COVID-19: Adaptation of a model to predict healthcare resource needs in Valle del Cauca, Colombia
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Background: Valle del Cauca is the region with the fourth-highest number of COVID-19 cases in Colombia (>50,000 on September 7, 2020). Due to the lack of anti-COVID-19 therapies, decision-makers require timely and accurate data to estimate the incidence of disease and the availability of hospital resources to contain the pandemic.
Methods: We adapted an existing model to the local context to forecast COVID-19 incidence and hospital resource use assuming different scenarios: (1) the implementation of quarantine from September 1st to October 15th (average daily growth rate of 2%); (2-3) partial restrictions (at 4% and 8% growth rates); and (4) no restrictions, assuming a 10% growth rate. Previous scenarios with predictions from June to August were also presented. We estimated the number of new cases, diagnostic tests required, and the number of available hospital and intensive care unit (ICU) beds (with and without ventilators) for each scenario.
Results: We estimated 67,700 cases by October 15th when assuming the implementation of a quarantine, 80,400 and 101,500 cases when assuming partial restrictions at 4% and 8% infection rates, respectively, and 208,500 with no restrictions. According to different scenarios, the estimated demand for reverse transcription-polymerase chain reaction tests ranged from 202,000 to 1,610,600 between September 1st and October 15th. The model predicted depletion of hospital and ICU beds by September 20th if all restrictions were to be lifted and the infection growth rate increased to 10%.
Conclusion: Slowly lifting social distancing restrictions and reopening the economy is not expected to result in full resource depletion by October if the daily growth rate is maintained below 8%. Increasing the number of available beds provides a safeguard against slightly higher infection rates. Predictive models can be iteratively used to obtain nuanced predictions to aid decision-making
- COVID-19
- Pandemics
- Quarantine
- Health Resources
- Intensive Care Units
- Hospitals
- Ventilators, Mechanical
Nicolas Iragorri, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada - Toronto Health Economics and Technology Assessment (THETA) collaborative, University Health Network, Toronto, Canada
Education and Training
Nicolas received his BA in Economics from Pontificia Universidad Javeriana in Colombia, and his MSc in Health Economics from the University of Calgary. Nicolas worked with national health policy authorities and the Ministry of Health to develop the health economic recommendations for the National Clinical Practice Guidelines for the diagnosis, follow-up, and treatment of type 1, type 2 and gestational diabetes, in Colombia. During his MSc program, Nicolas evaluated the health economic effects of organized screening programs for rheumatic disease in Canada. He currently works with the Canadian Partnership Against Cancer to shape public policy in cancer control across jurisdictions in Canada.
Research Interests and Expertise
Nicolas' primary research interests are in infectious disease, Global Health, and equity-informed decision-making.
https://orcid.org/0000-0002-8300-5784
Carlos Gómez-Restrepo, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
Psychiatrist. Professor and researcher of Pontificia Universidad Javeriana, Bogota Colombia. MSc in Clinical Epidemiology. Liaison Psychiatry Specialist. PhD (c) in Public Health. Psychoanalyst and full member of Sociedad Colombiana de Psicoanálisis and Asociación Colombiana de Psiquiatría. Full Professor, Department of Psychiatry and Mental Health, Pontificia Universidad Javeriana. Dean of Medicine, Pontificia Universidad Javeriana. Psychiatrist, Hospital Universitario San Ignacio. Editor in chief of Revista de la Sociedad Colombiana de Psicoanálisis.
https://orcid.org/0000-0002-9013-5384
Kali Barrett, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada - University Health Network, Toronto, Canada - Toronto Health Economics and Technology Assessment (THETA) collaborative, University Health Network, Toronto, Canada
Education and Training
Kali’s primary research interest is in value-based delivery of critical care medicine and health policy development. She is currently studying the cost-effectiveness of extracorporeal membrane oxygenation (ECMO) for patients with severe acute respiratory distress syndrome (ARDS) and related policy development for Ontario.
