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Critical Care Requirements Under Uncontrolled Transmission of SARS-CoV-2 #MMPMID33734835
Martinez-Ales G; Domingo-Relloso A; Arribas JR; Quintana-Diaz M; Hernan MA
Am J Public Health 2021[May]; 111 (5): 923-926 PMID33734835show ga
Objectives. To estimate the critical care bed capacity that would be required to admit all critical COVID-19 cases in a setting of unchecked SARS-CoV-2 transmission, both with and without elderly-specific protection measures.Methods. Using electronic health records of all 2432 COVID-19 patients hospitalized in a large hospital in Madrid, Spain, between February 28 and April 23, 2020, we estimated the number of critical care beds needed to admit all critical care patients. To mimic a hypothetical intervention that halves SARS-CoV-2 infections among the elderly, we randomly excluded 50% of patients aged 65 years and older.Results. Critical care requirements peaked at 49 beds per 100 000 on April 1-2 weeks after the start of a national lockdown. After randomly excluding 50% of elderly patients, the estimated peak was 39 beds per 100 000.Conclusions. Under unchecked SARS-CoV-2 transmission, peak critical care requirements in Madrid were at least fivefold higher than prepandemic capacity. Under a hypothetical intervention that halves infections among the elderly, critical care peak requirements would have exceeded the prepandemic capacity of most high-income countries.Public Health Implications. Pandemic control strategies that rely exclusively on protecting the elderly are likely to overwhelm health care systems.
|*COVID-19/epidemiology/transmission[MESH]
|*Communicable Disease Control[MESH]
|*Critical Care[MESH]
|*Hospitalization[MESH]
|Adult[MESH]
|Aged[MESH]
|Electronic Health Records[MESH]
|Female[MESH]
|Hospital Bed Capacity/*statistics & numerical data[MESH]