Guam's Estimated Trajectory for COVID-19 Cases and Impact for Hospitalized Patients Governor’s Physician Advisory Group March 23, 2020
Guam’s COVID-19 Positive Cases Total + COVID-19 Date Day New + COVID-19 Since Day 1 3 3 1 Sun, Mar 15 0 3 2 Mon, Mar 16 2 5 3 Tue, Mar 17 3 8 4 Wed, Mar 18 4 12 5 Thu, Mar 19 2 14 6 Fri, Mar 20 1 15 7 Sat, Mar 21 12 27 8 Sun, Mar 22 9 Mon, Mar 23
Guam’s COVID-19 Positive Cases 30 25 Total COVID-19 Cases Since Day 1 20 Additional Daily COVID-19 Cases # Cases 15 10 5 0 Sun, Mar 15 Tue, Mar 17 Thu, Mar 19 Sat, Mar 21 Mon, Mar 23
How does Guam compare to the rest of the world so far?
Guam’s COVID-19 Spread Matches Majority of Western Countries Guam’s Cumulative COVID-19 Cases Trajectory Based on Average Spread Rate of Western Countries (33%)
What does this mean for Guam’s hospitals with a spread rate this fast?
*Approximate GMHA + SNU + GRMC Combined Beds 350 Total Hospital Beds Guam’s Combined Bed Capacity Based on Nursing Staff Levels Civilian Hospital 250 (Already Reached) Capacity 100 Total Unstaffed Bed Space Available Total ICU Beds 28 ICU Capacity Based on Nursing Staff Levels 13 Critical care (Already Reached) system breakpoint. 15 Unstaffed ICU Beds Available Death rate will skyrocket from here, if not earlier. 85 Unstaffed Non-ICU Beds Available *Approximate values based on rapidly changing status
When will we get to that breakpoint, with death rates skyrocketing?
Guam's Trajectory Today for COVID-19 Cases & Hospitalization Predictions @ 33% Daily Spread Rate 150 135 120 Trajectory of COVID-19 Cases 105 At current spread rate, # of Cases *Estimated ICU Patients *Estimated Hospitalized 90 Guam’s critical care 75 system breakpoint 60 could occur by next 45 week, if not sooner. 30 15 15 5 9 3 7 1 4 1 1 2 2 3 r p r r r r r a a a a a A M M M M M , t a , , , , , * Assuming 20% of infected require n u n i e S r u h o u F T S T M hospitalization and that of 20% of those admitted end up in ICU. 1. Wu, Z, McGoogan, JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. Feb 24, 2020
Although still alarming, the current daily spread rate of 33% is because of our strong current efforts. But it also could have been much worse. What would be our current situation if we took no precautions from the beginning?
Guam's Trajectory for COVID-19 Cases & Hospitalization Predictions 150 135 123 120 Trajectory of COVID-19 Cases *Estimated ICU Patients *Estimated Hospitalized 105 If there were no GovGuam and # of Cases Community interventions done 90 from the beginning, 200% daily 75 spread rate would have been 61 60 seen. 45 31 30 Breakpoint Could 15 15 8 Have Been Yesterday 4 2 1 0 0 0 5 9 3 7 1 1 1 2 2 3 r r r r r a a a a a M M M M M , , , , , n u n i e * Assuming 20% of infected require r u h o u F T S T M hospitalization and that of 20% of those admitted end up in ICU. 1. Wu, Z, McGoogan, JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. Feb 24, 2020
We are bending hard. But by aggressively slowing the spread rate, we might prevent a break. #FlattenTheCurve
Can we make enough aggressive changes, this quickly, on top of what has already been done?
YES! 1. Everyone must take all our Governor’s orders and precautions advised very, very seriously. Most important is strict social distancing and very frequent hygiene. 2. The manåmko’ and all those with chronic medical problems like hypertension / high blood pressure, diabetes, heart disease, and especially those on dialysis are the most vulnerable and need additional isolation and protection.
Guam's Trajectory for COVID-19 Cases & Hospitalization Predictions If 16.5% Daily Spread Rate (half of current rate) 150 135 120 If we cut in half our current 105 # of Cases spread rate. Guam’s critical 90 Trajectory of COVID-19 Cases care system will have a 75 chance to bend without 60 breaking. 45 *Estimated COVID-19 Hospitalized 30 15 * E s t i m a t e d C O V I D - 1 9 9 8 7 6 5 4 4 3 3 I C U P a t i e n t s 2 2 2 1 1 1 1 0 0 0 0 0 0 5 9 3 7 1 4 1 1 2 2 3 r * Assuming 20% of infected require p r r r r r a a a a a A M M M M M hospitalization and that of 20% of , t a , , , , , n u n i e S r u h o u F those admitted end up in ICU. T S T M 1. Wu, Z, McGoogan, JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. Feb 24, 2020
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