Current Position and Professional Functions
Kali received her BA (Hon) with a major in Art History and a minor in Health Studies at Queen’s University, in Kingston, Ontario. She received her Medical degree from the Schulich School of Medicine and Dentistry at the University of Western Ontario. She completed her training in Internal Medicine and Adult Critical Care Medicine at the University of Toronto. She has a Master’s of Science in Health Policy, Planning & Financing from the London School of Economics & Policy, and the London School of Hygiene & Tropical Medicine.
https://orcid.org/0000-0001-7147-2222
Socrates Herrera, Comité Público Privado de Expertos en Salud COPESA, Cali, Colombia - Centro de Investigación Científica Caucaseco, Cali, Colombia
Comité Público Privado de Expertos en Salud COPESA, Cali, Colombia
Centro de Investigación Científica Caucaseco, Cali, Colombia
Isabel Hurtado, Secretaría Departamental de Salud, Cali, Colombia
Secretaría Departamental de Salud, Cali, Colombia
Yasin Khan, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada - University Health Network, Toronto, Canada - Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada - University Health Network, Toronto, Canada - Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
https://orcid.org/0000-0002-0426-1780
Stephen Mac, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada - Toronto Health Economics and Technology Assessment (THETA) collaborative, University Health Network, Toronto, Canada
Education and Training
Stephen completed his undergraduate degree and Master of Biotechnology degree at the University of Toronto. In his Master’s training, he was involved in research examining the effect of biomarker use in oncology and clinical trial success rates. Prior to starting his doctoral studies, Stephen spent several years in the pharmaceutical industry in R&D operations, vaccine manufacturing operations, and business development. He has training in project management, biostatistics, economic evaluation methods, systematic reviews, decision analytic modeling, and health services research using administrative data.
Research Interests and Expertise
Stephen’s research interests are focused on infectious diseases and health technology assessment methodologies (e.g. decision analytic modelling, evidence synthesis and healthcare costing using administrative data). For his thesis, Stephen is interested in exploring health-related quality of life associated with Lyme disease, economic burden using large administrative data sets and cost-effectiveness of various Lyme disease treatment and preventative strategies.
https://orcid.org/0000-0003-4736-1770
David Naimark, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada - Sunnybrook Hospital, Toronto, Canada
MD (University of Manitoba), MSc (University of Toronto). Associate Professor Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada - Sunnybrook Hospital, Toronto, Canada
Professional Interests
clinical effectiveness, clinical economics, technology assessment / drug utilization, medical decision-making, health informatics / e-Health, health services delivery, health research methods (biostatistics), renal disease, diabetes
Impact
David is a member of the community providing groundbreaking perspectives and inspiring contributions that define IHPME.
https://orcid.org/0000-0002-0621-0637
Petros Pechlivanoglou, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada - The Hospital for Sick Children, Toronto, Canada
MSc (University of Groningen, The Netherlands), PhD (University of Groningen, The Netherlands). Assistant Professor Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada - The Hospital for Sick Children, Toronto, Canada
Professional Interests
Dr. Pechlivanoglou's research activities currently are centered on the use of health decision analysis in economic evaluation; bridging evidence synthesis, administrative data and decision analysis; the application and extension of predictive models in health economics as well as other econometric and statistical applications in health economics and health policy, such as the estimation of empirical cost-effectiveness thresholds. He is currently involved in projects around the economics of preterm birth prevention, the economic evaluation of oncology and ophthalmic interventions in children and adolescents and the economic impact of obstructive sleep apnea and COPD in adults.
Detailed Research Interests
Use of decision analysis in healthcare
Development of prediction models for economic evaluation
Application of evidence synthesis methods in health economics
Use of real-world evidence in economic evaluation
Use of R in decision analytic modeling
https://orcid.org/0000-0001-5090-7936
Diego Rosselli, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia
Colombian neurologist, for many years lecturer in neuroscience. A master's degree in Education from Harvard and another master's in Health Policy from the London School of Economics sent me to another path, first in evidence-based medicine and then on to health economics. Currently associate professor of health economics at Pontificia Universidad Javeriana, in Bogota, past president of ISPOR Colombia Chapter, and current chair of ISPOR Latin America Consortium.
