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Modelling intensive care unit capacity under different epidemiological scenarios of the COVID-19 pandemic in three Western European countries
BACKGROUND: 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. METHODS: An integrated model of hospital capacity planning and epidemiological...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083295/ https://www.ncbi.nlm.nih.gov/pubmed/33837401 http://dx.doi.org/10.1093/ije/dyab034 |
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author | McCabe, Ruth Kont, Mara D Schmit, Nora Whittaker, Charles Løchen, Alessandra Baguelin, Marc Knock, Edward Whittles, Lilith K Lees, John Brazeau, Nicholas F Walker, Patrick GT Ghani, Azra C Ferguson, Neil M White, Peter J Donnelly, Christl A Hauck, Katharina Watson, Oliver J |
author_facet | McCabe, Ruth Kont, Mara D Schmit, Nora Whittaker, Charles Løchen, Alessandra Baguelin, Marc Knock, Edward Whittles, Lilith K Lees, John Brazeau, Nicholas F Walker, Patrick GT Ghani, Azra C Ferguson, Neil M White, Peter J Donnelly, Christl A Hauck, Katharina Watson, Oliver J |
author_sort | McCabe, Ruth |
collection | PubMed |
description | BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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. |
format | Online Article Text |
id | pubmed-8083295 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-80832952021-05-03 Modelling intensive care unit capacity under different epidemiological scenarios of the COVID-19 pandemic in three Western European countries McCabe, Ruth Kont, Mara D Schmit, Nora Whittaker, Charles Løchen, Alessandra Baguelin, Marc Knock, Edward Whittles, Lilith K Lees, John Brazeau, Nicholas F Walker, Patrick GT Ghani, Azra C Ferguson, Neil M White, Peter J Donnelly, Christl A Hauck, Katharina Watson, Oliver J Int J Epidemiol Covid-19 BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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. Oxford University Press 2021-04-09 /pmc/articles/PMC8083295/ /pubmed/33837401 http://dx.doi.org/10.1093/ije/dyab034 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the International Epidemiological Association. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Covid-19 McCabe, Ruth Kont, Mara D Schmit, Nora Whittaker, Charles Løchen, Alessandra Baguelin, Marc Knock, Edward Whittles, Lilith K Lees, John Brazeau, Nicholas F Walker, Patrick GT Ghani, Azra C Ferguson, Neil M White, Peter J Donnelly, Christl A Hauck, Katharina Watson, Oliver J Modelling intensive care unit capacity under different epidemiological scenarios of the COVID-19 pandemic in three Western European countries |
title | Modelling intensive care unit capacity under different epidemiological scenarios of the COVID-19 pandemic in three Western European countries |
title_full | Modelling intensive care unit capacity under different epidemiological scenarios of the COVID-19 pandemic in three Western European countries |
title_fullStr | Modelling intensive care unit capacity under different epidemiological scenarios of the COVID-19 pandemic in three Western European countries |
title_full_unstemmed | Modelling intensive care unit capacity under different epidemiological scenarios of the COVID-19 pandemic in three Western European countries |
title_short | Modelling intensive care unit capacity under different epidemiological scenarios of the COVID-19 pandemic in three Western European countries |
title_sort | modelling intensive care unit capacity under different epidemiological scenarios of the covid-19 pandemic in three western european countries |
topic | Covid-19 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083295/ https://www.ncbi.nlm.nih.gov/pubmed/33837401 http://dx.doi.org/10.1093/ije/dyab034 |
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