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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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Autores principales: Alavinejad, Mahnaz, Mellado, Bruce, Asgary, Ali, Mbada, Mduduzi, Mathaha, Thuso, Lieberman, Benjamin, Stevenson, Finn, Tripathi, Nidhi, Swain, Abhaya Kumar, Orbinski, James, Wu, Jianhong, Kong, Jude Dzevela
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022393/
https://www.ncbi.nlm.nih.gov/pubmed/36962677
http://dx.doi.org/10.1371/journal.pgph.0001113
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author Alavinejad, Mahnaz
Mellado, Bruce
Asgary, Ali
Mbada, Mduduzi
Mathaha, Thuso
Lieberman, Benjamin
Stevenson, Finn
Tripathi, Nidhi
Swain, Abhaya Kumar
Orbinski, James
Wu, Jianhong
Kong, Jude Dzevela
author_facet Alavinejad, Mahnaz
Mellado, Bruce
Asgary, Ali
Mbada, Mduduzi
Mathaha, Thuso
Lieberman, Benjamin
Stevenson, Finn
Tripathi, Nidhi
Swain, Abhaya Kumar
Orbinski, James
Wu, Jianhong
Kong, Jude Dzevela
author_sort Alavinejad, Mahnaz
collection PubMed
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 pubmed-100223932023-03-17 Management of hospital beds and ventilators in the Gauteng province, South Africa, during the COVID-19 pandemic Alavinejad, Mahnaz Mellado, Bruce Asgary, Ali Mbada, Mduduzi Mathaha, Thuso Lieberman, Benjamin Stevenson, Finn Tripathi, Nidhi Swain, Abhaya Kumar Orbinski, James Wu, Jianhong Kong, Jude Dzevela PLOS Glob Public Health Research Article 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. Public Library of Science 2022-11-02 /pmc/articles/PMC10022393/ /pubmed/36962677 http://dx.doi.org/10.1371/journal.pgph.0001113 Text en © 2022 Alavinejad et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Alavinejad, Mahnaz
Mellado, Bruce
Asgary, Ali
Mbada, Mduduzi
Mathaha, Thuso
Lieberman, Benjamin
Stevenson, Finn
Tripathi, Nidhi
Swain, Abhaya Kumar
Orbinski, James
Wu, Jianhong
Kong, Jude Dzevela
Management of hospital beds and ventilators in the Gauteng province, South Africa, during the COVID-19 pandemic
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
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022393/
https://www.ncbi.nlm.nih.gov/pubmed/36962677
http://dx.doi.org/10.1371/journal.pgph.0001113
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