Window of Opportunity for Mitigation to Prevent Overflow of ICU capacity in Chicago by COVID-19

TL;DR

This study uses computer simulations to estimate ICU demand in Chicago during COVID-19, emphasizing the critical importance of early mitigation strategies to prevent capacity overflow and avoid a healthcare crisis.

Contribution

It provides a timely analysis of ICU capacity risks and highlights the urgent need for early mitigation measures to prevent overwhelming the healthcare system.

Findings

ICU capacity may be exceeded by a factor of ten.

Early mitigation can prevent ICU overflow if implemented before April 1.

Delaying mitigation reduces its effectiveness and increases mortality risk.

Abstract

We estimate the growth in demand for ICU beds in Chicago during the emerging COVID-19 epidemic, using state-of-the-art computer simulations calibrated for the SARS-CoV-2 virus. The questions we address are these: (1) Will the ICU capacity in Chicago be exceeded, and if so by how much? (2) Can strong mitigation strategies, such as lockdown or shelter in place order, prevent the overflow of capacity? (3) When should such strategies be implemented? Our answers are as follows: (1) The ICU capacity may be exceeded by a large amount, probably by a factor of ten. (2) Strong mitigation can avert this emergency situation potentially, but even that will not work if implemented too late. (3) If the strong mitigation precedes April 1st, then the growth of COVID-19 can be controlled and the ICU capacity could be adequate. The earlier the strong mitigation is implemented, the greater the probability that it will be successful. After around April 1 2020, any strong mitigation will not avert the emergency situation. In Italy, the lockdown occurred too late and the number of deaths is still doubling every 2.3 days. It is difficult to be sure about the precise dates for this window of opportunity, due to the inherent uncertainties in computer simulation. But there is high confidence in the main conclusion that it exists and will soon be closed. Our conclusion is that, being fully cognizant of the societal trade-offs, there is a rapidly closing window of opportunity to avert a worst-case scenario in Chicago, but only with strong mitigation/lockdown implemented in the next week at the latest. If this window is missed, the epidemic will get worse and then strong mitigation/lockdown will be required after all, but it will be too late.