‘Healthcare system must prepare to tend to 7,928 ICU patients on May 6’

There is likely to be no respite from increases in the number of COVID-19 cases and deaths in the country for at least three weeks, predicts a mathematical model that projects the future burden on India’s healthcare system. Based on the relationship between COVID-19 deaths and cases from several countries, the model posits that the country’s healthcare system must prepare to tend to 7,928 ICU patients on May 6. Authorities have currently extended the nationwide lockdown up to May 3. As of today India has 24,644 ICU beds and bed-demands and deaths, according to the model’s authors, assume a “worst-case” scenario.

Also read: Indian scientists build model to estimate impact of interventions on COVID-19

The projections are available on a freely accessible website, covid19medinventory.in and the model has been developed by scientists spanning multiple institutions who were brought together by the office of the government’s Principal Scientific Advisor K. VijayRaghavan. The “academic initiative” as it describes itself bases its numbers on the number of COVID-19 deaths reported by hospitals. Though there are no projections on the number of cases, it derives numbers based on the global experience and relationships between testing and the true number of infections and, correlations such as: that 5% of total cases are critical, and 50% of those admitted to an ICU survive.

The website shows an India map with the expected number of positive cases in every district. The model itself, however, is yet to be peer-reviewed but is available as a preprint for perusal.

“Our model assumes a constant ratio between total infected (detected or not) and the number of deaths,” Aloke Kumar of the Indian Institute of Science, Bengaluru, wrote in an e-mail reply to The Hindu. “So, any increase in deaths is reflected proportionately in confirmed cases. Since the entire model focuses on the healthcare system, we decided against giving out our projections for true infected in the dashboard,” he added. “Having said that, the death rate is approximately 1% of the estimate of true infection (considering South Korea as a benchmark where testing was quite methodical and extensive) and around 2-3% of reported infection.”

From April 23 to April 29, the model projects 1,164 deaths, and from April 29 to May 6 predicts the number of fatalities to rise to 3,964 — again the authors emphasise — based on a worst case scenario. As of Thursday, India had reported 21,700 cases and 686 deaths. “It is certainly a large jump, as shown by the model,” P. Sunthar, of the Chemical Engineering Department at the Indian Institute of Technology, Mumbai, wrote in an e-mail. “But we do hope the health administrations will take measures to contain the outbreak in badly affected areas (in which case we won’t see such large numbers in a week). But going by the global trend this is what the model shows,” he added.

While these numbers take into account the impact of the lockdown, the authors say the model’s projections for the third week and beyond aren’t yet reliable. Because it bases itself on deaths, the model would falter if the number of COVID-19 deaths aren’t truthfully recorded and could be a problem in rural areas or regions with limited hospitalisation facilities. However, being an adaptive model, the numbers as well as healthcare demand can change on a daily basis. Other scientists who participated in developing the model include those from the Jawaharlal Nehru Centre for Advanced Scientific Research, Bangalore, and personnel of the Armed Forces Medical Services.

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