https://orcid.org/0000-0003-0960-9480
Dilian Francisca Toro, Comité Público Privado de Expertos en Salud COPESA, Cali, Colombia
Physician, specialist in Rheumatology and Colombian politics. He was president of the Senate from 2006 to 2007. She also served as Governor of the Valle del Cauca between 2016 and 2019. In 2016 she was President of the National Federation of Departments and in 2019 she was elected by Colombia Leader as the best Ruler among the special category departments
Pedro Villamizar, Facultad de Medicina, Pontificia Universidad Javeriana, Cali, Colombia
Pediatric Surgery. Dean of Facultad de Medicina, Pontificia Universidad Javeriana, Cali, Colombia
https://orcid.org/0000-0003-4753-0159
Raphael Ximenes, Toronto Health Economics and Technology Assessment (THETA) collaborative, University Health Network, Toronto, Canada - Escola de Matemática Aplicada, Fundação Getúlio Vargas, Rio de Janeiro, RJ, Brasil
Education and Training
Raphael completed his degree in Physics Bachelors in 2010 from the University of São Paulo in Brazil (CNPq scholarship) and received a Doctorate in Science (PhD) from the School of Medicine, University of São Paulo, Brazil (FAPESP scholarship). In 2014 he was awarded the Mitacs Globalink Research Award.
Research Interests and Expertise
Dr. Ximenes’s areas of expertise include mathematical modeling, computer simulation, optimization of disease control, decision analysis and simulation, epidemiology of infectious diseases such as dengue fever and zika virus. His doctoral theme was "dengue risk for tourists in Brazil at the FIFA World Cup 2014 and the Olympic Games Rio 2016, using mathematical modeling". He also developed a research, in the sandwich PhD in Scotland, focused on the factors which interfere at the application of the dengue vaccine (Sanofi Pasteur) in a given population at the Sao Paulo State where he examined issues like the dengue incidence, secondary infection of dengue, economic cost, and per capita risk of death due to dengue. He is a member of a large multidisciplinary international team evaluating zika virus mitigation strategies using data-driven simulation models, and estimating the burden of infectious diseases. Dr. Ximenes’s current research focuses on the modeling of zika virus disease (Life cycle of the mosquito, transmission, and ZIKV natural disease history).
https://orcid.org/0000-0003-2536-951X
Helmer Zapata, Secretaría Departamental de Salud, Cali, Colombia
Statistical. Magister in Health Administration
https://orcid.org/0000-0003-0883-6825
Beate Sander, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada - Toronto Health Economics and Technology Assessment (THETA) collaborative, University Health Network - Public Health Ontario, Toronto, Canada - ICES, Toronto, Canada
Education and Training
Beate completed her degree in Nursing (RN) in Germany and received postgraduate degrees in Business Administration (MBA) from Germany, Economics of Development (MEcDev) from the Australian National University, a Doctorate in Health Services Research (PhD) from the University of Toronto, and postdoctoral training in Public Health Policy.
Research Interests and Expertise
Dr. Sander’s areas of expertise include health economics, decision analysis and simulation, infectious disease epidemiology, and population health decision-making. Beate’s current research focuses on economic evaluation, ranging from methods development to applied research on infectious diseases. She is leading large multidisciplinary international teams evaluating Zika and West Nile virus (WNv) mitigation strategies using data-driven simulation models, and estimating the burden of infectious diseases (C.difficile, S.pneumoniae, hepatitis, WNv, Lyme disease) using linked population-based data. She has spearheaded the linkage of laboratory and reportable disease data with administrative data, enabling novel approaches to study the burden of infectious diseases. Beate has received several awards recognizing research excellence.
Beate provides scientific advice to decision makers and serves on scientific working groups and advisory bodies, including Canada’s National Advisory Committee on Immunization (NACI), Ontario’s Universal Influenza Immunization Program (UIIP) Review, and the National West Nile virus task force.
Dr. Sander is the Faculty Lead for the Health Technology Assessment (HTA) program at IHPME, and enjoys teaching a popular graduate course on clinical decision making and cost-effectiveness at IHPME.
https://orcid.org/0000-0003-2128-9133
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