ABSTRACT
BackgroundPredicting potential healthcare resource use under different scenarios will help to prepare the healthcare system for a surge in COVID-19 patients. In this study, we aim to predict the effect of COVID-19 on hospital resources in Nigeria. MethodWe adopted a previously published discrete-time, individual-level, health-state transition model of symptomatic COVID-19 patients to the Nigerian healthcare system and COVID-19 epidemiology. We simulated different combined scenarios of epidemic trajectories and acute care capacity. Primary outcomes included expected cumulative number of cases, days until depletion resources, and number of deaths associated with resource constraints. Outcomes were predicted over a 60-day time horizon. ResultsIn our best-case epidemic trajectory, which implies successful implementation of public health measures to control COVID-19 spread, the current number of ventilator resources in Nigeria (conservative resources scenario), were expended within five days, and 901 patients may die while waiting for hospital resources in conservative resource scenario. In our expanded resource scenarios, ventilated ICU beds were depleted in all three epidemic trajectories within 60 days. Acute care resources were only sufficient in the best-case and intermediate epidemic scenarios, combined with a substantial increase in healthcare resources. ConclusionCurrent hospital resources are inadequate to manage the COVID-19 pandemic in Nigeria. Given Nigerias limited resources, it is imperative to increase healthcare resources and maintain aggressive public health measures to reduce COVID-19 transmission. KEY QUESTIONSO_ST_ABSWhat is already known on this subject?C_ST_ABSWhile western countries seem to be recovering from the COVID-19 pandemic, there is an increasing community spread of the virus in many African countries. The limited healthcare resources available in the region may not be sufficient to cope with increasing numbers of COVID-19 cases. What this study adds?Using the COVID-19 Resource Estimator (CORE) model, we demonstrate that implementing and maintaining aggressive public health measures to keep the epidemic growth at a low rate, while simultaneously substantially increasing healthcare resources is critical to minimize the impact of COVID-19 on morbidity and mortality. The impact of COVID-19 in low resource settings will likely overwhelm health system capacity if aggressive public health measures are not implemented. To mitigate the impact of COVID-19 in these settings, it is essential to develop strategies to substantially increase health system capacities, including hospital resources, personal protective equipment and trained healthcare personnel and to implement and maintain aggressive public health measures.
