Estimated Demand for US Hospital Inpatient and Intensive Care Unit Beds for Patients With COVID-19 Based on Comparisons With Wuhan and Guangzhou, China.
Identifieur interne : 002748 ( Main/Corpus ); précédent : 002747; suivant : 002749Estimated Demand for US Hospital Inpatient and Intensive Care Unit Beds for Patients With COVID-19 Based on Comparisons With Wuhan and Guangzhou, China.
Auteurs : Ruoran Li ; Caitlin Rivers ; Qi Tan ; Megan B. Murray ; Eric Toner ; Marc LipsitchSource :
- JAMA network open [ 2574-3805 ] ; 2020.
English descriptors
- KwdEn :
- Adult (MeSH), Betacoronavirus (MeSH), COVID-19 (MeSH), China (epidemiology), Cities (MeSH), Coronavirus Infections (epidemiology), Critical Illness (epidemiology), Epidemics (MeSH), Forecasting (MeSH), Health Services Needs and Demand (MeSH), Hospital Bed Capacity (MeSH), Hospitalization (statistics & numerical data), Humans (MeSH), Incidence (MeSH), Infection Control (MeSH), Inpatients (MeSH), Intensive Care Units (MeSH), Pandemics (MeSH), Pneumonia, Viral (epidemiology), SARS-CoV-2 (MeSH), United States (epidemiology).
- MESH :
- geographic , epidemiology : China, United States.
- epidemiology : Coronavirus Infections, Critical Illness, Pneumonia, Viral.
- statistics & numerical data : Hospitalization.
- Adult, Betacoronavirus, COVID-19, Cities, Epidemics, Forecasting, Health Services Needs and Demand, Hospital Bed Capacity, Humans, Incidence, Infection Control, Inpatients, Intensive Care Units, Pandemics, SARS-CoV-2.
Abstract
Importance
Sustained 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 (24.5 per 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 Relevance
Even 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.
DOI: 10.1001/jamanetworkopen.2020.8297
PubMed: 32374400
PubMed Central: PMC7203604
Links to Exploration step
pubmed:32374400Le document en format XML
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<author><name sortKey="Li, Ruoran" sort="Li, Ruoran" uniqKey="Li R" first="Ruoran" last="Li">Ruoran Li</name>
<affiliation><nlm:affiliation>Harvard T.H. Chan School of Public Health, Center for Communicable Disease Dynamics, Department of Epidemiology, Boston, Massachusetts.</nlm:affiliation>
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<author><name sortKey="Rivers, Caitlin" sort="Rivers, Caitlin" uniqKey="Rivers C" first="Caitlin" last="Rivers">Caitlin Rivers</name>
<affiliation><nlm:affiliation>Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Center for Health Security and the Department of Environmental Health and Engineering, Baltimore, Maryland.</nlm:affiliation>
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<author><name sortKey="Tan, Qi" sort="Tan, Qi" uniqKey="Tan Q" first="Qi" last="Tan">Qi Tan</name>
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<affiliation><nlm:affiliation>Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China.</nlm:affiliation>
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<author><name sortKey="Murray, Megan B" sort="Murray, Megan B" uniqKey="Murray M" first="Megan B" last="Murray">Megan B. Murray</name>
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<author><name sortKey="Toner, Eric" sort="Toner, Eric" uniqKey="Toner E" first="Eric" last="Toner">Eric Toner</name>
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<author><name sortKey="Lipsitch, Marc" sort="Lipsitch, Marc" uniqKey="Lipsitch M" first="Marc" last="Lipsitch">Marc Lipsitch</name>
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<author><name sortKey="Rivers, Caitlin" sort="Rivers, Caitlin" uniqKey="Rivers C" first="Caitlin" last="Rivers">Caitlin Rivers</name>
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<author><name sortKey="Tan, Qi" sort="Tan, Qi" uniqKey="Tan Q" first="Qi" last="Tan">Qi Tan</name>
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<author><name sortKey="Murray, Megan B" sort="Murray, Megan B" uniqKey="Murray M" first="Megan B" last="Murray">Megan B. Murray</name>
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<term>Betacoronavirus (MeSH)</term>
<term>COVID-19 (MeSH)</term>
<term>China (epidemiology)</term>
<term>Cities (MeSH)</term>
<term>Coronavirus Infections (epidemiology)</term>
<term>Critical Illness (epidemiology)</term>
<term>Epidemics (MeSH)</term>
<term>Forecasting (MeSH)</term>
<term>Health Services Needs and Demand (MeSH)</term>
<term>Hospital Bed Capacity (MeSH)</term>
<term>Hospitalization (statistics & numerical data)</term>
<term>Humans (MeSH)</term>
<term>Incidence (MeSH)</term>
<term>Infection Control (MeSH)</term>
<term>Inpatients (MeSH)</term>
<term>Intensive Care Units (MeSH)</term>
<term>Pandemics (MeSH)</term>
<term>Pneumonia, Viral (epidemiology)</term>
<term>SARS-CoV-2 (MeSH)</term>
<term>United States (epidemiology)</term>
</keywords>
<keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>China</term>
<term>United States</term>
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<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term>
<term>Critical Illness</term>
<term>Pneumonia, Viral</term>
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<keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Hospitalization</term>
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<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
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<term>COVID-19</term>
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<term>Health Services Needs and Demand</term>
<term>Hospital Bed Capacity</term>
<term>Humans</term>
<term>Incidence</term>
<term>Infection Control</term>
<term>Inpatients</term>
<term>Intensive Care Units</term>
<term>Pandemics</term>
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<front><div type="abstract" xml:lang="en"><p><b>Importance</b>
</p>
<p>Sustained 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.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Objectives</b>
</p>
<p>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.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Design, Setting, and Participants</b>
</p>
<p>This comparative effectiveness study analyzed the confirmed cases of COVID-19 in Wuhan and Guangzhou, China, from January 10 to February 29, 2020.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Exposures</b>
</p>
<p>Timing of disease control measures relative to timing of SARS-CoV-2 community spread.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Main Outcomes and Measures</b>
</p>
<p>Number of critical and severe patient-days and peak number of patients with critical and severe illness during the study period.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Results</b>
</p>
<p>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 (24.5 per 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.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>Conclusions and Relevance</b>
</p>
<p>Even 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.</p>
</div>
</front>
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<Abstract><AbstractText Label="Importance">Sustained 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.</AbstractText>
<AbstractText Label="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.</AbstractText>
<AbstractText Label="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.</AbstractText>
<AbstractText Label="Exposures">Timing of disease control measures relative to timing of SARS-CoV-2 community spread.</AbstractText>
<AbstractText Label="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.</AbstractText>
<AbstractText Label="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 (24.5 per 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.</AbstractText>
<AbstractText Label="Conclusions and Relevance">Even 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.</AbstractText>
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<AffiliationInfo><Affiliation>Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China.</Affiliation>
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