COVID-19 ModCollab

University of Toronto - University Health Network - Sunnybrook Hospital

We are a group of scientists and clinicians working on simulating healthcare resource utilization for COVID-19 and identify capacity constraints to support planning.

Because this is ongoing work, we will post findings here as soon as possible and update regularly (i.e., blog-style).

All working documents (reports, figures) can be found here: Downloads

COVID-19: PREDICTING HEALTHCARE RESOURCE NEEDS IN ONTARIO

Results are simulated using the CORE (COVID-19 Resource Estimator) Model 1.3

NOTE: This is a preliminary model based on evolving data. The model continues to undergo testing and further development. All findings should be interpreted with caution.

April 03, 2020 - UPDATES

Key Message:

There is continued uncertainty in the epidemiology of COVID-19 (i.e., predicting number of cases is challenging). However, in both, our "Expected" (ON Predicted) and "Italy" scenarios, we may need to further increase capacity compared to the number of resources currently available.

New updated report and figures can be found here: Downloads

Figure 3 (from report): Case Predictions Summary March 23- April 19, 2020


What has changed?

  • The epidemiological curves (case scenarios) have been updated with more observed data for Italy and South Korea, predictions for Ontario are based on reported data

  • Updated hospitalization data based on Canadian/ON experience

  • Added assumption that patients hospitalized in ward do not deteriorate and require ICU

Updated report and figures can be found here: Downloads

March 26, 2020 - Interactive Model (ShinyApp) and Updates

An interactive model using ShinyApp (beta version) is now available on our website for anyone interested in trying new parameters to answer any questions. It can be accessed here: Interactive Model

This ShinyApp was developed in collaboration with David Rios, Anna Heath, and Petros Pechlivanoglou.

What has changed?

  • Minor bugs in the model were fixed, and all Figures have been updated in the report and are summarized below

Updated report and figures can be found here: Downloads

Figure 1 - Italy Scenario (Patients Needing Admission)

Figure 2 - Italy (Days Until Resource Depletion)

Figure 3 - Italy (Patients Waiting for Resources)

Figure 4 - 25% Scenario (Patients Needing Admission)

Figure 5 - 25% (Days Until Resource Depletion)

Figure 6 - 25% (Patients Waiting for Resources)

Figure 7 - 15% Scenario (Patients Needing Admission)

Figure 8 - 15% (Days Until Resource Depletion)

Figure 9 - 15% (Patients Waiting for Resources)

March 21, 2020 - Brief Summary (UPDATES)

What has changed?

  • Italy scenario updated with recent case counts from Italy.

  • We have included two new scenarios with a linear increase in new daily cases for 14 days, then the curve flattening to approximate effective social distancing measures.

  • With these new scenarios, the limitations/assumptions:

      • Social distancing is effective (curve becomes similar to South Korea)

      • Social distancing takes 14 days to see impact

      • Day 1 in our simulations is around March 15, i.e., we are now at day 7

  • Methods are not included in new report, they are unchanged from March 18, 2020 report.

Updated report can be found here: Downloads

March 18, 2020 - Brief Summary

Methods:

    • The analysis is for Ontario.

    • The base case analysis assumes we can free up 10% of existing hospital beds and 25% of ICU beds and ventilators for COVID-19 patients - different scenarios forthcoming

    • We run a “Conservative Scenario” with a 7.5% daily increase in new case numbers, and a worst-case “Italy Scenario”, i.e., case numbers in ON increase at the same rate as in Italy (this is almost a 33% daily increase in new case numbers, which roughly corresponds to the rate of growth currently seen in many European and North American countries)

Results:

    • “Conservative Scenario”: we run out of ICU beds and ventilators in ~ 37 days and ward beds in ~ 7 weeks

    • “Italy Scenario”: we run out of ICU beds and ventilators in ~ 16 days and ward beds in ~ 5 weeks

    • Scenario analyses that consider the effect of increased capacity for COVID-19 patients within existing resources and the addition of 2053 ICU beds and 600 ventilators demonstrate that the time to resource depletion is longer, but that there may still be a critical shortage of ventilators

    • More scenarios forthcoming.

All working documents (reports, figures) can be found here: Downloads

Figure 1. Base-case (Conservative Scenario) of Resources Available over Time

Figure 2. Base-case (Conservative Scenario) of Number of Individuals Waiting for Resources over Time

Figure 3. Base-case (Italy Scenario) of Resources Available over Time

Figure 4. Base-case (Italy Scenario) of Number of Individuals Waiting for Resources over Time