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Title:

Estimated Demand for US Hospital Inpatient and Intensive Care Unit Beds for Patients With COVID-19 Based on Comparisons With Wuhan and Guangzhou, China

Authors:
Li R, Rivers C, Tan Q, Murray MB, Toner E, Lipsitch M.
Date posted:
May 11, 2020
Publication type:
Article
Publication:
JAMA
DOI:
10.1001/jamanetworkopen.2020.8297
See also:
Introduction:

In the 2 months after the first report of 4 cases of atypical pneumonia in Wuhan, China, on December 27, 2019,1 the cumulative number of confirmed cases of coronavirus disease 2019 (COVID-19) in the city rose to 49 122, with 2195 deaths by the end of February 2020.2 On January 23, Wuhan city shut down in response to the quickly evolving epidemic. All public transportation within, to, and from the city was suspended, and residents were barred from leaving. An estimated 9 million people remained in the city after the lockdown.3 Strict social distancing measures were also implemented, including the compulsory wearing of face masks in public.

During the early phase of the response in Wuhan, the number of patients overwhelmed local fever clinics and hospitals designated to receive patients with COVID-19. The media reported a significant shortage of hospital beds, intensive care unit (ICU) beds, and other health care resources. By February 12, more than 18 000 health care workers had been sent to Wuhan from other parts of China to help with the coronavirus response.4 A total of 48 hospitals (including 2 new hospitals built specifically for patients with COVID-19) and more than 26 000 inpatient beds were designated for the isolation and treatment of patients with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Quarantine centers with more than 13 000 total beds were also established to isolate confirmed patients with milder illness. By the end of February, the local government reported that “finally patients don’t need to wait for beds. Now the beds are waiting for patients.”5

With human-to-human transmission now established in other countries, mitigating the potential consequences of COVID-19 on local health care systems is a top priority. A clinical study from China1 reported that 81% of patients in whom SARS-CoV-2 is detected experience mild disease, 14% experience severe disease, and 5% experience critical disease. However, questions still remain regarding the proportion of asymptomatic patients and the clinical course of the disease, preventing accurate prediction of hospitalization and ICU needs with transmission models.

Here, we describe the ICU and hospitalization needs for COVID-19 in 2 cities in China, ie, Wuhan, the epicenter of China’s outbreak, and Guangzhou, a metropolis that experienced an early importation of cases. As in all cities in China, Guangzhou implemented strict social distancing measures, contact tracing, and quarantine protocols in late January, which resulted in a much smaller outbreak size than in Wuhan. Describing and comparing the resource needs in both cities may create benchmarks to help other large metropolises prepare for potential outbreaks.

 

 

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