Estimated Demand for US Hospital Inpatient and Intensive Care Unit Beds for Patients With COVID-19 Based on Comparisons With Wuhan and Guangzhou, China

Abstract

IMPORTANCESustained spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has happened in major US cities. Capacity needs in cities in China could inform the planning of local health care resources. OBJECTIVES To describe and compare the intensive care unit (ICU) and inpatient bed needs for patients with coronavirus disease 2019 (COVID-19) in 2 cities in China to estimate the peak ICU bed needs in US cities if an outbreak equivalent to that in Wuhan occurs. DESIGN, SETTING, AND PARTICIPANTS This comparative effectiveness study analyzed the confirmed cases of COVID-19 in Wuhan and Guangzhou, China, from January 10 to February 29, 2020. EXPOSURES Timing of disease control measures relative to timing of SARS-CoV-2 community spread. MAIN OUTCOMES AND MEASURES Number of critical and severe patient-days and peak number of patients with critical and severe illness during the study period. RESULTS In Wuhan, strict disease control measures were implemented 6 weeks after sustained local transmission of SARS-CoV-2. Between January 10 and February 29, 2020, patients with COVID-19 accounted for a median (interquartile range) of 429 (25-1143) patients in the ICU and 1521 (111-7202) inpatients with serious illness each day. During the epidemic peak, 19 425 patients (24.5per 10 000 adults) were hospitalized, 9689 (12.2 per 10 000 adults) were considered in serious condition, and 2087 (2.6 per 10 000 adults) needed critical care per day. In Guangzhou, strict disease control measures were implemented within 1 week of case importation. Between January 24 and February 29, COVID-19 accounted for a median (interquartile range) of 9 (7-12) patients in the ICU and 17 (15-26) inpatients with serious illness each day. During the epidemic peak, 15 patients were in critical condition and 38 were classified as having serious illness. The projected number of prevalent critically ill patients at the peak of a Wuhan-like outbreak in US cities was estimated to range from 2.2 to 4.4 per 10 000 adults, depending on differences in age distribution and comorbidity (ie, hypertension) prevalence. CONCLUSIONS AND RELEVANCEEven after the lockdown of Wuhan on January 23, the number of patients with serious COVID-19 illness continued to rise, exceeding local hospitalization and ICU capacities for at least a month. Plans are urgently needed to mitigate the consequences of COVID-19 outbreaks on the local health care systems in US cities.

Critical care demand and intensive care supply for patients in Japan with COVID-19 at the time of the state of emergency declaration in April 2020: a descriptive analysis.

“…The total number of patient days in ICU was summed to estimate the total number of ICU days and the raw number of patients in ICU on each day was plotted [17]. The notation "ICU" denoted the total number of patients on mechanical ventilator and ECMO.…”

“…Exceeding hospital bed capacity would likely increase the community spread of SARS-CoV-2 and lead to decreased quality of healthcare and intensive care [17]. In China, national lockdown, quarantine, and social distancing measures were adopted to control the spread of infection, with > 10000 beds designated for the isolation and treatment of patients with con rmed COVID-19 by early February, 2020 [17].…”

“…Exceeding hospital bed capacity would likely increase the community spread of SARS-CoV-2 and lead to decreased quality of healthcare and intensive care [17]. In China, national lockdown, quarantine, and social distancing measures were adopted to control the spread of infection, with > 10000 beds designated for the isolation and treatment of patients with con rmed COVID-19 by early February, 2020 [17]. Despite these efforts to control the spread of infection, this did not lead to an immediate downturn in demand for hospitalization in critical care units and in ICUs in China [17], and this situation has been similar in Japan.…”

“…During the COVID-19 epidemic, there has been a dramatic surge in the number of critically ill patients with an urgent need for ICU admission [14], as occurred in other natural disasters [15,16]. An analysis of the epidemic peak in Wuhan indicated that the number of severely and critically ill adult patients requiring intensive care was estimated to be 12.2/10000 and 2.6/10000, respectively [17]. However, this situation clearly differs between countries, and speci c data sourced in terms of Japanese circumstances are needed [18].…”

The acquisition of Multi-drug resistant bacteria in patients admitted to COVID-19 intensive care units: a monocentric retrospective case control study

“…The respiratory infection COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide, being considered pandemic by the World Health Organization since March 11, 2020. [1] During this pandemic, health care systems worldwide became overloaded and experienced shortages of intensive care unit (ICU) beds [2] and protective personal equipment (PPE). [3] In the most severely affected countries, ICUs were lled with only COVID-19 patients, and named "COVID-19 ICUs"; new ICUs and hospital beds had to be opened, [4] health care professionals were reassigned and started working longer hours.…”