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Estimation of COVID-19-induced depletion of hospital resources in Ontario, Canada.

加拿大安大略省医院资源COVID-19-induced消耗的估计。

  • 影响因子:1.12
  • DOI:10.1503/cmaj.200715
  • 作者列表:"Barrett K","Khan YA","Mac S","Ximenes R","Naimark DMJ","Sander B
  • 发表时间:2020-06-15
Abstract

BACKGROUND:The global spread of coronavirus disease 2019 (COVID-19) continues in several jurisdictions, causing substantial strain to health care systems. The purpose of our study was to predict the effect of the COVID-19 pandemic on patient outcomes and use of hospital resources in Ontario, Canada. METHODS:We developed an individual-level simulation to model the flow of patients with COVID-19 through the hospital system in Ontario. We simulated different combined scenarios of epidemic trajectory and hospital health care capacity. Our outcomes included the number of patients who needed admission to the ward or to the intensive care unit (ICU) with or without the need for mechanical ventilation, number of days to resource depletion, number of patients awaiting resources and number of deaths. RESULTS:We found that with effective early public health measures, hospital system resources would not be depleted. For scenarios with late or ineffective implementation of physical distancing, hospital resources would be depleted within 14-26 days, and in the worst case scenario, 13 321 patients would die while waiting for needed resources. Resource depletion would be avoided or delayed with aggressive measures to increase ICU, ventilator and acute care hospital capacities. INTERPRETATION:We found that without aggressive physical distancing measures, the Ontario hospital system would have been inadequately equipped to manage the expected number of patients with COVID-19 despite a rapid increase in capacity. This lack of hospital resources would have led to an increase in mortality. By slowing the spread of the disease using public health measures and by increasing hospital capacity, Ontario may have avoided catastrophic stresses to its hospitals.

摘要

背景: 冠状病毒疾病 2019 (新型冠状病毒肺炎) 的全球传播在多个司法管辖区继续,对卫生保健系统造成重大压力。我们研究的目的是预测加拿大安大略省新型冠状病毒肺炎大流行对患者预后和医院资源使用的影响。 方法: 我们开发了一个个体水平的模拟,通过安大略省的医院系统对新型冠状病毒肺炎患者的流动进行建模。我们模拟了流行病轨迹和医院保健能力的不同组合场景。我们的结果包括需要进入病房或重症监护病房 (ICU) 的患者人数,是否需要机械通气,资源消耗的天数,等待资源的患者数量和死亡人数。 结果: 我们发现,有了有效的早期公共卫生措施,医院系统资源不会枯竭。对于物理距离实施较晚或无效的场景,医院资源将在 14-26 天内耗尽,在最坏的情况下,13 321 名患者将在等待所需资源时死亡。通过积极的措施来增加ICU、呼吸机和急症护理医院的能力,可以避免或推迟资源消耗。 解释: 我们发现,如果没有积极的物理距离措施,安大略省医院系统将没有足够的设备来管理预期数量的新型冠状病毒肺炎患者,尽管容量迅速增加。医院资源的缺乏会导致死亡率的增加。通过使用公共卫生措施减缓疾病的传播和增加医院容量,安大略省可能避免了对其医院的灾难性压力。

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影响因子:4.36
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翻译标题与摘要 下载文献
影响因子:2.48
发表时间:2020-04-01
来源期刊:Infection
DOI:10.1007/s15010-020-01401-y
作者列表:["Cheng ZJ","Shan J"]

METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.

呼吸道感染方向

呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。

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