The COVID-19 virus is a type of coronavirus, which is the same type of virus that causes the common cold. The problem is it is believed to be much more severe - and more deadly - than the common cold. Specifically, it causes lower respiratory tract infections - as opposed to the upper respiratory issues of the cold - and can quickly turn into pneumonia.

Though East Tennessee has not had a confirmed case of COVID-19 yet, it is only a matter of time. It is pretty clear that we, as a nation, have moved from a posture of containment into a posture of mitigation and that coronavirus will traverse the country.

The Simulation

Second disclaimer: There is not a lot of data available on COVID-19 yet. It is a new virus, so we do not yet know how fast it spreads, how long it lives on surfaces, and other information that would allow for better forecasting of the spread of the disease and the severity of the disease.

The impact of COVID-19 on East Tennessee is an open question. To examine some possible outcomes and their impact on our healthcare system, I have developed a simulation to model how a surge could affect the availability of hospital beds in East Tennessee. The simulation is modeled using four variables:

1. Infection Rate - This represents the percent of people in East Tennessee infected by the Coronavirus. As a baseline, between 9 million (2.75%) and 45 million (13.75%) Americans get the flu each year (CDC). As an example, if you choose a 5% infection rate that would mean 5% of the population of say Anderson County would be infected by the virus or about 3,824 of the 76,482 population (via U.S. Census data) of Anderson county would be infected.

2. Hospitalization Rate - There is not enough data to know the hospitalization rate for COVID-19. Hospitalization rates for the flu are about 1.5% (CDC), whereas, Italy is experiencing a 10% hospitalization rate for COVID-19.

3. Average Nights in Hospital - Again we don't know, but the average hospital stay for flu is 6.3 days (H-CUP). Since the beginning of the COVID-19 outbreak, a 14-day quarantine period has been standard, though hospital stays might be longer or shorter.

4. Speed of Spread - There is not enough data to know how fast COVID-19 will spread. Additionally, if we engage in preventative measures we can slow the spread. This variable represents the number of weeks it take to reach the full infection rate (i.e., 10% of pop). The more weeks, the slower the spread. [Note: This variable is based on the spread of the disease being nearly evenly distributed. The model does accept that the first handful of the weeks after the virus is introduced it will spread slowly. After the initial period (9 weeks), the rest of the cases are evenly distribute. It is likely that the spread of the virus will not follow an even distribution, but will likely be bimodal with an increase at introduction, a decrease during summer, and an increase in the fall. But since we have no real understanding of the distribution of the spread, the even distribution is the most conservative choice.]

If COVID-19 in East Tennessee ends up being similar to the flu, it will more than likely not overwhelm our system.