Journal article
Modelling ICU capacity under different epidemiological scenarios of the COVID-19 pandemic in three western European countries
- Abstract:
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Background: The coronavirus disease 2019 (COVID-19) pandemic has placed enormous strain on intensive care units (ICUs) in Europe. Ensuring access to care, irrespective of COVID-19 status, in winter 2020–2021 is essential.
Methods: An integrated model of hospital capacity planning and epidemiological projections of COVID-19 patients is used to estimate the demand for and resultant spare capacity of ICU beds, staff and ventilators under different epidemic scenarios in France, Germany and Italy across the 2020–2021 winter period. The effect of implementing lockdowns triggered by different numbers of COVID-19 patients in ICUs under varying levels of effectiveness is examined, using a ‘dual-demand’ (COVID-19 and non-COVID-19) patient model.
Results: Without sufficient mitigation, we estimate that COVID-19 ICU patient numbers will exceed those seen in the first peak, resulting in substantial capacity deficits, with beds being consistently found to be the most constrained resource. Reactive lockdowns could lead to large improvements in ICU capacity during the winter season, with pressure being most effectively alleviated when lockdown is triggered early and sustained under a higher level of suppression. The success of such interventions also depends on baseline bed numbers and average non-COVID-19 patient occupancy.
Conclusion: Reductions in capacity deficits under different scenarios must be weighed against the feasibility and drawbacks of further lockdowns. Careful, continuous decision-making by national policymakers will be required across the winter period 2020–2021.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, 1.9MB, Terms of use)
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- Publisher copy:
- 10.1093/ije/dyab034
Authors
- Publisher:
- Oxford University Press
- Journal:
- International Journal of Epidemiology More from this journal
- Volume:
- 50
- Issue:
- 3
- Pages:
- 753–767
- Publication date:
- 2021-04-09
- Acceptance date:
- 2021-02-10
- DOI:
- EISSN:
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1464-3685
- ISSN:
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0300-5771
- Language:
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English
- Keywords:
- Pubs id:
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1160657
- Local pid:
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pubs:1160657
- Deposit date:
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2021-02-10
Terms of use
- Copyright holder:
- McCabe et al.
- Copyright date:
- 2021
- Rights statement:
- © The Author(s) 2021. Published by Oxford University Press on behalf of the International Epidemiological Association. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
- Licence:
- CC Attribution (CC BY)
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