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Navigating hospitals safely through the COVID-19 epidemic tide: Predicting case load for adjusting bed capacity.
Donker, Tjibbe; Bürkin, Fabian M; Wolkewitz, Martin; Haverkamp, Christian; Christoffel, Dominic; Kappert, Oliver; Hammer, Thorsten; Busch, Hans-Jörg; Biever, Paul; Kalbhenn, Johannes; Bürkle, Hartmut; Kern, Winfried V; Wenz, Frederik; Grundmann, Hajo.
  • Donker T; Institute for Infection Prevention and Hospital Epidemiology, University Medical Center Freiburg, Medical Faculty, University of Freiburg, Freiburg, Germany.
  • Bürkin FM; Institute for Infection Prevention and Hospital Epidemiology, University Medical Center Freiburg, Medical Faculty, University of Freiburg, Freiburg, Germany.
  • Wolkewitz M; Institute of Medical Biometry and Statistics, University Medical Center Freiburg, Medical Faculty, University of Freiburg, Freiburg, Germany.
  • Haverkamp C; Institute of Digitalization in Medicine, University Medical Center Freiburg, Medical Faculty, University of Freiburg, Freiburg, Germany.
  • Christoffel D; Institute of Digitalization in Medicine, University Medical Center Freiburg, Medical Faculty, University of Freiburg, Freiburg, Germany.
  • Kappert O; Public Health Office, Public Health District Freiburg, Breisgau-Hochschwarzwald, Freiburg, Germany.
  • Hammer T; Department of Orthopedics and Trauma Surgery, University Medical Center Freiburg, Medical Faculty, University of Freiburg, Freiburg, Germany.
  • Busch HJ; Department of Emergency Medicine, University Medical Center Freiburg, Medical Faculty, University of Freiburg, Freiburg, Germany.
  • Biever P; Department of Medicine III, Medical Intensive Care, University Medical Center Freiburg, Medical Faculty, University of Freiburg, Freiburg, Germany.
  • Kalbhenn J; Department of Anesthesiology and Critical Care, University Medical Center Freiburg, Medical Faculty, University of Freiburg, Freiburg, Germany.
  • Bürkle H; Department of Anesthesiology and Critical Care, University Medical Center Freiburg, Medical Faculty, University of Freiburg, Freiburg, Germany.
  • Kern WV; Department of Medicine II, Infectious Diseases, University Medical Center Freiburg, Medical Faculty, University of Freiburg, Freiburg, Germany.
  • Wenz F; Chief Medical Officer, Chairman of the Board of Directors, University Medical Center Freiburg, Medical Faculty, University of Freiburg, Freiburg, Germany.
  • Grundmann H; Institute for Infection Prevention and Hospital Epidemiology, University Medical Center Freiburg, Medical Faculty, University of Freiburg, Freiburg, Germany.
Infect Control Hosp Epidemiol ; 42(6): 653-658, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-2096425
ABSTRACT

BACKGROUND:

The pressures exerted by the coronavirus disease 2019 (COVID-19) pandemic pose an unprecedented demand on healthcare services. Hospitals become rapidly overwhelmed when patients requiring life-saving support outpace available capacities.

OBJECTIVE:

We describe methods used by a university hospital to forecast case loads and time to peak incidence.

METHODS:

We developed a set of models to forecast incidence among the hospital catchment population and to describe the COVID-19 patient hospital-care pathway. The first forecast utilized data from antecedent allopatric epidemics and parameterized the care-pathway model according to expert opinion (ie, the static model). Once sufficient local data were available, trends for the time-dependent effective reproduction number were fitted, and the care pathway was reparameterized using hazards for real patient admission, referrals, and discharge (ie, the dynamic model).

RESULTS:

The static model, deployed before the epidemic, exaggerated the bed occupancy for general wards (116 forecasted vs 66 observed), ICUs (47 forecasted vs 34 observed), and predicted the peak too late general ward forecast April 9 and observed April 8 and ICU forecast April 19 and observed April 8. After April 5, the dynamic model could be run daily, and its precision improved with increasing availability of empirical local data.

CONCLUSIONS:

The models provided data-based guidance for the preparation and allocation of critical resources of a university hospital well in advance of the epidemic surge, despite overestimating the service demand. Overestimates should resolve when the population contact pattern before and during restrictions can be taken into account, but for now they may provide an acceptable safety margin for preparing during times of uncertainty.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Hospital Bed Capacity / Hospitals, University Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: Europa Language: English Journal: Infect Control Hosp Epidemiol Journal subject: Communicable Diseases / Nursing / Epidemiology / Hospitals Year: 2021 Document Type: Article Affiliation country: Ice.2020.464

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Hospital Bed Capacity / Hospitals, University Type of study: Observational study / Prognostic study / Randomized controlled trials Limits: Humans Country/Region as subject: Europa Language: English Journal: Infect Control Hosp Epidemiol Journal subject: Communicable Diseases / Nursing / Epidemiology / Hospitals Year: 2021 Document Type: Article Affiliation country: Ice.2020.464