title_full Management of hospital beds and ventilators in the Gauteng province, South Africa, during the COVID-19 pandemic.
title_fullStr Management of hospital beds and ventilators in the Gauteng province, South Africa, during the COVID-19 pandemic.
title_full_unstemmed Management of hospital beds and ventilators in the Gauteng province, South Africa, during the COVID-19 pandemic.
title_short Management of hospital beds and ventilators in the Gauteng province, South Africa, during the COVID-19 pandemic.
title_sort management of hospital beds and ventilators in the gauteng province south africa during the covid 19 pandemic
url https://doi.org/10.1371/journal.pgph.0001113
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