Predicted Effects of Stopping COVID-19 Lockdown on Italian Hospital Demand

Disaster Med Public Health Prep. 2020 Oct;14(5):638-642. doi: 10.1017/dmp.2020.157. Epub 2020 May 18.

Abstract

Objectives: Italy has been one of the first countries to implement mitigation measures to curb the coronavirus disease 2019 (COVID-19) pandemic. There is currently a debate on when and how such measures should be loosened. To forecast the demand for hospital intensive care unit (ICU) and non-ICU beds for COVID-19 patients from May to September, we developed 2 models, assuming a gradual easing of restrictions or an intermittent lockdown.

Methods: We used a compartmental model to evaluate 2 scenarios: (A) an intermittent lockdown; (B) a gradual relaxation of the lockdown. Predicted ICU and non-ICU demand was compared with the peak in hospital bed use observed in April 2020.

Results: Under scenario A, while ICU demand will remain below the peak, the number of non-ICU will substantially rise and will exceed it (133%; 95% confidence interval [CI]: 94-171). Under scenario B, a rise in ICU and non-ICU demand will start in July and will progressively increase over the summer 2020, reaching 95% (95% CI: 71-121) and 237% (95% CI: 191-282) of the April peak.

Conclusions: Italian hospital demand is likely to remain high in the next months. If restrictions are reduced, planning for the next several months should consider an increase in health-care resources to maintain surge capacity across the country.

Keywords: COVID-19; intensive care; pandemic; surge capacity.

MeSH terms

  • COVID-19 / complications*
  • COVID-19 / epidemiology
  • Health Services Needs and Demand / statistics & numerical data*
  • Hospitalization / statistics & numerical data
  • Hospitals / statistics & numerical data
  • Humans
  • Intensive Care Units / organization & administration
  • Intensive Care Units / statistics & numerical data
  • Italy / epidemiology
  • Pandemics / prevention & control*
  • Pandemics / statistics & numerical data
  • Quarantine / methods*
  • Quarantine / standards
  • Quarantine / statistics & numerical data
  • Surge Capacity / standards*
  • Surge Capacity / statistics & numerical data