Michigan Medicine: Aggressive Social Distancing Will Dramatically Reduce the Peak Number of Hospitalized COVID-19 Patients

(April 1, 2020 11:27 AM) Forecasting models from Michigan Medicine clinicians show aggressive social distancing could reduce the number of COVID-19 patients at U-M hospitals in early May by as much as 65 percent at peak.

“This data confirms that everyone in Michigan can help us flatten the curve and it is crucial. This is not to be taken lightly,” said Vikas Parekh, M.D., associate chief clinical officer for Michigan Medicine’s adult hospitals and professor of internal medicine.

Parekh adds that through sustained and prolonged social distancing, Michigan residents can greatly reduce the portion of the population who become infected and significantly reduce these estimates for the number of patients who would require hospitalization.

“In a scenario where the virus spreads throughout the local population infecting the majority of the population, our model shows tremendous differences between less and more aggressive social distancing,” Parekh said.

“Our models show that in this worst-case scenario, with less social distancing, our peak census of patients in U-M hospitals could be as high as 5860 patients on May 4. With aggressive social distancing, the model shows about 2000 patients on that same date.”

The reduction of 65 percent is the difference in census in early May between the two models, Parekh said. 

Michigan Medicine is licensed for 1,000 beds. However, knowing this patient surge will exceed our current capacity, teams are developing other options that could accommodate a surge of patients, including redeployment of staff, converting other space in the hospitals for patient care, or converting nearby university dormitories.

All of this planning is taking place, but Michigan Medicine leaders are asking the community to heed the warnings from Michigan Gov. Gretchen Whitmer and public health officials.

“We have teams working around the clock to plan for this potential surge in patients. The projections are alarming. But we know, based on experiences in Italy and China and other countries, that we can significantly flatten that curve with the help of the public,” said Marschall Runge, M.D., Ph.D., CEO of Michigan Medicine, dean of the U-M Medical School and executive vice president for Medical Affairs at the University of Michigan.

“I want to reassure the public that we are doing all we can to prepare to care for COVID-19 positive patients as well as other patients who urgently require the highly-specialized, safe and reliable advanced medical care that Michigan Medicine delivers. We have reached out for donations of medical equipment and received thousands of gloves, masks and more so we can better meet this challenge.

“We prepare constantly for emergencies like this and have some of the world’s top experts preparing for the problem. But we need your help, and these projections prove it.”

Aggressive social distancing means staying away from anyone else outside your immediate family and limiting going out to a store or pharmacy for only urgent needs. Schools and businesses close and large gatherings are cancelled. Walking outside is fine as long as people maintain a six-foot distance.

Parekh and others are closely monitoring how often the number of patients double each day. In Italy, after each social distancing intervention was made, the doubling time went from 3 days to greater than 8 days after several weeks of sustained social distancing interventions.

“The impact is striking. It is critical that our community maintains a high level of social distancing to help our healthcare community continue to care for COVID-19 patients and all of our patients at the highest, best standards,” Parekh said.

Parekh says that if the doubling time slows there are fewer infected individuals at any given time point which will result in less overall transmission.  

The forecasting model was created by a team that includes Jenny Pardo, IT project manager and Max Garifullin, staff specialist from Michigan Medicine’s capacity management team. 

Michigan Medicine has made important changes to open up capacity in its hospitals, in anticipation of the patient surge, postponing all elective surgeries and procedures. We are consolidating our clinic services, providing many more video visits and plan to redeploy staff to assist in COVID-19 care.

Michigan Medicine also has opened a 32-room Regional Infectious Containment Unit that allows grouping of patients with COVID-19, which adds to the many isolation rooms around the hospital. Our engineers have been working to convert even more rooms to accommodate patients in an optimally safe environment.

“We are facing a challenging future. Michigan Medicine’s healthcare providers are doing all they can to prepare and plan for what’s to come. We need the help of all Michiganders. Stay at home and away from others, practice good hand hygiene and you’ll be doing all you can to help our caregivers,” Runge said.