VUMC, HCA scientists warn of overwhelmed hospitals if precautions relaxed

Scientists from HCA Healthcare and Vanderbilt University Medical Center on Thursday detailed new, Nashville- and Tennessee-specific coronavirus models that predict peak pandemic in May or June, depending on whether precautions are loosened or intensified.

HCA Chief Data Officer Edmund Jackson said his company’s internal modeling draws from the experiences at its hospitals across the country and that the upward curve of the pandemic “has been brought down.”

“We are actually able in Nashville right now to keep up with the pandemic,” he said.

The providers' prediction — paired with the warning that relaxed social distancing would likely worsen the situation — tracks with a widely cited model used by the state, which predicts relatively low hospitalization numbers and a peak as soon as next week.

John Graves, a professor at the Vanderbilt University School of Medicine, said his team's model considers three scenarios: optimistic, status quo and pessimistic. And theirs, unlike the IHME model, was built with local data.



In the optimistic scenario, which assumes continued progress in slowing the spread of the disease, Vanderbilt’s model predicts an epidemic peak in early- or mid-May, Graves said. In that version of the pandemic, between 2,000 and 3,000 Tennesseans would be hospitalized due to COVID-19, compared to the about 500 currently hospitalized statewide, and less than the approximately 8,000 hospital beds in the state without accounting for emergency, pop-up facilities currently being outfitted.

In the status-quo scenario, Graves said, the initial wave of the epidemic would peak in June and the hospital system would be stressed to capacity. But it’s the most pessimistic scenario that caused Graves and others to warn against relaxing social distancing precautions.

If social distancing rules were lifted without widespread testing and contact tracing in place, he said, hospitals could be overwhelmed by mid-May. The state currently does not have the testing capacity to relax social distancing, Graves and Jackson said.

“Testing is critical for us to understand when it’s safe to relax,” Jackson said.

Despite the potentially disastrous worst-case scenario, Graves offered what he called “really good news.”

“We’re finally seeing, as a result of the social distancing, evidence of Tennessee at the statewide level starting to remove itself from the initial exponential trajectory,” he said.

Though the scientists said Tennessee does not have the necessary testing capacity, state officials are working on increasing the number of tests available. Tennessee Health Commissioner Lisa Piercey said Wednesday that the state has the ability to perform a new rapid COVID-19 test that produces results in less than 20 minutes, but only for 120 individuals so far. Private labs have also ramped up testing capacity.

Though some national figures, including President Trump, have urged the opening of the American economy “sooner rather than later,” and state and local safer-at-home orders expire later this month, Metro Health Board Chair Alex Jahangir on Thursday warned against declaring victory against the disease.

“What we don’t want to do is prematurely relax,” he said. “We are still on the upward part of the curve.”