The coronavirus pandemic has taken a toll on most countries, prompting the need for more beds in regular isolation wards as well as intensive care units (ICUs) to accommodate the influx of ill patients. A new study published in JAMA Network Open sheds light on the increased demand for intensive care and inpatient beds amid the coronavirus outbreak, based on two cities in China to determine the level of hospital capacity needed to respond to outbreaks of severe coronavirus disease 2019 in U.S. cities.
The coronavirus disease (COVID-19), caused by the novel coronavirus, first emerged in a seafood market in Wuhan City, Hubei Province, China in December 2019. Though some reports show that the virus has been spreading earlier, the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), has now rapidly spread across 187 countries, infecting more than 3.83 million people, and causing 270,000 deaths.
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Wuhan’s fight against COVID-19
In January, Wuhan City was named the epicenter of the emerging viral illness, with thousands of people being infected. The country has placed the city and the province in lockdown, with strict social distancing measures in place.
Travel to and from the city was banned, while an estimated 9 million people remained in the city. Residents were required to wear masks in public. Still, the number of cases soared, overwhelming the country’s health care system. Authorities built three makeshift hospitals in ten days to make up for the lack of beds for patients infected with the illness.
By February, more than 18,000 health workers had been sent to Wuhan to assist in caring for patients, while a total of 48 hospitals and more than 26,000 inpatient beds were allotted solely for COVID-19 patients. Quarantine centers for patients had more than 13,000 beds. By the end of that month, the local government declared that patients did not need to wait for beds.
Lessons learned from Wuhan at the epicenter of the pandemic, which went on to successfully “flattened the curve,” should be considered by other countries now experiencing the wrath of the novel coronavirus.
U.S. coronavirus cases surge
The United States is now the country with the highest number of confirmed cases of the SARS-CoV-2 infection. The country has a staggering case toll of 1.25 million and more than 75,000 deaths. Of these, only about 195,000 have recovered.
The sustained spread of SARS-CoV-2 has happened in every major U.S. city, particularly in New York, the country’s COVID-19 epicenter. The capacity needs in China could help provide insight into the planning of health care resources in the U.S.
The research team estimated confirmed case counts for severe and critical cases in two China cities, Wuhan and Guangzhou, from situation updates. They noted the number of COVID-19 beds and hospitalizations, along with the peak number of patients with critical and severe illness during the study period.
The team also noted the number of confirmed cases, newly recovered cases, new deaths, critical cases, severe cases, and the number of currently confirmed cases and recoveries.
The findings of the study show that, based on the comparison with Chinese cities, the U.S. should work by increasing its hospital beds capacity, particularly in intensive care units, to accommodate all patients needing care.
In China, there is an average of 429 patients in the ICU and about 1,521 inpatients with serious illness per day. During the peak of the COVID-19 pandemic, more than 19,000 were admitted to hospitals, and more than 9,600 were in a serious condition. At least 2,000 people needed critical care each day.
Based on these numbers, the estimates for the United States of critically-ill patients at the peak of a Wuhan-like outbreak in the United States are estimated to range between 2.2 to 4.4 per 10,000 adults.
“Even after the lockdown of Wuhan on January 23, 2020, the number of patients with serious void-19 cases continued to rise, exceeding local hospitalization and ICU capacities for at least a month. Plans are urgently needed to mitigate the consequences of COVID-19 outbreaks on local health care systems in U.S. cities,” the researchers concluded in the study.
The U.S. should make it a point to reduce transmission for hospitals to cater to all patients, without being overwhelmed. Further, increasing the bed capacity can help, just like what China did as they built additional makeshift hospitals for COVID-19 patients.
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