If gaps in health care resources aren’t filled, more than 80,000 Americans will die over the next four months due to the coronavirus pandemic, epidemiologists at the University of Washington predict.
The grim forecast — based on an analysis of statistics from the World Health Organization, as well as from national and local governments and hospitals — is laid out today in a research paper that’s being submitted to the MedRxiv preprint server but hasn’t yet been peer-reviewed.
Researchers at the UW’s Institute for Health Metrics and Evaluation say their forecast takes current policies on social distancing into account. The problem is that shortages of hospital beds and medical supplies are projected to boost the death toll nevertheless.
Peak excess demand is projected to occur in the second week of April, when the researchers predict a shortage of 64,000 beds and 19,000 ventilators. “The date of peak excess demand by state varies from the second week of April through May,” the researchers say.
With those inputs, the computer models project a total of 81,114 deaths in the U.S. over the next four months. Most of those deaths are expected to occur during April, peaking at more than 2,300 deaths per day. That rate is projected to drop below 10 deaths per day sometime between May 31 and June 6.
There are also state-by-state projections of hospital resource usage and deaths. In Washington state, for example, the peak resource use is projected to occur on April 19, the death rate is projected to rise to a maximum of 27 per day, and total COVID-19 deaths are projected to amount to 1,429 through Aug. 4. As of today, Washington state’s cumulative COVID-19 death toll is 147.
The researchers say patients suffering from other diseases will face increased risk as well. “In addition to a large number of deaths from COVID-19, the epidemic in the U.S. will place a load well beyond the current capacity of hospitals to manage, especially for ICU care,” they say.
If the forecast proves correct, that suggests a dramatic upswing in the U.S. outbreak. Today’s figures from the Coronavirus Research Center at the Johns Hopkins School of Medicine show nearly 1,200 U.S. deaths to date due to COVID-19, out of more than 82,000 confirmed cases.
The global death toll has risen above 23,000, with 523,000 confirmed cases worldwide. Just today, the United States took the top spot on JHU’s nation-by-nation tally of confirmed cases, surpassing China and Italy.
The UW team’s predictions are couched in statistical caveats. For example, the death toll projection of 81,114 has a 95% confidence interval of 7,977 to 251,059 deaths.
Additional travel restrictions and social distancing policies could make a difference in states that haven’t taken such measures so far. But based on the modeling, the most urgent measures would be to boost available beds and medical supplies — by reducing the demand for medical services not related to COVID-19, and increasing system capacity by any means possible.
“These are urgently needed, given that peak volumes are estimated to be only three weeks away,” the researchers say.
Update for 11 a.m. PT March 27: During a March 26 briefing, Deborah Birx, the White House’s coronavirus response coordinator, stressed the efforts being made to ensure that the worst-case scenario won’t happen.
“To make the implication that when [patients] need a hospital bed, it’s not going to be there, or when they need that ventilator, it’s not going to be there — we don’t have evidence of that right now … It’s our collective job to make sure that doesn’t happen,” she said.
The next few weeks will tell the tale on that front. In the meantime, the UW researchers will continue to update their projections at COVID19.Healthdata.org. As of March 27, the unmet need at the peak is projected to amount to 49,292 hospital beds, 14,612 ICU beds and 18,767 ventilators. Projected death toll through Aug. 4 is still 81,114.
The preprint research paper, “Forecasting COVID-19 Impact on Hospital Bed-Days, ICU-Days, Ventilator-Days and Deaths by US State in the Next Four Months,” comes from the IHME COVID-19 Health Service Utilization Forecasting Team under the direction of UW Professor Christopher J.L. Murray.
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