Abstract
Background: The current pandemic requires hospitals to ensure care not only for the growing number of COVID-19 patients but also regular patients. Hospital resources must be allocated accordingly. Objective: To provide hospitals with a planning model to optimally allocate resources to intensive care units given a certain incidence of COVID-19 cases. Methods: The analysis included 334 cases from four adjacent counties south-west of Munich. From length of stay and type of ward [general ward (NOR), intensive care unit (ICU)] probabilities of case numbers within a hospital at a certain time point were derived. The epidemiological situation was simulated by the effective reproduction number R, the infection rates in mid-August 2020 in the counties, and the German hospitalization rate. Simulation results are compared with real data from 2nd and 3rd wave (September 2020-May 2021). Results: With R = 2, a hospitalization rate of 17%, mitigation measures implemented on day 9 (i.e., 7-day incidence surpassing 50/100,000), the peak occupancy was reached on day 22 (155.1 beds) for the normal ward and on day 25 (44.9 beds) for the intensive care unit. A higher R led to higher occupancy rates. Simulated number of infections and intensive care unit occupancy was concordant in validation with real data obtained from the 2nd and 3rd waves in Germany. Conclusion: Hospitals could expect a peak occupancy of normal ward and intensive care unit within ~5-11 days after infections reached their peak and critical resources could be allocated accordingly. This delay (in particular for the peak of intensive care unit occupancy) might give options for timely preparation of additional intensive care unit resources.
Highlights
The current pandemic requires hospitals to ensure care for the growing number of COVID-19 patients and regular patients
Data from N = 334 patients was collected from the five major hospitals in adjacent counties south-west of Munich comprising a population of 629,295 inhabitants and 1,591 hospital beds
We modeled this length of stay (LOS) against the backdrop of the epidemiological situation
Summary
The current pandemic requires hospitals to ensure care for the growing number of COVID-19 patients and regular patients. The first wave of COVID-19 hit Germany relatively weakly in comparison to other countries [1] Potential reasons for this include extensive testing [2], early onset of mitigation measures [1] and the extensive intensive care unit (ICU) infrastructure [3]. Waiting time for elective surgery increased and supplies were reduced [5, 7] in order to provide intensive care unit (ICU) capacities for COVID-19 patients. This has led to enhanced economic pressure on hospitals [8]. In August 2020, with eased contact precautions and lifted travel bans for the summer holidays, infection rates were surging again with 15.84 per 100,000 cases in Bavaria [29th of August, 7-day incidence [9]]
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