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Live Updates - April 8, 2020
Novel Coronavirus (COVID-19)
- Countries, Territories & Areas
with infections* 202
April 1, 2020
It’s completely understandable that everyone wants to know, “When can we go out again.” But the question we must answer is: “What do we have to do, right now, so we reopen as soon and safely as possible?”
A key concept is that we need to reopen the faucet gradually, not allow the floodgates to reopen. We can then loosen or tighten physical distancing according to levels of virus transmission, healthcare preparedness and public health capacity.
Dr. Cyrus Shahpar and Former CDC Director Dr. Tom Frieden: Number of intensive care beds needed for COVID-19 in the United States could far exceed the number available
March 19, 2020
Initially, we estimated that the surge of critically ill COVID-19 patients would require an increase of up to three times the supply of intensive-care unit (ICU) beds in the United States. Now, we believe there could be a need for ten times more intensive care beds and ventilators in some areas. This revision is based on new information from infectious disease modeling, evolving trends in Italy, and other location-specific analyses which account for local and regional critical care capacity. We must continue to try to flatten the curve and reduce the demands on the health system. At the same time, we need to increase the number of available ICU beds, including the equipment and staff needed to expertly manage patients.
The Imperial College modeling study projects that without any intervention, there will be a need for more than 250 critical care beds per 100,000 people. With maximum suppression strategies we can reduce this to less than 100 beds per 100,000 people.
Source: Imperial College
This article from the heavily-affected area of Lombardy, Italy, shows that ICU demand far outstrips supply. There were 482 ICU beds available, but projected needs ranged from 869 (1.8x) to 14,542 (30x) ICU admissions by March 20.
This recent analysis of hospital capacity in the United States showed that across the country, peak demand for hospital beds could far outstrip supply. Overall, the author estimated that there could be six severely ill patients for every hospital bed.
Source: USA Today
March 10, 2020
*Adapted from Reed, et al. Emerg Infect Dis. 2013;19:85-91. Data as of March 9, 2020
The figure above shows that both COVID-19 spread and severity appear to increase with age, with the most severe cases in people 60 or older and those with underlying health conditions. Children appear much less likely to become severely ill, and for them this pandemic may be mild. For healthy adults between ages 20 and 60, it cannot yet be predicted whether this will be a moderate or more severe pandemic. For the vulnerable group of people who are over 60, particularly those with chronic health conditions, COVID-19 is currently projected to be a severe pandemic.
A pandemic framework allows for initial and ongoing assessment of how infectious and severe a pandemic is, and can help identify appropriate response strategies, including whether communities should cancel large events. To estimate the overall severity of a pandemic, the framework considers how easily the virus spreads and how severe the symptoms are that patients experience. The figure above shows past pandemics and seasonal influenza, including:
- The 1918 Spanish flu pandemic (up to 675,000 deaths in the U.S. and up to 50 million deaths globally)
- 1957 H2N2 pandemic (116,000 deaths in the U.S. and 1.1 million deaths globally)
- 1968 H3N2 pandemic (100,000 deaths in the U.S. and 1 million deaths globally)
- 2009 H1N1 pandemic (12,500 deaths in the U.S. and up to 575,000 deaths globally).
- 2011-2012 seasonal influenza (12,000 deaths in the U.S.)
- 2014-2015 seasonal influenza (51,000 deaths in the U.S.)
Many of these pandemics occurred in a much different global context than today. The US population in 1918 was less than one third of the current population. Vaccines and medications can be developed more rapidly than half a century ago. Intensive care is more effective now. But, today diseases can have greater impact due to increased travel and urbanization, we have a larger older population and more people with chronic health conditions, and wide disparities between the most and least prepared countries in the world. Although there is now more timely access to information, there is also faster spread of misinformation.
March 6, 2020
We’re excited to share our new video series, Global Health Minute.
This series focuses on public health practices that maximize impact and save lives, all in sixty seconds or less. Our inaugural video is about COVID-19: what we know, what we need to learn, and how to prevent future epidemics. Future videos will focus on diverse health topics from prototyping to field supervision.
February 20, 2020
This image outlines response measures in COVID-19 containment and mitigation. Activities that help reduce spread of the disease and effectively treat those infected should be in place from the beginning of an outbreak. During the containment phase tracking down contacts of infected individuals is important, but wouldn’t be helpful when there is already extensive spread of the disease in a community. Routine strategies you might use during a typical flu season are also used, and include washing hands, covering coughs, staying home when ill, and making sure surfaces are cleaned. As COVID-19 becomes a pandemic, additional strategies may be implemented, including staying home if a family member is sick, and community measures such as closing schools, mandatory telework and cancelling mass gatherings. These measures will dampen the impact of the pandemic, and improve survival, and delay cases in the hope that pharmaceutical interventions such as antiviral treatments and vaccines will become available.