Modelling ICU capacity under different epidemiological scenarios of the COVID-19 pandemic in three western European countries

<p><strong>Background:</strong> The coronavirus disease 2019 (COVID-19) pandemic has placed enormous strain on intensive care units (ICUs) in Europe. Ensuring access to care, irrespective of COVID-19 status, in winter 2020–2021 is essential.</p> <p><strong>Method...

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Main Authors: McCabe, R, Kont, MD, Schmit, N, Whittaker, C, Løchen, A, Baguelin, M, Knock, E, Whittles, LK, Lees, J, Brazeau, NF, Walker, PGT, Ghani, AC, Ferguson, NM, White, PJ, Donnelly, CA, Hauck, K, Watson, OJ
Format: Journal article
Language:English
Published: Oxford University Press 2021
_version_ 1826279647175770112
author McCabe, R
Kont, MD
Schmit, N
Whittaker, C
Løchen, A
Baguelin, M
Knock, E
Whittles, LK
Lees, J
Brazeau, NF
Walker, PGT
Ghani, AC
Ferguson, NM
White, PJ
Donnelly, CA
Hauck, K
Watson, OJ
author_facet McCabe, R
Kont, MD
Schmit, N
Whittaker, C
Løchen, A
Baguelin, M
Knock, E
Whittles, LK
Lees, J
Brazeau, NF
Walker, PGT
Ghani, AC
Ferguson, NM
White, PJ
Donnelly, CA
Hauck, K
Watson, OJ
author_sort McCabe, R
collection OXFORD
description <p><strong>Background:</strong> The coronavirus disease 2019 (COVID-19) pandemic has placed enormous strain on intensive care units (ICUs) in Europe. Ensuring access to care, irrespective of COVID-19 status, in winter 2020–2021 is essential.</p> <p><strong>Methods:</strong> An integrated model of hospital capacity planning and epidemiological projections of COVID-19 patients is used to estimate the demand for and resultant spare capacity of ICU beds, staff and ventilators under different epidemic scenarios in France, Germany and Italy across the 2020–2021 winter period. The effect of implementing lockdowns triggered by different numbers of COVID-19 patients in ICUs under varying levels of effectiveness is examined, using a ‘dual-demand’ (COVID-19 and non-COVID-19) patient model.</p> <p><strong>Results:</strong> Without sufficient mitigation, we estimate that COVID-19 ICU patient numbers will exceed those seen in the first peak, resulting in substantial capacity deficits, with beds being consistently found to be the most constrained resource. Reactive lockdowns could lead to large improvements in ICU capacity during the winter season, with pressure being most effectively alleviated when lockdown is triggered early and sustained under a higher level of suppression. The success of such interventions also depends on baseline bed numbers and average non-COVID-19 patient occupancy.</p> <p><strong>Conclusion:</strong> Reductions in capacity deficits under different scenarios must be weighed against the feasibility and drawbacks of further lockdowns. Careful, continuous decision-making by national policymakers will be required across the winter period 2020–2021.</p>
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spelling oxford-uuid:763e2e0c-f513-4208-ab5b-706aa17d1bfb2022-03-26T20:14:32ZModelling ICU capacity under different epidemiological scenarios of the COVID-19 pandemic in three western European countriesJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:763e2e0c-f513-4208-ab5b-706aa17d1bfbEnglishSymplectic ElementsOxford University Press2021McCabe, RKont, MDSchmit, NWhittaker, CLøchen, ABaguelin, MKnock, EWhittles, LKLees, JBrazeau, NFWalker, PGTGhani, ACFerguson, NMWhite, PJDonnelly, CAHauck, KWatson, OJ<p><strong>Background:</strong> The coronavirus disease 2019 (COVID-19) pandemic has placed enormous strain on intensive care units (ICUs) in Europe. Ensuring access to care, irrespective of COVID-19 status, in winter 2020–2021 is essential.</p> <p><strong>Methods:</strong> An integrated model of hospital capacity planning and epidemiological projections of COVID-19 patients is used to estimate the demand for and resultant spare capacity of ICU beds, staff and ventilators under different epidemic scenarios in France, Germany and Italy across the 2020–2021 winter period. The effect of implementing lockdowns triggered by different numbers of COVID-19 patients in ICUs under varying levels of effectiveness is examined, using a ‘dual-demand’ (COVID-19 and non-COVID-19) patient model.</p> <p><strong>Results:</strong> Without sufficient mitigation, we estimate that COVID-19 ICU patient numbers will exceed those seen in the first peak, resulting in substantial capacity deficits, with beds being consistently found to be the most constrained resource. Reactive lockdowns could lead to large improvements in ICU capacity during the winter season, with pressure being most effectively alleviated when lockdown is triggered early and sustained under a higher level of suppression. The success of such interventions also depends on baseline bed numbers and average non-COVID-19 patient occupancy.</p> <p><strong>Conclusion:</strong> Reductions in capacity deficits under different scenarios must be weighed against the feasibility and drawbacks of further lockdowns. Careful, continuous decision-making by national policymakers will be required across the winter period 2020–2021.</p>
spellingShingle McCabe, R
Kont, MD
Schmit, N
Whittaker, C
Løchen, A
Baguelin, M
Knock, E
Whittles, LK
Lees, J
Brazeau, NF
Walker, PGT
Ghani, AC
Ferguson, NM
White, PJ
Donnelly, CA
Hauck, K
Watson, OJ
Modelling ICU capacity under different epidemiological scenarios of the COVID-19 pandemic in three western European countries
title Modelling ICU capacity under different epidemiological scenarios of the COVID-19 pandemic in three western European countries
title_full Modelling ICU capacity under different epidemiological scenarios of the COVID-19 pandemic in three western European countries
title_fullStr Modelling ICU capacity under different epidemiological scenarios of the COVID-19 pandemic in three western European countries
title_full_unstemmed Modelling ICU capacity under different epidemiological scenarios of the COVID-19 pandemic in three western European countries
title_short Modelling ICU capacity under different epidemiological scenarios of the COVID-19 pandemic in three western European countries
title_sort modelling icu capacity under different epidemiological scenarios of the covid 19 pandemic in three western european countries
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