North Carolina will be short hundreds of hospital beds and intensive care units at the state’s peak of the COVID-19 pandemic, which is still weeks away, according to a model touted by a leading expert on Sunday.
Developed by the University of Washington’s Institute for Health Metrics and Evaluation, the model estimates that there will be dozens of COVID-19-related deaths daily during the virus’ projected peak. The model projects 79 COVID-19 deaths in North Carolina on April 22, with about 2,400 people in the state dying from the disease by Aug. 4.
North Carolina could face a shortage of hospital beds from April 17 until April 27, according to the model, which shows the need for beds for COVID-19 patients peaking at 7,774, including 1,173 intensive care unit beds.
NC's expected need for ventilators
The projections estimate the maximum need for ventilators, which effectively breathe for patients who cannot do so on their own, to peak shortly before the needs for beds does, climbing as high as 661 on April 19 and beginning to gradually recede.
According to data released Sunday by the N.C. Department of Health and Human Services, the number of available beds and intensive care unit beds falls short of the projected need. Of 3,223 intensive care unit beds available in the state, 691 are open, while 5,726 of the 14,594 in-patient hospital beds are available. DHHS’ information only includes 70% of state hospitals.
“Even with social distancing measures enacted and sustained, the peak demand for hospital services due to the COVID-19 pandemic is likely going to exceed capacity substantially,” the University of Washington group wrote in a white paper describing the study. “Alongside the implementation and enforcement of social distancing measures, there is an urgent need to develop and implement plans to reduce non-COVID-19 demand for and temporarily increase capacity of health facilities.”
“That’s a big planning factor because that tells me how much time I have. When do I have to make sure I’m ready for max capacity? How much time do I have?” Mike Sprayberry, North Carolina’s director of emergency management, said in a Saturday interview with the News & Observer.
As of early Sunday afternoon, North Carolina had more than 1,100 reported cases of COVID-19 and six reported deaths. Hospitals began bracing for COVID-19 patients weeks ago by delaying procedures that are not considered urgent, the News & Observer previously reported.
Emergency management and DHHS’ Office of Emergency Medical Services are working together to decide what happens if those measures are not enough to prevent hospitals from filling up, Sprayberry said. Among the options being considered as part of what is called a “medical surge plan” are adding beds to existing hospitals, temporarily re-opening recently vacated hospitals or even caring for patients in sports arenas, Sprayberry said.
Sprayberry added that he expects officials to have a better handle on when the disease will peak in North Carolina during the coming week.
The nation's projected peak
Nationally, the University of Washington expects the peak number of resources to be needed on April 14, a date when it projects a 49,292-bed shortage nationwide and a 14,601-bed ICU shortage. Individual states are expected to begin peaking around the same time, with some seeing the most significant need as late as May.
“No state, no metro area will be spared and the sooner we react and the sooner the states and the metro areas react and ensure that they’ve put in full mitigation, at the same time understanding exactly what their hospitals need, then we’ll be able to move forward together and protect the most Americans,” Dr. Deborah Birx, the White House Coronavirus Task Force’s response coordinator, said on a “Meet The Press” appearance Sunday.
Then Birx mentioned the University of Washington website, which, she said, uses an infectious disease model to project the virus’ spread.
The Institute for Health Metrics and Evaluation was founded in 2007 with the stated goal of “providing an impartial, evidence-based picture of global health trends.” Past projects have included a study on maternal mortality in 181 countries, county-level life expectancy estimates and global studies evaluating alcohol and firearm mortality.
In a post describing the study, Christopher Murray, the institute’s director, wrote that the goal was to determine when people across the nation are likely to die from COVID-19 and when hospitals could run out of resources.
North Carolina’s deaths are projected to steadily rise until April 22, reaching double digits on April 4. On April 22, the projection estimates deaths will top out, with the virus causing 79 people to die that day. At that point, the number is expected to begin declining, remaining in double digits until May 28.
Per the institute’s data, North Carolina’s deaths could range from 1,600 to 3,291.
'Extremely optimistic findings'
The University of Washington model assumes that people will continue to stay physically separated by practicing “social distancing” and taking similar protective measures to protect the spread of the new coronavirus.
At least one expert pointed to that assumption as reason to believe that the model may present a too-rosy picture of the unfolding pandemic. Carl T. Bergstrom, a University of Washington biologist, posted a Twitter thread saying that he believed the findings were “extremely optimistic,” in part because they are based on the numbers in Wuhan, China, after the government took lasting, significant steps to limit physical contact.
Because the study assumes that governments will implement and continue taking significant action to prevent the coronavirus’ spread, Bergstrom wrote, even the “worst-case scenario” it presents isn’t as dire as things could become.
“If the model is truly assuming Wuhan-levels of lockdown, I’m worried about whether we can reach that, let alone maintain it,” Bergstrom wrote. “In Seattle we’re ahead of the curve, but I saw numerous groups of kids hanging out by the lake last time I went out of the house. ... And I think we’ll see large variation among states, both in the measures enacted and in factors like population density, transit use and compliance.”
North Carolina’s statewide stay-at-home order is set to become effective at 5 p.m. Monday. Gov. Roy Cooper has said it will remain effective for at least a month.