Social Distancing Successes Provide Policy Opportunities
Evidence continues to mount that the public’s social distancing measures are slowing the spread of new COVID-19 infections in AZ. The IHME model as run by Joe K. Gerald, MD, PhD now predicts hospitalizations will peak on April 26th. The mid-range estimate calls for 1,460 beds at the peak, suggesting that bed capacity (including ICU beds) will be fine – with a safety margin (even without the 50% bed capacity increase directed by Executive Order). For perspective, we currently have 6,017 regular beds available- a wide safety margin indeed.
On the intensive care front, the Model now predicts ICU usage will peak on April 27th. The mid-range estimate calls for 293 beds at the peak, below the 508 available (a nice safety margin). Again, suggesting that ICU bed capacity will be fine even without the mandated 50% ICU bed capacity increase.
These models assume that we continue to maintain our social distancing efforts over the coming weeks. According to Dr Gerald’s analysis, the lag between new infections and hospitalizations and ICU admissions means that the pace of these outcomes will increase for the next 1-3 weeks before slowing.
Over the next 2 weeks, hospitals should prepare for a continued increase in admissions until a peak around April 27th. The strain is likely to be greater in critical care settings than general floor beds, but there appears to be adequate capacity to meet demand.
Our mitigation successes provide policy makers with an opportunity to revise some earlier policy decisions that will improve public health while continuing to ensure that Arizona has the hospital surge capacity to meet peak demand for patients with COVID-19.
Hospital Capacity
Under Executive Order 2020-16, Arizona hospitals have already implemented plans to increase hospital capacity by 25%. The Order further directs that hospitals implement an additional 25% increase by April 26. Given the success of Arizona’s control measures (and the predictive models suggesting that Arizona already has adequate capacity to meet peak demand with a wide safety margin) we urge the governor to suspend the directive that Arizona hospitals increase capacity by another 25% by April 26.
Elective Procedures
The resulting safety margin for hospital capacity and our hospital system’s improving planning regarding the use of personal protective equipment also provides an opportunity to relax the limitations on elective procedures under Executive Order 2020-10. Specifically, we believe that adjusting Executive Order 2020-10 to allow hospitals more discretion regarding elective procedures would benefit public health by allowing Arizonans access to procedures while ensuring hospital capacity.
Note: Here is Maricopa County Department of Public Health’s hospital admissions epi-curve data… updated 4/14/20.
