Abstract
Evidence-based models may assist Mexican government officials and health authorities in determining the safest plans to respond to the coronavirus disease 2019 (COVID-19) pandemic in the most-affected region of the country, the Mexico City Metropolitan Area. This study aims to present the potential impacts of COVID-19 in this region and to model possible benefits of mitigation efforts. The COVID-19 Hospital Impact Model for Epidemics was used to estimate the probable evolution of COVID-19 in three scenarios: (i) no social distancing, (ii) social distancing in place at 50% effectiveness, and (iii) social distancing in place at 60% effectiveness. Projections of the number of inpatient hospitalizations, intensive care unit admissions, and patients requiring ventilators were made for each scenario. Using the model described, it was predicted that peak case volume at 0% mitigation was to occur on April 30, 2020 at 11,553,566 infected individuals. Peak case volume at 50% mitigation was predicted to occur on June 1, 2020 with 5,970,093 infected individuals and on June 21, 2020 for 60% mitigation with 4,128,574 infected individuals. Occupancy rates in hospitals during peak periods at 0%, 50%, and 60% mitigation would be 875.9%, 322.8%, and 203.5%, respectively, when all inpatient beds are included. Under these scenarios, peak daily hospital admissions would be 40,438, 13,820, and 8,650. Additionally, 60% mitigation would result in a decrease in peak intensive care beds from 94,706 to 23,116 beds and a decrease in peak ventilator need from 67,889 to 17,087 units. Mitigating the spread of COVID-19 through social distancing could have a dramatic impact on reducing the number of infected people and minimize hospital overcrowding. These evidence-based models may enable careful resource utilization and encourage targeted public health responses.
Highlights
The outbreak of the novel coronavirus disease 2019 (COVID-19), first identified in the Hubei Province in China in December 2019, was declared a Public Health Emergency of International Concern by the World Health Organization (WHO) on January 30, 2020 [1, 2]
The purpose of this study is to present the potential impacts of COVID-19 in the Mexico City Metropolitan Area (MCMA) and to better understand the consequences of its mitigation efforts
COVID-19 Hospital Impact Model for Epidemics (CHIME) was recently developed by the University of Pennsylvania to assist hospitals and public health officials with capacity planning in the United States during the COVID-19 pandemic [29]
Summary
The outbreak of the novel coronavirus disease 2019 (COVID-19), first identified in the Hubei Province in China in December 2019, was declared a Public Health Emergency of International Concern by the World Health Organization (WHO) on January 30, 2020 [1, 2]. In Mexico as of October 21, 2020, there have been approximately 860,000 confirmed cases of COVID-19 and more than 86,000 reported deaths, some experts have estimated the true values to be up to 50 times greater than those reported [5, 6]. According to a recent technical report by the Scientific Technical Commission analyzing COVID-19 deaths, there was an excess mortality of 22,366 deaths (143% more than expected) in Mexico City from April to June 30, 2020. This excess was greatest in the population aged 45 to 60 years (278% excess) [11]. Recent reports using death certificate registries in Mexico City have shown the number of deaths due to COVID-19 to be nearly three times higher than figures reported by the Ministry of Health [13]
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