Estimating critical care capacity needs and gaps in Africa during the COVID-19 pandemic

Abstract

ObjectiveThe purpose of this analysis was to describe national critical care capacity shortages for 52 African countries and to outline needs for each country to adequately respond to the COVID-19 pandemic.MethodsA modified SECIR compartment model was used to estimate the number of severe COVID-19 cases at the peak of the outbreak. Projections of the number of hospital beds, ICU beds, and ventilators needed at outbreak peak were generated for four scenarios – if 30, 50, 70, or 100% of patients with severe COVID-19 symptoms seek health services—assuming that all people with severe infections would require hospitalization, that 4.72% would require ICU admission, and that 2.3% would require mechanical ventilation.FindingsAcross the 52 countries included in this analysis, the average number of severe COVID-19 cases projected at outbreak peak was 138 per 100,000 (SD: 9.6). Comparing current national capacities to estimated needs at outbreak peak, we found that 31of 50 countries (62%) do not have a sufficient number of hospital beds per 100,000 people if 100% of patients with severe infections seek out health services and assuming that all hospital beds are empty and available for use by patients with COVID-19. If only 30% of patients seek out health services then 10 of 50 countries (20%) do not have sufficient hospital bed capacity. The average number of ICU beds needed at outbreak peak across the 52 included countries ranged from 2 per 100,000 people (SD: 0.1) when 30% of people with severe COVID-19 infections access health services to 6.5 per 100,000 (SD: 0.5) assuming 100% of people seek out health services. Even if only 30% of severely infected patients seek health services at outbreak peak, then 34 of 48 countries (71%) do not have a sufficient number of ICU beds per 100,000 people to handle projected need. Only four countries (Cabo Verde, Egypt, Gabon, and South Africa) have a sufficient number of ventilators to meet projected national needs if 100% of severely infected individuals seek health services assuming all ventilators are functioning and available for COVID-19 patients, while 35 other countries require two or more additional ventilators per 100,000 people.ConclusionThe majority of countries lack sufficient ICU bed and ventilator capacity to care for the projected number of patients with severe COVID-19 infections at outbreak peak even if only 30% of severely infected patients seek health services.This analysis reveals there is an urgent need to allocate resources and increase critical care capacity in these countries.

The Impact of Non-Pharmaceutical Interventions on the First COVID-19 Epidemic Wave in South Africa

“…Another COVID-19 Model of note was the model produced by the Center for Disease Dynamics, Economics & Policy (CDDEP) [27,29]. The CDDEP COVID-19 Models tried to understand the impact of Country-Wise Lockdowns [29] and the Health Care system preparedness of African countries [27]. 15 shows that the predicted total infections, peak active infections, total deaths, peak hospitalised cases in the reviewed models had a standard deviation of 4 865 693, 2 362 685 cases, 48 303 deaths, 25780 cases with a coefficient of variance of 12.9 %, 102.7 %, 118.4 %, 84.2 % respectively.…”

“…COVID-19 has been widely modelled with variations of the SEIR model [26][27][28][29][30][31][32]. One of the earliest Global COVID-19 transmission models to be published was the Imperial College London COVID-19 Model [28,33].…”

“…The Imperial College London COVID-19 Model had a great influence in the early policy response to COVID-19 in the United Kingdom and many other countries including Africa [28]. Another COVID-19 Model of note was the model produced by the Center for Disease Dynamics, Economics & Policy (CDDEP) [27,29]. The CDDEP COVID-19 Models tried to understand the impact of Country-Wise Lockdowns and Health Care system preparedness in African countries [27].…”

Global Health Care Infrastructure and Africa in Times of COVID-19: Insights for Sustainable Development and Future Pandemics

“…For instance, in Americas and Europe, the density is higher than 5 (Ma & Vervoort, 2020). Estimating the critical care capacity needs and gaps in Africa during the Covid-19 pandemic, Craig et al (2020a) find that even if only 30% of patients with severe cases seek health services at outbreak peak, then 71% of the countries would not have a sufficient number of ICU beds per 100,000 people to handle projected needs.…”

“…In this paper, two categories of data are used for African countries. The first are from the pandemic, there is a strand of literature on the availability of these health tools and critical care capacity (Ma &Vervoort, 2020;Weissman et al, 2020;White & Lo, 2020;Craig et al, 2020a, 2020b) which has not critically engaged Africa as done in the present study. The definitions and sources of the variables are disclosed in Table 1. As for the methodology, given that the study is exploratory, we rely on exploratory descriptive analysis based on tables, summary statistics and maps to depict the lack of health infrastructure made more apparent, by the Covid-19 pandemic in African countries.…”