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Forecasting peak cases and demand for hospital beds, ICU beds, and ventilators by state

Brian Leiter

MOVING TO FRONT FROM MARCH 26–UPDATED

A new study out of the University of Washington, that makes both U.S. forecasts and state-by-state forecasts.  The charts starting around page 20 digest the key information.  This confirms something we've noted previously, namely, that there is some wide variation by state in terms of capacity to deal adequately with a surge in patients.   These estimates, by the way, assume wide use of social distancing, closures, etc.  Comments welcome from those who have time to digest more of the details.

UPDATE:  See these useful comments on this study from a biologist.

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2 responses to “Forecasting peak cases and demand for hospital beds, ICU beds, and ventilators by state”

  1. Robert Lee

    A quick review:

    This is a death-rate based model curve fit to global data and then used to make local predictions. It's biggest assumption, by far, is that the longer term world death rate will follow Wuhan. (They acknowledge this way down in the discussion.) That is to say, they are assuming the we can collectively can achieve a consistently decreasing growth rate quickly based on one hotspot. In contrast, Japan and South Korean seemed to have stabilized and intermittently decreased the growth rate but are apparently struggling to drive it to zero. Consequently, I would place this model on the optimistic end of the spectrum. I could pick lots of other nits but most of these get lost in the noise.

    On a side note, growth rate models are typically quite simple and this one is no exception. It is the assumptions and data behind them that really matter.

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  2. Shane

    I can tell you from a front line clinician's perspective, that this variation in capacity runs all the way down to the county level. Many rural hospitals may actually be the least prepared. Those counties' populations tend to run older as it is. Regardless, let's say SARS-CoV-2 catches hold in a nursing home in such a county with one or two small hospitals. That hospital could be overwhelmed in a single day.

    In my mind, this highlights the need for a focus triage and a broader discussion about what constitutes "public health" in addition to the building of capacity that we're already doing. Building capacity is also something that should be done by increasing the number of public health nurses that can treat and check in on patients at home to keep them out of the hospital. Unfortunately, this is a capacity that has been gutted systematically over time.

    On the matter of whether we can drive the growth rate to zero, I am with Dr. Amesh Adalja on this one. SARS-CoV-2 is a Coronavirus. Coronaviruses cause seasonal colds as it is. There is a very good chance that this virus will become endemic in the human population and become a seasonal illness much like the various strains of influenza. As it is, it will never be eradicated completely, as it has a reservoir outside of humans. It is a zoonosis.

    Here's Adalja's talk weeks ago where he brings up the likelihood of the virus becoming endemic:



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