B.C. models look at possible impact of COVID-19 on hospitals

Provincial Health Officer Dr. Bonnie Henry: “I'm starting to see some glimmers of hope, if you will, that we have flattened out. Our trajectory has levelled off a bit. We need to see that continue and I really want to see it go down.”

“If we do this the right way, this is what is going to save us.”

Those were the words of Provincial Health Officer Dr. Bonnie Henry during a COVID-19 report from government on Friday.

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Henry emphasized the importance of the measures that must be taken to prevent the further spread of the disease as details of the province’s capacity to respond to the pandemic are made public.

Epidemiologists have developed a series of models that compare B.C.’s situation to other COVID-19 timelines. These models include comparisons to the Chinese province of Hubei, South Korea and two different scenarios in Italy.

COVID graph 1

It is that information informing Henry’s plea to British Columbians to double down on measures such as self-isolation and social distancing.

Henry said the models will allow health officials to make “rational decisions about planning” with regard to the availability and distribution of health-care resources in the province — but she noted they are not predictions.

“I'm starting to see some glimmers of hope, if you will, that we have flattened out. Our trajectory has levelled off a bit,” she said. “We need to see that continue and I really want to see it go down.”

B.C. has identified 17 “primary COVID” hospital sites, but is also preparing to use all hospital sites if necessary. Should the need arise, there are also plans in place to add off-site beds not in hospitals for less severe medical and surgical patients so further hospital capacity can be used for COVID patients.

The province has already cancelled all elective surgeries, taking the hospital bed occupancy rate in the province from 103.5 per cent to 63.6 per cent to prepare for the surge. In B.C., there are 5,610 medical and surgical inpatient beds in total, which includes 1,007 beds in the Interior Health region.

The province provided a conservative estimate that 80 per cent of all critical care hospitalized cases will require the use of a ventilator and that about 4.7 per cent of all COVID-19 cases will require critical care in hospital, likely for between seven and 10 days.

Using this data, the province looked at various other eruptions of disease around the world and measured B.C.’s capacity to respond against them.

In a South Korea-type epidemic, B.C. would have 295 ventilators to spare and four ICU beds would remain available. In the Interior Health region specifically, 42 ventilators would remain spare and there would be 11 excess beds.

COVID graph

If COVID-19 emerges as it did in China’s Hubei province, B.C. would be short 133 ICU beds and have an excess of 77 ventilators. In the Interior Health region, that model’s figures leave hospitals short 12 ICU beds and two ventilators.

Two models are available for the emergence of COVID-19 in Italy. In a case-based epidemic, B.C. would see a shortage of 182 ICU beds, but have 38 excess ventilators, while Interior Health would be short 22 ICU beds and also short 10 ventilators.

Following a Northern Italy hospital-based model, the situation is more dire, where B.C. would see a shortage of 341 beds and an excess of 19 ventilators, while Interior Health would be short 47 ICU beds and short five ventilators.

Similar models were run examining non-critical care demand versus current capacity, where B.C. as a whole met or exceeded capacity in every scenario except in the Northern Italy hospital-based model, where there was a shortage of 1,778 beds available for non-critical care patients.

Should B.C. encounter any of the modelled scenarios, plans are in place to meet capacity by transporting patients between sites.

But what is B.C.’s actual scenario? The province said an epidemic at or below the level of Hubei is likely and graphs displayed by the province show further evidence of that, with B.C.’s curve beginning to flatten.

“I will say there is a slight chance of optimism, perhaps, that our rate of growth is being impacted by the measures we have put in in the last couple weeks,” Henry said.

Henry said other measures are also helping curb the spread of COVID-19, including a testing strategy that is on par with Singapore and South Korea, which have been seen as gold standards when it comes to response to the novel coronavirus.

Henry said B.C. is now conducting more than 3,000 tests per day. The BC Centre for Disease Control said 34,561 tests have been conducted as of March 25.

© Kamloops This Week


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