We need the answers to these questions about Covid-19

We can’t promise that we know the answers to every question. But what is essential, in times of huge uncertainly, is to be able to plan out different scenarios for different populations quickly and then be able to adjust these scenarios based upon new information (that comes to light at breakneck speed).

Over the last 15 years, we have undertaken many capacity and demand projects for our public hospital clients, so we decided that it was pertinent to apply some of this thinking to where we are currently at with Covid-19.

Demand

At the time of writing (24 March 2020), Australia has confirmed 1,682 cases of Covid-19 (Source: Johns Hopkins Corona Virus Resource Centre). This continues to rise exponentially, although the federal and various state Governments have recently announced a raft of measures to attempt to slow down this rate of growth, to reduce the chances of our health systems being overwhelmed. In many cases the illness will be mild but there is a 1 – 2% chance that intensive care will be needed (and this chance rises dramatically with age) hence the importance of physical distancing, particularly from older people.

Capacity

In terms of secondary care capacity, we have estimated up to date number of Intensive Care Unit (ICU) beds in Australia (using 2005-6 data from Anaesth Intensive Care 2010; 38: 149-158 and assuming a similar increase as we have seen in the number of beds in Australian hospitals during this time). There is a 2.5-fold variation in critical care capacity, per 100,000 population across the states and territories of Australia (see chart below). Even this chart doesn’t tell the whole story – the fact that certain states have a huge land area compared to their population means that it is important to understand what these number mean at a local level. Furthermore only 70% of these ICU beds are ventilated. All states and territories (along with all health systems in the world) are looking to increase their ICU capacity.

Scenario planning: Balancing capacity and demand

Once we have an idea of capacity and demand we can start to explore what this means going forward nationally and at a state / territory level. The diagram below (adapted from NHS Improvement in UK) provides a neat visualisation of hospital capacity and demand at this time.

The Grattan Institute released their thoughts recently showing how long it will be before Australia runs out of hospital beds and the analysis is sobering, hence the importance of ‘flattening the curve’.

To contribute to this analysis, we have produced a scenario planner that allows several key variables to be altered, to instantly derive approximations as to the effect this will have in terms of demand and capacity at an Australian / state / territory / local level. But this is just the start as there are different sets of inputs and outputs that will be useful to different groups. Using an externally validated set of assumptions and a flat curve for New South Wales, we estimate that the current outbreak will last a little more than a year before we reach herd immunity. Even with extensive physical distancing there will be a peak (where demand outstrips supply) and then a drop off, meaning that the outbreak will likely be around 50 – 75% of this length.

Conclusion

These are some of the most challenging times any of us have lived in. No-one can claim to have all of the answers, but if this analysis or view could be of use to you in any way, please do add a comment or drop us a message.

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About us         www.newhighconsulting.com              [email protected]

New High Consulting is a growing, niche, Sydney based company providing strategic support to healthcare providers, commissioners and Government departments predominantly in the healthcare strategy and analytics arena. We now able to offer all of our support virtually to support the goal of appropriate physical distancing. Paul White is the Managing Director and he is a highly experienced management consultant with a deep understanding of the challenges facing healthcare based upon 20 years’ experience in the sector.