COVID-19 models draw terrible scenarios for California hospitals

LOS ANGELES (AP) – When Gov. Gavin Newsom offered a terrifying view of the out-of-control growth of coronavirus and hospitalization cases in California this week, he was referring to projected patterns of future deaths and misery that he said they become “alarming” more accurately.

If true, in the next four weeks state hospitals could be overflowing with 75,000 patients – about five times the current level – and an average of 400 people will die every day.

Hospitals were on the verge of being overwhelmed by nearly 15,000 patients with COVID-19 when Newsom made the announcement on Tuesday. The hospitalization projection is based on cases that continue to increase at the current rate of infection, without people taking additional precautions to prevent the virus from spreading.

It doesn’t take long for the state to be in a very bad place, said Marm Kilpatrick, an infectious disease expert at the University of California, Santa Cruz.

“One worrying thing is that for some time now, in California, we have had hospitalizations and exponential cases,” Kilpatrick said. “It’s kind of terrifying.”

The models posted online by the California Department of Public Health largely show a key indicator – the rate of transmission – that is improving in recent days. But this number still remains at a time when each person with the virus infects more than one other person, leading to its out-of-control spread.

The state uses several models to try to predict hospitalizations. When combined into an ‘overall’ projection, the total is less awful, but still shockingly high until mid-January: over 33,000. That would create another overwhelming burden for hospitals.

The model for the increase in deaths does not include an estimate based on the current infection rate. But an average of dozens of different models show that deaths increase by about 25% from the current figure to almost 27,000 by January 9th.

Other models in the chart predict a series of deaths of up to 22,000, which the state will probably exceed on Friday, to a maximum of 43,000 in about three weeks.

The nation’s most populous state, which has maintained a very small number of infections per capita for months, while other states have been hit, is facing its own crisis as it records a record number of cases and deaths every day. .

On Thursday, 379 deaths were recorded. There have been over 1,000 deaths in the last five days and over 100,000 newly confirmed cases in the last two days.

Most of the models posted on the state’s website show that the situation is getting worse before an improvement, as the repercussions of Thanksgiving gatherings and travel are borne by hospitals that have already begun to run out of beds.

“Our modeling is becoming increasingly accurate, alarming,” Newsom said Tuesday, when it also announced that 5,000 body bags have been ordered and more than 50 refrigerated trucks are ready to serve as temporary mounts. .

At the beginning of the pandemic, some models were extremely wrong. In March, Newsom said the state of nearly 40 million is on track to record 25 million cases of COVID-19 within two months. Nine months later, the state recorded more than 1.7 million cases, the largest in the country, but a small part of the previous prediction.

The wide variation of some models is due to the use of different data and mathematical formulas and the weighting of more data.

Bradley Pollock, an epidemiologist at the University of California, Davis, said recent models have been more accurate. He said the value of the models is that they help guide public policy, showing trends that are likely if no action is taken.

“What we see now is exactly what we predicted,” Pollock said. “The major use of models is to tell you what might happen, not what will happen.”

As cases erupted in November, Newsom took steps that made business worse and frustrated some residents. He placed most of the state under a new order to stay at home, which stopped dining at restaurants and put an end to haircuts and manicures and closed many other types of businesses. Capacity at retailers has been reduced.

If these commands have an impact, it will probably take weeks to appear in case of counting and even more so in hospitalizations, as there are gaps from infection to detection to the time when an illness is severe enough to lead to a stay. in the hospital and usually even more for death to occur.

While the models have been helpful to public health authorities, they could be more accurate and useful to the public if they compiled a larger group of available data, said Dr. Eric Topol, head of the Scripps Research Translational Institute in San Diego.

Topol criticized the fact that it does not have a national approach to fighting the virus in the US and said it extends to not adopting a multi-layered approach to data collection for modeling. He referred to the various efforts as “solo acts.”

He said there is so much data available that could be used to create better models – from mobility data on phones showing if home orders are being tracked to data taken from smart thermometers to see where fevers are recorded until the wastewater is sampled where the tips of the virus can be detected a few days before the cases are reported.

“Modeling is based on so many hypotheses without complete data,” Topol said. “You have some raw data to see that people have big problems.”